Podiatry Services at Livewell Southwest continues to face a demand for the service that has necessitated that the service has had to prioritise treatment for those with the greatest clinical need within the finite resources available to it.
Patients have primarily been limited to accessing treatment only for acute issues. This scenario is not unique to the Livewell’s Podiatry Services and reflects the nationally recognised problems of accessing NHS funded Podiatry care. However, the service continues to aim to assess and treat acute problems such as foot ulceration in a timely way.
What Podiatry Services are available locally on the NHS?
- Diagnosis and treatment of acute foot conditions below the ankle such as foot wounds, suspected ulceration, suspected infection
- PIFU (Patient Initiated Follow Up) for very high-risk conditions for 12 months post wound healing. Patients can directly access care for specific problems without seeing their doctor or nurse first if they have been seen by the Service previously and placed on the PIFU list.
- Minor surgery such as for the treatment of acutely presenting in-growing toenails e.g. with a wound, infection or significant pain or a non-acute presenting in-growing toenail plus a relevant co morbidity e.g. diabetes
- Musculoskeletal Podiatry to diagnose and treat a range of muscle and joint related foot and lower limb problems which may be due to development, posture, occupation and exercise. As per the local Foot & Ankle Pathways
- Children and young people may access the service for a variety of musculoskeletal and developmental problems, as well as to minor surgery for nail avulsions.
- Self-management advice & signposting information for routine foot conditions and specific conditions that effect the foot e.g. diabetes and some musculoskeletal conditions
- Domiciliary Visits – on the basis that the patient has a foot wound below the level of the malleoli, AND is either bed or chair bound, or requires hoisting to transfer
What Podiatry Services are not available locally on the NHS?
- Basic foot care such as toenail care
- Routine treatment of corns and calluses in the absence of significant medical risk & wound symptoms
- Routine monitoring and foot care for people whose feet are at risk due to diabetes
- Long term routine care for those unable to self-care
- Treatment for warts and verrucae
What does this mean for people with diabetes?
- People with diabetes presenting with a new foot wound, suspected Charcot Foot and infection etc, should still be referred to the Diabetes MDFT at University Hospitals NHS Trust (UHP) as per the current pathway. Referral forms and details can be found here.
- People with diabetes who present to you with moderate, high or active foot problem risk factors as described in the local diabetic foot pathway can be referred to Livewell Southwest. (Patients deemed at low risk with regard to NG19 continue to be ineligible for accessing Podiatry Services – there is no change for this cohort). Depending on their need and risk factors the service will determine whether to offer a face-to-face appointment or to provide written self-care and management advice including signposting to alternative providers OR people may be signposted directly to this website.
- The service will not be offering routine foot care.
How do I make a referral?
- Preferred route: Referrals can continue to be made via DRSS or LRSS
- You can also refer by email to: [email protected], using a Podiatry Services Referral Form
- The referral form is available here.
Self-referral
In keeping with the 2023/24 NHS Priorities and Operational Planning Guidance, the service has introduced the ability for people to refer themselves, their child, a relative or someone they care for, directly to Podiatry Services.
The same access criteria apply and guidance and instruction is given to the public on the website regarding this before they complete a self-referral.