Eligibility criteria for referral to this service: patients must present with a medical condition and a podiatric problem that impacts on their foot and general health i.e. at risk of developing a pressure, neuropathic and or ischaemic foot ulcer (this includes referrals for patients who have diabetes).
The Podiatry Service will not routinely cut healthy toenails and will expect the person’s family or carers to support them to maintain their foot health when appropriate.
If the patient meets the criteria, they will receive appointments at intervals appropriate to their clinical needs and will also be re-assessed at regular intervals (NICE guidance).
Patients who do not meet the new eligibility criteria will be discharged and be given a discharge pack (which includes a list of non NHS providers of toe nail cutting services and podiatry).
Risk factors
- Signs and symptoms of poor foot and lower limb circulation e.g. lack of foot pulses using Doppler
- Signs and symptoms of neuropathy e.g. lack of sensation in the feet using 10g monofilament
- Poor tissue viability with history of previous ulceration
- Deformity with areas of peak pressures
- Dialysis
- Podiatric signs and symptoms (not long healthy or fungal toenails)
- Patient who has diabetes with unkempt feet who would benefit from a one off treatment with foot care advice and education (must be evidenced on referral)
- Patients who have diabetes with ischaemia and or neuropathy are automatically eligible with a moderate or high risk status.
The Podiatry Service is happy to continue to support Nurses in managing recalcitrant foot ulcers.