Diabetes-related amputations drop by almost 50 per cent

  • Diabetes-related amputations drop in Sheffield by almost 50% at a time when national amputation rates have remained static
  • New measures introduced include a diabetes foot hotline, a restructured footcare pathway to enable rapid access to the specialist team and improved training for GPs and other healthcare professionals
  • Survival after a major amputation is bleak – at 50% at two years, but thanks to changes 18 fewer people in Sheffield are losing a limb to diabetes every year
  • Treatment of patients with foot problems related to diabetes is complex, but changes have led to improved care

 

THE NUMBER of diabetes-related amputations in Sheffield has nearly halved in the past four years following the introduction of an innovative diabetes footcare programme by Sheffield Teaching Hospitals NHS Foundation Trust.

In 2007 Sheffield had one of the highest diabetes-related amputations in the country, but thanks to a new diabetes foot hotline, a restructured footcare pathway enabling rapid access to a specialist team and improved training for GPs and other healthcare professionals, amputation rates have dropped significantly – with 18 fewer people with diabetes losing a limb in Sheffield every year.

This is at a time when national amputation rates have remained static, and the number of patients attending the Sheffield diabetes foot clinic has increased by 80%.

Around 6,000 people with diabetes undergo a major amputation every year – with mortality rates of 50% at two years (worse than most cancers). Yet improved care and screening could result in 80% of these amputations being avoided.

Foot problems related to diabetes can deteriorate in a matter of hours and caring for people with diabetes foot disease is a complex process, involving a large number of healthcare professionals, including GPs, podiatrists, microbiologists, vascular surgeons and nursing staff.

The diabetes foot hotline, which is run by a consultant diabetologist provides immediate advice to any community healthcare professional on diabetes-related foot disease and receives ten to 20 calls a week. Improved training for primary care professionals has enabled foot problems to be identified earlier.

Dr Rajiv Gandhi, a diabetes consultant based at the Northern General Hospital’s diabetes centre, said: “Amputation is one of the most feared complications of diabetes and has an enormous impact on patients’ lives, including loss of occupation and status, disfigurement, reduced mobility and depression.

“As a result of the interventions we have put into place, there has been a major reduction in the number of people with diabetes having to undergo amputations at a time when national amputations rates have remained static. We are delighted that despite a dramatic increase in the number of people developing diabetes and diabetic foot problems in Sheffield in recent years, the changes we have made have led to this astonishing drop in the number of amputations in such a short period.”

Other measures introduced include closer liaison with microbiologists, which have led to the development of more stringent protocols for the collection of wound specimens and appropriate antibiotic prescribing and improved education for patients highlighting specialist services can be accessed without the need for a GP referral. The restructuring of the diabetes foot clinics also means that staff can review patients who visit the clinic with a diabetes-related foot emergency within 24 hours if required. Feedback of the service has been positive, with 90% of patients saying they were satisfied with the services provided.

The Sheffield Diabetes Footcare Team have been shortlisted for a national Health Service Journal Patient Safety and Care Award in the Diabetes Care category. The winners will be announced in a ceremony in London on the 15 July.

ENDS

Photo: The Sheffield Diabetes Footcare Team outside the Northern General Hospital.

MEDIA CONTACT:
Claudia Blake, Communications Specialist
Tel: 0114 226 5033
Email: claudia.blake@sth.nhs.uk
 


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