Brent’s diabetes care plan ‘could save millions for NHS England’

PUBLISHED: 11:09 02 March 2017 | UPDATED: 10:19 06 March 2017

Brent CCG now has the lowest diabetes amputation rate in England. (Photo: Hana Rous portraits)

Brent CCG now has the lowest diabetes amputation rate in England. (Photo: Hana Rous portraits) Photographer Nick Strugnell

Highlighting positive work in Brent which has had good results, Diabetes UK found significant savings could be made by improving foot care services and reducing the number of foot ulcers in patients.

In 2004, Brent Clinical Commissioning Group (CCG - then known as Brent Teaching Primary Care Trust) and The London North West Healthcare NHS Trust established a multidisciplinary specialist foot care team operating two consultant-led clinics a week and an emergency service five days a week.

As well as having close links with community podiatry services, it also works closely with intermediate care services providing home care to avert admissions and support rapid discharge.

Brent CCG now has the lowest diabetes amputation rate in England. The major amputation rate in Brent is 71 per cent below the England rate, and 55pc below the rate for demographically similar CCGs. The number of days in hospital for diabetic foot disease is 26pc below the England level and 22pc below the level for comparator CCGs.

Dr Wing May Kong, who leads the multidisciplinary specialist foot care team, said: “Since 2004 we have provided an integrated foot service that works across community and secondary care. We work as one team with a shared pathway and simple traffic light referral criteria.

“Diabetic foot complications have a huge personal cost to patients and early multidisciplinary input can prevent amputations. Our core approach is patient-centred care with a service that is easy to access. We are working with a range of teams, including STARRS, GP surgeries and hospitals, and the district nursing team, to give people prompt access to the best care.”

Diabetes UK Head of London, Roz Rosenblatt, said: “There are more than 20 leg, foot or toe amputations each day and most of these result from a diabetic foot ulcer. Today, around 60-75,000 people with diabetes experience a foot ulcer. That’s roughly the same as the whole population of Boston, Lincolnshire.

“NHS Commissioners should be spending money on treating ulcers rather than on managing their extreme consequences. And prompt treatment for a person with a foot ulcer can prevent both the personal and economic cost of an amputation. It makes sense for NHS Commissioners and budget-holders to invest now in effective foot care services, especially as the diabetes crisis facing the UK means an ever growing number of people are being diagnosed with the condition.”

After making foot services more effective, the charity estimated three NHS Trusts – including Brent – saved more than £1.38 million between them in just one year. Diabetes UK’s report recommends these savings be ploughed into services preventing diabetes patients getting foot ulcers which can lead to amputations.

Professor Jonathan Valabhji, National Clinical Director for Diabetes and Obesity at NHS England, said: “This report is well timed, just as we at NHS England are about to invest £40million per year over the next two years in specific areas of diabetes treatment and care.

“One of the specific areas for investment is improved access to the multidisciplinary diabetes specialist teams to which this report refers.”


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