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Soc of Pod and Chirop rules on nail surgery

Discussion in 'United Kingdom' started by fayp, Mar 16, 2017.

  1. fayp

    fayp Member


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    I had an email yesterday from the soc of pod and chiropodists giving new rules for nail surgery. It says, amongst other things that we now must have another podiatrist plus a Foot Health Assistant present to perform nail surgery. This might be fine in the NHS......but many of us in private practise are alone or with a receptionist. In effect this new rule would make nail surgery impossible for many of us (I don't actually know any foot health assistants anyhow!) It would also make the cost double, which in many areas people would not pay for.

    GP's are now paid to rip nails off, and I'm sure they don't have two trained staff at hand to assist. Dentists regularly do major invasive techniques, without another dentist present.

    I'm not challenging the highest possible standards and the need to have someone with you to assist in the non sterile fields. I am however questioning paying a second podiatrist plus a FCA.

    I have written to the Society to ask if our insurance is now invalid if we don't follow their new rules.

    Increasingly, you wonder why you train when our own organisations make it more and more difficult. The FHP two doors down from me is now an "expert in diabetic foot care" and charges £39 for a mono filament test! Happily this has not affect my business at all!
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Did you get a response?
     
  3. Mike Plank

    Mike Plank Active Member

    The actual wording is
    "Single handed practice is not recommended when performing nail surgery. The Society recommends two podiatrists or a podiatrist and a foot care assistant are present when performing surgery. If performing nail surgery alone, it is difficult to maintain the sterile field and summon assistance in an emergency." Quote from Society Guidelines for Nail Surgery.

    It does not say another Podiatrist and a footcare assistant. I have trained my receptionist to act as an assistant for nail surgery who in an emergency can phone 999 whilst I stay with the patient. I do not have a footcare assistant. Dentists always have a Dental Nurse who can act in an Emergency. The guidance is there as it would be unwise to perform Nail Surgery alone with no other person around to help in an emergency. Common sense IMHO.
     
  4. fayp

    fayp Member

    Thanks for that. I just know everyone is getting fussy insurance wise so wanted to know my back is covered.

    The Society basically said the same, that they realise we don't all have access to another trained person. They said make sure your risk assessment paper work is up to date and you have thought it through. As you say a receptionist seems fine, and mine does the annual first aid course too for double back up.
     
  5. Catfoot

    Catfoot Well-Known Member

    Fay,
    Amazing isn't it ?!

    "Increasingly, you wonder why you train when our own organisations make it more and more difficult. The FHP two doors down from me is now an "expert in diabetic foot care" and charges £39 for a mono filament test! "

    Have you seen this one ; http://www.inst.org/foot-health-practitioner/index.htm ?
     
  6. Mike Plank

    Mike Plank Active Member

    Wow, Makes some interesting reading. Such as
    "This profession is now recognised by the NHS where it is known as a ‘Podiatry Assistant’. You may even call yourself a podologist, which is an emerging term for someone who treats foot and gait problems."

    and

    "As a FHP you will have the opportunity to treat a wide range of cases and clients including:
    Minor procedures such as Nail Surgery and Laser treatment."

    Which raises some interesting questions. A search on line finds the definition of Podiatry as:
    po·di·a·try

    (pō-dī'ă-trē),
    The specialty concerned with the diagnosis and/or medical, surgical, mechanical, physical, and adjunctive treatment of the diseases, injuries, and defects of the human foot.
    Synonym(s): chiropody, podiatric medicine, podology
    [pod- + G. iatreia, medical treatment]
    Farlex Partner Medical Dictionary © Farlex 2012

    So how does Joe Public tell the difference between a Podiatrist and a Podologist?
    Also how does a FHP get to use Local Anaesthesia and Lasers?

    All this for 595 pounds!

    Unbelievable!
     
  7. Catfoot

    Catfoot Well-Known Member

    The parts about being able to join SOCAP, earning £92 per hour and "easing foot ulcers" tickle me.

    And £45.00 for a home visit???:eek: Maybe in Henley on Thames, but up here they balk at paying £20 !!!
     
  8. fayp

    fayp Member

    I've just sent this link to the Society to ask for their comments! It is outrageous to claim that people can do no practical training at all, yet be associate members of the Society!
    The practise nurse at my GP's last week told me that she'd love to do the online podiatry course and trim toe nails!! And they have age concern in to the practice to do their patients! She had no idea of the difference. Clearly the message is not getting through.......
    Yet again I wonder why we bother!
     
  9. Catfoot

    Catfoot Well-Known Member

    I've just had a look at the link again - am I missing something here or is there no practical content to this course??

    From what I have read, it seems that the practical part of the course is taught via videos.:eek: please, please someone tell me I've got it wrong .....o_O
     
  10. fayp

    fayp Member

    you are correct, you qualify by watching videos, then they suggest you practise on your friends, family then work free for a charity to gain experience (let's hope the charity is well insured!).....but for only £100 more you can attend a one day clinic to practise!!!
     
  11. Certainly makes you wonder why a prospective student would choose the BSc course at a potential outlay of over £4oK when they can get on the job for a fraction of time and money. It's just as outrageous that someone who has a BSc in Podiatry and is registered with the HCPC can be struck off and still call themselves a podiatrist or chiropodist. I suppose it is less confusing for Joe Public though...
     
  12. Mike Plank

    Mike Plank Active Member

    What a pity we did not get closure of function at the same time as title. Our scope of practice has been undermined from all angles and professions. Nothing has really changed from the days of the unregistered apart from what we are called. I still come across people who don't know what a Chiropodist is, even more don't know what a Podiatrist is. I would say that hardly anyone knows what the HCPC is or does :confused:. Still mustn't grumble!
     
