Foot screening for individuals with Diabetes is changing


The Scottish Diabetes Foot Action Group working in close consultation with the Scottish Diabetes Group and Diabetes Scotland is introducing some changes to the way in which Diabetes foot screening is to be delivered in Scotland.

These changes are in line with up-to-date scientific evidence and are designed to provide you, as an individual living with diabetes, a more streamlined, effective and efficient service

Diabetes foot screening is an important part of your NHS diabetes care.  The screening process checks for any signs or symptoms of changes to your feet, as a result of your diabetes, that could increase your risk of developing a foot ulcer that could lead to amputation.

Following your foot screening you should be informed of your risk category and understand what it means to you as an individual living with diabetes and what action you should be taking to help keep yourself safe.

How often you will receive a foot screening from now on will depend on your previous foot screening results. 

·         If your first or most recent foot screening showed that you are in the Low risk category you will now receive a foot screening every two years and not every year as previously, in line with recent evidence.

 

·         If the findings of your foot screening have shown that you have transitioned from Low risk to Moderate risk, you will be referred to a Podiatrist for an assessment. This assessment may be a ‘one off’ appointment and if the result of the assessment shows you do not have a need for any podiatry treatment or management you will continue to receive an annual screening by whoever is currently screening your feet. If you do have Podiatry needs you will receive a treatment and management plan, agreed with yourself, according to your needs which will include an annual screening.

 

·         If you are in the High risk category your duty of care now falls to podiatry working in conjunction with yourself. You will now have a documented treatment and management plan implemented by a Podiatrist experienced in the diabetic foot.  The plan will be reviewed at least once a year and will be developed with yourself, according to your needs, which may involve referral to other specialists. The aim of this treatment and management plan, which will include a self-management plan, is to try and prevent you from developing a foot ulcer that could lead to an amputation.

 

·         If you are in the In Remission category this means that you have had a previous foot ulcer, amputation or other significant diabetes related foot problem. Your duty of care now falls to podiatry working in conjunction with yourself. You will now have a documented treatment and management plan implemented by a podiatrist experienced in the diabetic foot.  The plan will be reviewed at least once a year and will be developed with yourself, according to your needs. This may involve referral to other specialists. The aim of this treatment and management plan, which will include a self-management plan, is to try and prevent you from developing a further foot ulcer, amputation or other significant diabetes related foot problem.

 

When will my next appointment be?

The diabetic foot screening programme has experienced significant disruption due to the COVID-19 pandemic. 

This service will resume as soon as it is safe to do so, albeit still at a reduced capacity as long as social distancing measures are in place.

 

Daily foot checks

As always, it is extremely important that you, your partner or carer, check your feet daily for any signs or symptoms that you may have a diabetes related foot problem.

These signs or symptoms are;

·         Any break in the skin

·         Any discharge of fluid

·         Any colour changes or area of redness 

·         Any new area of swelling

·         Any new pain

 

Seeking help

If you, your partner or carer notice any of the above problems it is important that you seek help and advice immediately from your podiatrist or GP practice during working hours or if outwith working hours by contacting the NHS 24 111 service.

These new screening measures have been designed to ensure you receive the most appropriate care, implemented at the earliest possible opportunity according to your risk to help ensure your continued mobility, ulcer free days and quality of life.

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