North Devon received transformation funding of £262,000 in 2017-18 and £258,000 in 2018-19 to improve diabetic foot care (equivalent to £291,000 annual average in 2022-23 prices).
All GP practices were visited by a member of the MDFT to improve links with podiatry services and ensure more timely referral. A virtual MDFT was established, meeting for 90 minutes a week, so that GP practice staff and community podiatrists could seek guidance on individual cases and upload photographs of foot ulcers.
During the first two years, 416 virtual consultations were conducted, covering 220 patients. Of these, 50% did not need face to face MDFT review, 14% were referred directly to the arterial centre, and 36% were referred to the face to face MDFT.
The major amputation rate fell by 80% in the first year of transformation funding, and the reduction was sustained in subsequent years. The rate per 10,000 people with diabetes was 13.4 in 2014-16 and 3.1 in 2017-19. The minor amputation rate fell from 34.4 to 17.9 per 10,000 over the same period. The annual saving from averted amputations is estimated at £284,000. Local data indicate that there were further savings from a reduction in hospital bed days for diabetic foot disease.