Cornwall & IoS Diabetic foot check & referral pathway Jan 2014
Contact with patient with diabetes. Inspect feetremove patients’ shoes, socks and any dressings
YES
Are any of these
present?
Evidence
of foot
problems
♦
Are any of
these present?
New ulceration
♦
♦
Neglected feet
Known
ulceration with
cellulites or
infection
Corns or Callus
♦
Known ulceration
with
deterioration in
condition
♦
Suspected
osteomyelitis/ulcer
probing to bone
♦
Suspected acute
Charcot foot
♦
Critical limb
ischaemia, necrosis
or gangrene
Emergency
admission
NO
* diabetic
patients do
not
automatically
qualify for
routine toe
nail cutting
All patients should be referred,
on diagnosis of diabetes, to
podiatry for an initial
assessment then on-going
follow up as below.
If this is not happening please
arrange
♦
♦
Toe nail
problems*
♦
Peripheral
vascular
disease
♦
Peripheral
neuropathy
♦
Patients at
low risk of
foot
ulceration
should
receive
annual foot
checks
provided by
their GP
practice
Patients at
increased
risk of foot
ulceration
should
receive foot
checks every
6 months
provided by
podiatry
Patients at
high risk of
foot
ulceration
should
receive foot
checks
every 1-3
months
provided by
podiatry
Structural foot
deformity
♦
Painful
feet/abnormal
sensations
Refer to Hotline
for urgent
podiatry
appointment
01579 373550
Triaged phone
line 5 days a
week, office hours
Refer to Community Podiatry clinic listing
patient’s current foot problem.
Patient will be contacted for appropriate
appointment (18 week RTT, 13 week av wait)
District hot foot clinic (access within 72 hours
max )–specialist podiatrist in 1of 3 area centres
with informal access to M.D.T.
Specialist podiatry clinic at RCHT (access
within 72 hours max) with informal access to
M.D.T.
Diabetic foot clinic weekly M.D.T @RCHT to
stabilise & prevent emergency foot