A new guide to help prevent unnecessary diabetes-related amputations has been released.
The document has been designed by Diabetes UK, after the charity recently identified diabetes-related amputations in England had reached an all-time high.
Amputations that result from diabetes are typically of the lower leg, including amputations of one or more toes, the foot or below the knee.
Public Health England data suggests there are about 20 amputations carried out a day and experts estimate believe that four out of five could be prevented because 80 per cent are normally preceded by a foot ulcer.
The new guide is encouraging healthcare professionals to carry out root cause analysis (RCA) on each patient.
RCA determines to what extent an amputation could have been avoidable or unavoidable, and whether or not it was the best possible outcome for the person with diabetes.
If the amputation was deemed avoidable, changes will be identified to prevent another one occurring in the same person.
The document was based on the South West Cardiovascular Clinical Network’s Diabetes Foot Care Resource Pack.
Dr Richard Paisey, honorary consultant and diabetes footcare lead at South West Cardiovascular Clinical Network, said: “Using this guide should provide each area an accurate and up-to-date picture of the proportion of major amputations which were potentially avoidable by prompter intervention.
“Ultimately, using root cause analysis should highlight best practice and also facilitate follow up of missed opportunities in provision of care in each case.
“There may be generic problems in delivering foot care in an area which could be addressed by constructive discussion with all care providers involved. Changes required in footcare provision are often cost neutral short term and longer term will be cost saving.”
The RCA approach has been used in Torbay and South Devon for 10 years and data in the area shows the amputation rates are now lower than neighbouring providers of diabetic foot services.
Angie Abbott, head of Podiatry and Orthotic Services from the NHS Foundation Trust in the area, said: “For each RCA that has been undertake, the learning has been huge in terms of recognising and helping put in place action plans to address any necessary improvement that has been identified in terms of process and services.
“The RCA process has increased the profile of diabetic foot, and increased knowledge and awareness of the risk to diabetics of foot disease. The RCA process has been the vehicle to set up a diabetic foot improvement group to improve services and raise awareness of diabetic foot disease.”
People with diabetes must ensure good foot care as this can help to reduce your risk of complications. There are also several ways in which you can look after your feet at home.

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