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Patients put at risk with wait times

PUBLISHED: 10:07 08 September 2008 | UPDATED: 21:13 05 July 2010

Diabetes patients in Norfolk and Waveney could be at increased risk of ulcers or even amputation because of long waiting times for foot screening in the east of the area and the loss of a specialised service in central Norfolk.

Diabetes patients in Norfolk and Waveney could be at increased risk of ulcers or even amputation because of long waiting times for foot screening in the east of the area and the loss of a specialised service in central Norfolk.

Patients in Yarmouth and Waveney have been suffering from long-running shortages of podiatrists, with more than 200 people on the routine waiting list. It is particularly important that patients with diabetes are seen regularly to reduce the risk of amputation. National guidelines say that everyone with diabetes should have a foot screening once a year, with those at higher risk having more frequent checks. But in Yarmouth and Waveney, people who should be seen every three months are having to wait six or seven months. High-risk patients who have to be seen more often are usually seen within two to four weeks of the time they should be seen.

The issue was raised at Thursday's health overview and scrutiny committee. Nick Wright, head of podiatry at NHS Yarmouth and Waveney, said more podiatrists have been recruited, with three new people starting on Monday, and two in the process of being recruited. He said: “This will increase the force of the team by a third.”

Meanwhile there are concerns about diabetes patients in central Norfolk, because a specialist foot screening unit stopped operating last year. The mobile unit, which also offered eye screening, visited the 70 surgeries in central Norfolk and was staffed by diabetes care technicians who specialised in examining feet. Now the service is offered by practice nurses.

Professor Mike Sampson, diabetes consultant at the Norfolk and Norwich University Hospital, has raised concerns that the nurses are not trained to the same level. He said in an email to the committee: “I think this is a real and active gap in service that puts patients at risk…The main issue is that this represents a real loss of service as previously foot screening was undertaken by highly skilled trained staff who 'triaged' highest risk feet to prevent amputation and ulceration.”

He said that the problem could be solved with extra training in foot care for practice nurses.

Nigel Legg, a GP who has diabetes himself, said: “In my own practice I still see diabetes patients who do not seem to be getting any specialist care at all. NHS Norfolk seems to be trying to devolve the responsibility onto GPs. I suppose they are trying to do some of this stuff on the cheap. There doesn't seem to be an acceptance that it is a big medical and social problem which is going to increase.”

Jane Webster, NHS Norfolk's commissioning manager for long term conditions, said they were “committed to improving the lives of people with long term conditions”. She said foot health checks were done by trained practice nurses who attend additional training at the Elsie Bertram Diabetic Centre.

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