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Professional

Referring Patients for Diabetes Footcare
 

The Diabetic Foot Clinics are now held at the Leicester General Hospital. The foot clinic has multidisciplinary teams consisting of Medical and Nursing staff, Podiatrists and Orthotists for optimal patient care See Clinic Information
 

Foot clinic dressing

Referral Form

 

New Diabetes Foot Clinic Referral form January 2015 -

 


This form can be filled in electronically now, Download, save , fill and email /fax to the team.
 

Who Can Make Referrals?

 

 

The General Practitioner (GP), Community or Practice Nurse and the Podiatrist can make referrals. Urgent referrals will be seen as soon as possible, during the week within 24 hours. All other patients will be seen at the next available foot clinic. Download the 

New Foot Clinic Referral Form  (January 2015)


Who Should Be Referred? 

 

Patients with neuropathy who are at risk of ulcerations should be referred to the normal diabetic clinics but the patients who have any damage to their feet should be immediately started on suitable antibiotics (see UHL Antimicrobial guidelines for Diabetes foot infection) and referred to the Diabetic Foot Clinic at either the Leicester General Hospital. Download the Diabetic foot clinic Referral form 
 

Risk Assesment Critera


The feet of patients with diabetes should be assessed for risk of ulceration and amputation. They should be categorised into three risk levels

 

Low Risk


  • Patients with no clinical evidence of neuropathy or peripheral vascular disease.
    These patients require general foot care education from the GP, Nurse or Podiatrist and regular risk assessment at community clinics. 

 

Moderate Risk 


Patients with “At risk feet” with clinical features of:

  • Previous ulceration
  • Neuropathy
  • Peripheral Vascular Disease
  • Callus
  • Foot Deformity
  • Partial Sight
  • Elderly
  • Living alone
 

These patients require regular intensive foot care education and podiatrist follow-up, either at specialist diabetic podiatry clinics in the community or by referral to the hospital diabetic foot clinic.


High Risk 

 

  • Patients who have developed ulceration or gangrene with risk of amputation 
  • Urgent referral should be made to the hospital diabetic foot clinic, which should be able to respond to such emergency requests. Use the form below.
  • After a period of treatment in the hospital clinic to heal the lesion, including antibiotic therapy for infection, pressure relief and debridement, these patients may then be referred back to the community as patient with “ at risk” feet.
  • Where serious limb threatening conditions are present, including non- healing ulcers, there should be easy access to a specialist surgical opinion through clearly defined and well publicised channels.


 

What Happens Next?

 

  • Patients referred will be put on courses of antibiotics, which will need to be taken until the ulcer is healed.
  • Pressure relief will be obtained by giving either a removable plaster cast boot or a modified sandal.


Foot clinics have access to vascular surgeons and orthopaedic surgeons, if necessary. It is important that the patient has good diabetes control in order to aid healing, and their diabetes will be monitored when they attend the foot clinic and treatment changed if necessary. 
 

 

Appointments

 

  • The multidisciplinary foot team will see patients on a regular basis with podiatry only appointments given when appropriate, between these visits.
  • The patient’s dressings will need to be changed on a regular basis by either Practice or Community Nurse. If there is any deterioration in the foot, the clinic should be contacted.
  • The foot clinic advises dry dressings only as most patients with diabetes will have neuropathy and manual debridement is performed regularly so a simple non-adhesive dressing with small amounts of gauze is adequate.
     

Please contact for further advice or appointment:


Rachel Berrington,
Diabetes Specialist Nurse
 -Foot Lead - 0116 258 4919

F: 0116 273 3067  T: 0116 258 8304
Clinic Cordinator: 0116 258 4409 (LGH)
 


Documents

Antimicrobial Guideline for Diabetic foot Infections

UHL Guidelines Download Document

Dressing Selection for the Diabetic Foot Ulcers (215KB)

UHL First line clinical decision guide to dressing selection for diabetic foot ulcers 2012  Download Document

DUK Touch the Toes Test

Simple yet easy test for patients and GPs to perform Download Document

Leicestershire Diabetes Footcare Pathway 2013

Developed by the University of Hospital of Leicester Diabetes Team (with thanks to Rachel Berrington - Foot Specialist DSN) Download Document

UHL Diabetes Foot Clinic Referral Form - (PDF - 189KB)) Jan 2015

Please use this form to refer to the MDFT Download, save , fill in and attach to email or fax to the team. Download Document