North East Diabetes Footcare Network v3 1. Background NHS Diabetes is working with local healthcare professionals to develop regional footcare networks, designed to share ideas and good footcare practice across the country. The regional networks will feed into a national network. There are over 100 limb amputations a week in England and the three-year survival rate following a major amputation is 50 per cent - less than some cancers. The combined cost to the NHS of ulceration and amputation is an estimated 600m a year. The variation in amputation incidence between PCTs is sixfold and the network is seen as an important mechanism to enable collaborative working across the footcare pathway to improve quality of care for all patients with diabetes. 2. Mission Statement Our mission is to bring about improvements in the management and prevention of diabetic foot disorders. We aim to do this by increasing awareness of the problem among patients, health professionals and policy makers. We will encourage and promote understanding of the need to support diabetic foot services by the relevant commissioners and providers in the North East and will also provide a forum for exchange of information, skills and expertise and models of best practice amongst relevant health care professionals. We will also create effective mechanisms to improve the quality and equality of patient experience. 3. Aims & Objectives Promoting improvement in diabetic footcare through communication and shared learning. Supporting the development of systems and processes that would contribute to ongoing improvement in footcare for people with diabetes in primary, community and acute sectors. To develop national and regional footcare networks to improve the standard of footcare for people with Diabetes in England to reduce the number of diabetes amputations. Bring together best practice based on latest guidance and tools to reduce variation in care and improve outcomes for foot disease for people with diabetes.
4. Deliverables Challenge: National reduction in amputations by 50% in 5 years Overall objective: To see diabetic foot care pathway included in the Joint Strategic Needs Assessment on the Health and Wellbeing Board Outcomes to be delivered in 2012-13: 1. Establish local and regional foot care networks 2. All organisations sign up to one pathway - Putting Feet First Integrated pathway 3. Active whole pathway MDT/FPT group is established in each district to include commissioners and service users 4. Challenge culture and behaviour of HCPs - Ensure competencies in diabetes ulcer awareness - Ensure education is provided to patients on diagnosis - Every patient knows their risk status 5. Engage commissioners in the network - Promote CIP (Cost Improvement Plan) potential from foot care to commissioners - Commissioners commission full pathway service specification to include FPT/MDT competencies, participation of NDA and DiabetesE and ulcer audit 6. 24/7 facility for receiving diabetic foot care patients by a competent representative of the MDT team and seen within 24 hours by the foot care specialist team. - Facility to have phone number - How this happens is a local decision (e.g. A&E) 7. Staff competencies required to deliver the agreed pathway and ensure prevention and early detection and referral - Competencies commissioned 8. Map a directory of foot care services across England - Use DiabetesE structural audit to map current services in England 9. Foot care audits become mandatory for clinically commissioned service - include DiabetesE, NDA and Ulcer Audit 10. Root cause analysis undertaken for major amputations
- Identify potential for improvement in prevention by identifying blocks and gaps in the service. 5. Success Criteria as agreed on 3.11.11 at NICE Quality Standards Event Better than the national average on data presented. Less variation within the North East. Increased screening in primary care. 6. Accountability The North East Diabetes Footcare Network will report to the National Network group as appropriate. The NE Diabetes Footcare Network will be represented by the Clinical Champion and a Podiatrist. 7. Chairmanship The Chair will be a local clinician. The term of office should be two years. After this the Chair should change or be re-elected. Chair s responsibilities are: To provide strategic leadership to the network. To liaise between the national and local footcare networks by attending the National Diabetes Footcare meetings and working with other Clinical Champions where appropriate. To ensure stakeholders representing the patient journey across the network are involved and the group is multi-professional in nature. To foster a network approach to issues. NHS Diabetes will support the Chair in development of agendas, minutes taking and work programmes for the network. 8. Membership Stakeholders and representatives should be identified from each of the following professional groups/ organisations: Podiatrists Diabetologists Vascular surgeons Patients Primary care practitioners including GPs Commissioners The above would be core members of the network but other professional groups and organisations maybe invited to join either as regular members or as temporary
members depending upon areas of work. This could include Diabetes UK and education professionals. It would be good practice to have a representative from each acute NHS organisation across the North East to represent their Trust. Details of membership at September 2012 are: Name Mathew Thomas Trudi Keast Nicola Coates Madeleine Henson Dr Simon Ashwell Jonathan Duffy Elaine Ricci Diane Knowles Dr Rahul Nayar (Chair) Linda Hicks Professor Gerry Stansby Dr K Dukhan Lynsey Dovey Dr G Tarigopula Linda Wood Julie Parsons Dr Narayanan Kilimangalam Job title & Organisation Assistant Commercial Manager, NHS County Durham & Darlington Podiatrist, Gateshead PCT Principal Podiatrist - Diabetes, Newcastle hospitals community health Principal Podiatrist, NHS Hartlepool Consultant Endocrinologist, South Tees Hospitals NHS Clinical Principal Podiatrist, County Durham & Darlington NHS Clinical Specialist Podiatrist, Diabetes & wound care, Sunderland City Hospitals NHS Senior Podiatrist, Sunderland City Hospitals NHS Consultant Diabetologist, Sunderland City Hospitals NHS Principle Podiatrist, County Durham & Darlington NHS Vascular Surgeon, Newcastle upon Tyne Hospitals NHS Consultant Diabetologist, South Tyneside NHS Service Improvement Lead, North of England Cardiovascular Network Consultant Diabetologist, County Durham & Darlington NHS Regional Manager, Diabetes UK Diabetes Specialist Podiatrist, Northumbria Healthcare NHS Foundation Trust Consultant Physician with interest in Diabetes and Endocrinology, Gateshead Health NHS Foundation Trust
Name Dr N Aggarwal Kate Mackay Robert Blair Shirley Pearson Helen Warburton Rob Colclough Dr W Jose Simon Donaghy Helen Ramsay Dr P Dunlop Dr Muhammad Kamaruddin Job title & Organisation Specialist Registrar in Diabetes and Endocrinology Northern Deanery Footcare Network Co-ordinator, NHS Diabetes Patient Representative Patient Representative Podiatrist, NHS Hartlepool Principal Lecturer, Sunderland University GP, Sedgefield Locality Head of Dept, RLS Steeper Orthotics Nurse Practitioner, Oxford Terrace Medical Group, Gateshead Consultant Vascular Surgeon, City Hospitals Sunderland Consultant in Diabetes, South Tees NHS Trust Northallerton 9. Frequency of Meetings The network members will meet at least 4 times per year and a minimum attendance will be a representative from each element of the footcare pathway (see core members in number 7) for the group to be quorate. 10. Administrative Support This will be provided by the Footcare Network Co-ordinator, NHS Diabetes to book rooms and circulate agendas and minutes for meetings, if required. Kate Mackay Primary Care Quality Improvement Co-ordinator North East NHS Diabetes 1.10.12 V 3.0