Podiatry

[macabee]

About 18 months ago, I requested [GP] referral to the local NHS podiatry service, my practice nurse advised me that whilst my feet were in good condition, I was cutting my toenail's too short and that going to the local NHS podiatry service would ensure that my feet stayed in good condition.

Since then I have been going about every six month's. When I attended yesterday the podiatrist told me that I was low risk and that they were getting a high level of high risk referrals, I would be kept on their books for the next six months, but would have to then referred by my GP.

The implication being don't bother us until you have complications and become high risk.

In my opinion what is liable to cost more two 15 minute sessions a year, or stay in hospital with foot complications.😡

 

[Northerner]

Another misguided 'efficiency' I'm wondering if I will hear something similar in a couple of weeks. Like you, I referred myself to the Podiatry Service and have been going once a year. However, my feet are in good condition so I'm pretty low risk. I'm also considered 'low risk' for my diabetes generally, and have now been put in the 'care' of my GP surgery for my reviews instead of seeing a consultant - they just arranged the appointment yesterday. The 'diabetic' nurse knows absolutely nothing about Type 1 diabetes, and certainly not about my own particular variety of it, so it looks like it will be getting it over with and biting my lip...

I know resources are scarce, but as you say these 'savings' seem misguided long term

 

[KateR]

I was told I don't qualify and I have to pay for my own treatment. 😡

 

[Northerner]

I was told I don't qualify and I have to pay for my own treatment. 😡

Do you get your feet checked at your surgery Kate? It's one of the NICE recommendations that you get your feet checked at least annually, so they are in breach of this if they make you pay.

 

[Copepod]

Another way of looking at your situation, macabee, is that podiatrist considers you've learned how to cut your toenails correctly, so no longer need professionl help. As long as you continue to look after your feet correctly and get annual foot checks from a diabetes specialist, whether nurse, doctor or podiatrist, then you should have many more years of healthy feet.

Health services do have to prioritise patients according to risks, and risks can change, becoming higher or lower.

 

[robert@fm]

Back in March, I accidentally dropped a (full😱) can of aerosol cream on my toe (the same toe that, 13 months earlier, had a massive ulcer requiring me to be hospitalised for a week). The result was a flesh wound which produced a copious amount of blood, but fortunately turned out to be superficial.

I was given an urgent referral to my local foot clinic (about a mile from where I live), and they saw me and promised follow-up appointments. That's the last I heard from them.

 

[KateR]

Do you get your feet checked at your surgery Kate? It's one of the NICE recommendations that you get your feet checked at least annually, so they are in breach of this if they make you pay.

Yes, the DN checks my feet twice a year but other treatments such as removing hard skin and cutting nails I have to pay for.

 

[Northerner]

Yes, the DN checks my feet twice a year but other treatments such as removing hard skin and cutting nails I have to pay for.

Ah, that's good then. My area introduced charges for some services too a couple of years ago. This is what gets me about the so-called 'savings and efficiencies' in the NHS - you end up paying for things that used to be covered, and it's the people less able to pay that suffer most. I wonder how many people put off getting things done now because they can't afford to pay for them, possibly leading to problems down the line? Better not get on to one of my frequent rants! 😱

 

[trophywench]

My main problem with feet is finding a chiropodist anywhere handy to get to - they are either miles away from a bus stop or they have no parking, round here.

I did visit one a while ago because I'm not happy with the state of my toenails, they are getting REALLY hard to cut - literally, the nails are really hard even with the proper Scholl implement - and I think there's more going on than just old age though dunno what? - but apart from not being able to suggest anything - his hands shook, all the while ..........

They still grow like billy-o though, I've always had to cut them all weekly and still do. And this time of year now it's warmed up a bit (generally though I'm frozen again right now) it's worse, same as hair. It's a right pain in the everywhere contorting meself to get to some of them, so frequently.

 

[grovesy]

For a few years I saw a private podiatrist, he told me that some of his Diabetic clients who were still getting NHS care, were telling him that were not getting as long appointments, as they had previously done!

 

[NigelOfKent]

Podiatry is one element of diabetes care that seems to have disappeared in my case. About three months ago I developed a very simple foot problem for which my pharmacist refused to offer any advice, insisting that I saw my GP. My GP made a referral to the local podiatry service and as of today (a quarter of a year on), I still haven't received an appointment. My foot is extremely painful and when I tried to chase up the appointment, I was advised to go to A&E if I felt I needed urgent treatment. My guess is that an A&E medic would simply refer me to the same podiatry service (apart from an A&E attendance seeming entirely inappropriate). What are we supposed to do in the face of such inadequate provision?

