The transformation funding was used to add 3.4 WTE podiatrists to the foot care service, plus administrative support and equipment.
Reported impacts include:
• a substantial increase in the number of podiatry visits to inpatients with diabetes
• more frequent review of at-risk patients
• improved arrangements for home visits, and MDFT review of patients receiving domiciliary care
• educational outreach to primary care.
Service transformation in Sheffield
Sheffield CCG received transformation funding of £112,000 in 2017-18 and £185,000 in 2018-19 to improve diabetic foot care. Before the transformation funding there was insufficient capacity in the foot protection service, leading to excess demand for the MDFT, late referrals and delays to healing.
Rajiv Gandhi is a consultant diabetologist at Sheffield Teaching Hospitals.
Band 6 podiatrists from the foot protection service have rotated into the acute service, to deal with high-risk patients and release more senior podiatrists to look after patients with active foot disease.
Oliver Binns-Hall is a specialist podiatrist who has rotated into the acute service.
The service reports a reduction in the proportion of ulcers that are severe when first seen by the MDFS.
Local analysis indicates that the savings over the first two years of the improved service exceed the cost, and the CCG has decided to fund the additional resource after the transformation funding period.
Ceri James is a commissioning manager at Sheffield CCG.