Brent CCG and London North West Healthcare NHS Trust
In 2004, Brent CCG (then known as Brent Teaching PCT) and London North West Healthcare NHS Trust established a multidisciplinary specialist foot care service (MDFS). The MDFS operates two consultant-led clinics a week, a fortnightly vascular clinic and an emergency service five days a week. There are close links with community podiatry services, which can refer patients directly to the specialist service, and with the vascular surgery team at the outer North West London vascular hub. Patients with recurring ulcers can self-refer to the service.
Wing May Kong is a consultant diabetologist at London North West Healthcare NHS Trust.
Brent CCG has one of the lowest diabetes amputation rates in England.
In 2015-2018, there were 9 fewer major amputations and 8 fewer minor amputations per year in Brent than the expected level. (The expected level is the average rate for the 10 CCGs in the country that are most demographically similar to Brent.)
There were 1,293 fewer bed days for diabetic foot care per year than the expected level.
The estimated marginal cost of the improved foot care service in Brent is £102,670 a year.
Savings from averted amputations are estimated at £179,000 a year.
Savings from averted diabetic foot bed days are estimated at £511,000 a year.
In total, these savings are more than 6 times the cost of the improvements to the service.
Antonio Guerreiro is a patient at London North West Healthcare NHS Trust. He believes the integrated and multidisciplinary care he's received has made a crucial difference to keeping him ulcer-free.
Brent is now working with other CCGs in North West London to improve diabetic foot care across the entire area.