 

[Northerner]

Podiatry is one element of diabetes care that seems to have disappeared in my case. About three months ago I developed a very simple foot problem for which my pharmacist refused to offer any advice, insisting that I saw my GP. My GP made a referral to the local podiatry service and as of today (a quarter of a year on), I still haven't received an appointment. My foot is extremely painful and when I tried to chase up the appointment, I was advised to go to A&E if I felt I needed urgent treatment. My guess is that an A&E medic would simply refer me to the same podiatry service (apart from an A&E attendance seeming entirely inappropriate). What are we supposed to do in the face of such inadequate provision?

Hi @NigelOfKent , very sorry to hear this I think you need to chase this up with some urgency. Things can get missed - not excusing that - but you really need to push sometimes until someone finally sits down and listens. Do you just have pain in the one foot? Are there any signs of infection? Please make an appointment to see either a nurse or your GP and find out what has happened to your referral, I hope you can get the treatment you need very soon.

 

[NigelOfKent]

Hi @NigelOfKent , very sorry to hear this I think you need to chase this up with some urgency. Things can get missed - not excusing that - but you really need to push sometimes until someone finally sits down and listens. Do you just have pain in the one foot? Are there any signs of infection? Please make an appointment to see either a nurse or your GP and find out what has happened to your referral, I hope you can get the treatment you need very soon.

Thanks for this. My GP has repeated the referral on three occasions. However the local podiatry booking service takes the view that they cannot treat any referral as urgent, no matter how often it has been requested. The local urgent care centre suggested that one of their doctors could "patch it up" for me while I wait for an appointment. However I'm not sure how appropriate or effective this might be.

 

[Northerner]

Thanks for this. My GP has repeated the referral on three occasions. However the local podiatry booking service takes the view that they cannot treat any referral as urgent, no matter how often it has been requested. The local urgent care centre suggested that one of their doctors could "patch it up" for me while I wait for an appointment. However I'm not sure how appropriate or effective this might be.

This is pretty appalling Nigel, and shoud NOT be happening! Can I suggest you call the Diabetes UK Careline service and explain your problems to them? They may be able to help you get the care you should be getting, as footcare is particularly high on their list of campaigns! The following link has all the contact details:

https://www.diabetes.org.uk/How_we_help/Talk-to-someone/Careline/

 

[Amberzak]

I'm not allowed to the referred. Apparently my feet are in too good condition. I take that as a complement.

What is really funny is I don't feel I especially look after my feet. I mean, I clean them obviously, but I don't do any special lotion or anything like that. But I do get them checked every couple of years with the GP nurse. Last time she had someone she was training, and she said to them 'now here's someone who definitely looks after their feet.' Made me wonder what God awful state the other peoples feet were in.

 

[Vicsetter]

I've had 2 referrals to a podiatrist and both times it took about 2-3 months to get an appointment, they are very busy people (and they only visit the village once a week). As a result they will drop you off their list if they think your feet don't need their expertise. I don't think they will routinely clip toenails either.
You can go privately (see here for costs:http://painfreefeet.co.uk/servicespodiatry/chiropody-cost/ £40 for diabetic assessment), a bit like the dentist. I am lucky to have found an NHS dentist.

 

[robert@fm]

I have been told that diabetic toenails have to be trimmed by a podiatrist, as doing so safely requires special training; I asked if my carers could do this, and was emphatically told that they wouldn't be allowed.

 

[pav]

For years I was seen a podiatrist even when at low risk, used to be about every 18 months as I had problems with ingrowing toe nails that were painful, in the end they took them off. I am now classed as high risk and was originally on a monthly check up, this has now slipped to 2 monthly check ups, seeing this makes one wonder if this is part of the cost cutting exercise.

Though if I have any problems I just have to give them a call and they will see me, after I got a telling off for not calling them when I had a golf ball size blister on my foot without me feeling it, did see the nurse at the GP's.

I no longer have the annual review where they check the feet sensitivity tests as they said they know I am high risk and there's no point in doing them.

 

[trophywench]

My toenails grow like weeds in manure - every ruddy week I have to cut them. I don't mind but I am having more and more trouble getting me and my feet into close enough proximity to do a decent job. I did notice yesterday that my right big toe - the one with the bunion, seems to have started ingrowing all along the outer edge - and though I know what to do when a 'normal' tip/side of a nail starts in ingrow, but not when it's along the length and I can't cure the reason or stop it getting aggravated while it heals - cos it's the bunion and the fact its turning in towards my little toe, underneath my 'index' toe.

Think I'll have to see a doc. There are a couple of chiropody places (but not one particularly near where we live) but you can't park close by and they are all a good walk from the bus routes !

 

[Bessiemay]

I don't have any medical problems with my feet it's more nails and hard skin etc. and though I have an annual check at surgery, I pay to see a private chiropodist because I think it's important and that's my choice.