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Time to improve diabetes foot care services

Time to improve diabetes foot care services

Publication date: Tuesday, 11 April 2017
Contributor(s): Jeremy Bray

The latest review of diabetes foot care in England and Wales shows significant room for improvement. The National Diabetes Foot Care Audit (NDFA) 2014-2016 found that less than half of diabetes services in England and Wales have the recommended NICE care structures in place. In addition, 40% of ulcer episodes referred by a health professional only had an expert assessment after 2 or more weeks.

The NDFA includes data on over 11,000 people with acute diabetic foot ulcers (Table). The audit enables all diabetes foot care services to measure their performance against NICE clinical guidelines and similar services, and to monitor adverse outcomes for people with diabetes who develop diabetic foot disease.

The Audit comes at the same time as new analysis by Diabetes UK which suggests that NHS England could save as much as £250 million a year - a quarter of the £1 billion it spends on diabetes foot care. The charity found significant savings could be made by improving foot care services and by reducing the number of foot ulcers in people with diabetes. The charity says the savings should be ploughed into improving treatment for people with foot ulcers. For example, saving £250 million would pay for the 7000 podiatrists needed in England to ensure every person with diabetes received adequate specialist foot care.

Diabetes UK Chief Executive Chris Askew said: “Every Clinical Commissioning Group in the country needs to ensure they’re providing adequate foot services and information about where they’re located. People with diabetes need the right care in the right place at the right time.”

Table: key findings from the National Foot Care Audit 2014-2016.

  • The average patient was 67 years old with diabetes for 15 years. 13 % had Type 1 diabetes, and 87% had Type 2 diabetes.
  • 43% met the NICE HbA1c ≤58 mmol/mol target.
  • One third of people still had ulcers and almost 1 in 20 had died 24 weeks after assessment.
  • People seen within two weeks are more likely to be alive and ulcer-free than those seen later.


More information

The National Diabetes Foot Care Audit 2014-2016

Kerr M. Improving foot care for people with diabetes and saving money: an economic study in England. Insight Health Economics. 2017 -

Topics covered:
Category: Have You Heard
Edition: Volume 2 Number 3 PCCJ Online 2017
Contributor(s): Jeremy Bray

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