Martin

The figures I refer to are compiled from Diabetes UK and the DofH KT23's.

Diabetes UK's website claims that there are 1.4million diagnosed and 1
million undiagnosed diabetics in the UK. The capacity of the NHS podiatry
service is currently 2.18 million patients. I called Diabetes UK today to
check their figures and was somewhat surprised to hear that the 1.4/1.0
million figures were taken from research in 1993. There are no up-to-date
figures for diabetics according to the charity. However the British Heart
Foundation statistics website on CHD give an estimate on prevalence as a
percentage of population which mirrors this claim. See
http://www.heartstats.org/temp/2003spDiabetesspchapter.pdf for more info.

The ONS however suggest that these figures are not accurate given that the
diagnostic rate has increased substantially since 1993. I would be
interested if anyone else has accurate figures regarding prevalence and
diagnosis rates in the UK.

What is clear is that if all UK diabetics had access to NHS podiatry
services for annual screening/clinical intervention programmes, there will
be no spare capacity to treat anyone else. That’s okay if the NHS podiatry
service is only to manage the diabetic caseload, but it begs the question -
who treats the other patients (the rheumatoid patient; those with PVD &
etc? If we are to design a new podiatry service I would have thought that
we first look at the incidence and demand from the sectors that we are
targeting. The other problem with diabetes is that there is no new money to
fund the additional work that the NSF has thrown up – it’s not just
patients with DFS that access podiatry departments now – it’s all diagnosed
diabetics, which begs the question – are podiatry departments the best
place to conduct screening and annual reviews? Given that the majority of
diabetics undergo review with their GP surgery and/or diabetic clinic,
would it not make sense that they receive their foot screen there too and
only get a referral to podiatry if they have pathology that warrants
intervention -otherwise we will have a workforce of predominately diabetic
educators duplicating work of other diabetic educators in other locations!

Alan Crawford makes what I feel is a very pertinent point on the 'podiatry
education' stream last month when he writes; “Podiatrists should only be
involved with the severe cases and the education associated with dealing
with the presenting problem.”  Do you agree with this?

I’m quite happy to give my view on what care should be provided by the
State, but at the end of the day, these decisions need to be taken by
government – not the profession – although the profession needs to offer
input and guidance to assist ministers in reaching the right [sic]
decision! (It’ll have to wait until next week as I’m off to Germany
tonight.) Interesting debacle in immigration at the moment and how
ministers are blaming middle management over decisions to implement new
eligibility criteria……..another case of shifting the balance of
responsibility? Didn’t do Bev Hughes much good though! I wonder if Hutton
will resign over podiatry?

Best wishes

Mark

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