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Cancelled podiatry appointments putting lives and limbs at risk

Cancelled podiatry appointments putting lives and limbs at risk

70% of podiatry clinics were cancelled by NHS Foundation Trusts across England during the coronavirus pandemic, a Freedom of Information (FOI) request by national law firm Stephensons has found.

Stephensons, through its clinical negligence department, contacted 119 NHS Trusts in England due to an awareness that many patients with complex needs, including those with diabetes, need regular comprehensive assessment of their feet for signs of cuts, grazes or rubbing. In these patients, infections must be identified and treated quickly to avoid loss of toes, limbs or – in extreme cases – loss of life.

Of the 60 NHS Trusts who responded to the FOI request, the overwhelming majority (70%) postponed or cancelled routine podiatry assessments in the peak of the pandemic’s first wave, between April and August. While many NHS Trusts have since restarted in-person appointments in some capacity, four NHS Trusts had still not resumed services in full by November.  

While some appointments were cancelled altogether, a number of Trusts moved services online, with virtual appointments for those patients with particular concerns.

Laura Sheehan, Partner in the medical negligence department at Stephensons said: “The challenge facing NHS services at the moment is unprecedented and we’ve seen countless examples of where delays in treatment or diagnosis are having devastating consequences. Thousands of people every year rely on regular podiatry appointments to ensure their feet are healthy, the pandemic has dramatically impacted those services and placed many people at significant risk.

“While the switch to online and remote services is a helpful touch point for patients, it is simply not thorough enough to determine whether a foot is in good health or whether an ulceration is forming. Many people in these circumstances suffer with peripheral neuropathy, where the feet have little or no sensation, often making it difficult for them to feel pain or discomfort and often leading podiatry teams to underestimate the health of the foot.

“It seems inevitable, that as this pandemic continues to play out, we will begin to see patients taking legal action against the NHS for the stoppage of these services and putting their health and wellbeing in jeopardy.”

It is estimated that one in ten adults in the UK over the age of 55 are affected by peripheral neuropathy (nerve damage) and consequent loss of sensation, with diabetes (types 1 and 2) being the most common cause.

Emphasising the importance of regular podiatry check-ups for people with diabetes, national charity Diabetes UK states: “Evidence shows that providing an integrated footcare pathway, with trained staff in foot protection services in the community and speedy access to multidisciplinary specialist teams, considerably lowers the risk of amputation.”

If you are living with diabetes or have been diagnosed with peripheral neuropathy it is crucial to check your feet for symptoms and warning signs, such as:

  1. Breaks in the skin of your foot, or a discharge seeping from the wound
  2. The skin over part or all of your foot changes colour, becoming more red, blue, pale or dark
  3. Your feet are swelling where there was a blister or injury 
  4. There is a redness or swelling on an active ulcer or where you have been warned to seek immediate attention