  13. Yep, except we didn't get protected titles either, Mike.
     
  14. Mike Plank

    Mike Plank Active Member

    Mark, I understand where you are coming from. The Patients are not protected either!
     
  15. Indeed. That is the greatest concern - the public have been duped - as well as he professions. But who cares?
     
  16. Pauline burrell-saward

    Pauline burrell-saward Active Member

    Any one who carries out nail surgery in a building by themselves is asking for trouble.

    I sent my receptionist to a first aid course and then taught her how to help me,( keeping times, unwrapping equipment, talking to pt, etc and also when to call for help ( never happened yet!!)

    how on earth do you carry out a sterile procedure with no help??
     
  17. You're kidding, right? I don't think I've used an assistant for nail surgery for over thirty years. Do you really need someone to talk to the patient and keep time whilst you operate?
     
  18. Pauline burrell-saward

    Pauline burrell-saward Active Member

    Absolutly,yes.

    How do you carry out a sterile procedure without someone to help ? Packages to be opened ,fluids to be poured ,times of the tounique to be noted.
    And whilst rare you can get reactions to L/A.
    If anything goes wrong you don't stand a hope in hell if you are by yourself.
    Also, if something does go wrong you have no witnesses .
    Lastly, I was taught ( by Society podiatrists) that I should have a second person present.
    Whilst a pna/ tna may be minor surgery, it should be treated with due respect and as a ex theatre nurse that is something I have always done
     
  19. Crikey. Really?
     
  20. Claire72

    Claire72 Active Member


    I think generally, people will pay for quality and the reassurance of having a second person present. (I know I do when I visit the dentist).
     
  21. Ian Reilly (2)

    Ian Reilly (2) Welcome New Poster

    The SCP have a working party looking at updating the guidance. Im chairing it - plus a mix of NHS - rural - PP pods.

    Single handed working is a tricky one but my own view is that it is possible. Not ideal but I'm quite sure GPs give an LA/steroid injection with no one else in the room. While its not about dumbing down, we also have to acknowledge real world issues... Open all packs first - have spares gloves!

    ATB

    Ian Reilly
     
  22. Claire72

    Claire72 Active Member

    Actually, it might be worth checking if GPs do administer LA/steroid injections with no one in the room, and if they are subject to any policies/regulations surrounding it. As a student I watched nail surgery in the NHS and there was a Podiatrist, Pod assistant & myself. This may have changed in the past 5 years or so? But what are the NHS regulations for nail surgery? I am sure the NHS wouldn't expend extra staff on a procedure if it wasn't necessary.
     
  23. Ian Reilly (2)

    Ian Reilly (2) Welcome New Poster

    The NHS don't have that regulated as such - some depts might - local protocol - and have an asst is clearly better than not. But in rural Scotland even having an asst is impossible in some places ...
     
  24. In 2001 I worked as a locum in Fort William for a year and had a wonderful 'patch' across Ardnamurchan, Glencoe, the Great Glen and the Inner Hebrides. Some weeks I would have the mobile chiropody van and travel around doing six 'doms' and 100 miles of driving in one day. The fishing rod was always packed in the back, Ian! I had a seven week return visit to the island of Eigg and worked out of the GP's house - - she put me up for the night too. One of the patients was in Cleadale on the west coast - there's a one mile track of road across the island and her croft was a two mile trek down a sandy track. She had a badly infected OC with severe medial involution and needed a PNA urgently. I was lucky. I had some phenol swabs, two cartridges of scandonest and one 30g needle - plus a set of chiropody instruments. The 'op' was carried out in her scullery with some of her own contributions - towels, chairs, cotton buds - and I had just enough dressings to giver her for a month's use.

    I went back six years ago for a visit and she was still there and her toe was still magnificent too. An amazing place. This is the view from her beach, twenty yards from the door....
     

    Attached Files:

    Last edited: Apr 26, 2017
  25. Dieter Fellner

    Dieter Fellner Well-Known Member

    Mark, that's an amazing life style. I'd like some of that with a bottle of Jim Beam.
     
  26. raun

    raun Active Member

    Well this is amazing but many are still confused between podiatrist or chiropodist
     
  27. fayp

    fayp Member

    I thought when we were state registered patients understood, as they knew nurses had to be state registered. Ever since, confusion has arisen. We tried to get them used to HPC then it changed a few more times until I am confused!
    The nurse practitioner at my GP's last week clearly had no idea of what we do, as she mentioned she nearly did the online chiropody course, and they regularly have the age concern toe nail cutting service that provides chiropody! If GP surgeries don't know the difference, the system is not working.
     
  28. Dieter Fellner

    Dieter Fellner Well-Known Member

    Raun, why do you think that's the case ... we bemoaned this fact, in the UK, since the official name switch. If memory serves me correctly this officially took place sometime in the early 90s; although our school already carried the title of Podiatry in 1987. Yet the Society still clings on to the title of 'Chiropody' with a willful tenacity. Is it surprising, then, the public and other colleagues will be confused?

    Same switch took place in the US in the early 20th Century. I believe it took several generations before this entered commonly into the public's (and healthcare) mainstream psyche.
     
  29. Claire72

    Claire72 Active Member

    We (podiatrists) are in the best position to educate the public, media, whoever, as to what we do. We could always stop moaning about how frustrating it might be, take some responsibility and get on and do something about it. Fancy that.
     
  30. Dieter Fellner

    Dieter Fellner Well-Known Member

    Agreed, and have done so for 27 years
     
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