Crisis in waiting lists.

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Long waiting lists for podiatry cause concern
http://www.thisisstaffordshire.co.u...ent-deadline/story-19628626-detail/story.html

Passed on in good faith

toeslayer

 

I have just read the article and am shocked ridged.

" 11,000 patients DUMPED"

These are people who are being referred to as dumped,

I'm not surprised they are making there way back to the Podiatry clinics if over a quarter were removed, they must have been referred for some reason in the first place and there is no way the PP's can cope with that many all at once.

I thought we were in the caring profession,

 

Daer All,

this has been an issue since I graduated in 1986 and joined the NHS. Then it was 2 year waiting list, so essentially dead mans shoes.

People have to realise that the NHS cannot provide t/t for all for life for all who want Podiatry t/t.

So what happened in the early 2000 was that all pts were assessed as to RISK, Symptoms, T/T required to address these issues.

So many had no risk and symptoms were long nails and dry skin. T/T required NIL..

So discharged into own care.

This enabled the dept to deal with the ridiculous waiting list. 1st question how long have you been on waiting list???? Women since my 60th birthday, Men since my 65th birthday. So how have you managed your care for the last 2 years???
Did it myself
Got family member to do it for me
Went Privately which is more expensive than having my hair done

If I had my way, for most referrals it would be

NO NAIL CARE except when the viability of the limb is at major risk

Again no nail care

For callus and Heloma foot wear advice and a short course of t/t then discharge into care of P/P. The NHS does not have the resources to provide routine palliative care for 30 years for each pt..

How it should be viewed>

How can I reduce the admission rate to Hospital for at risk limbs?

End of story.

ALL NAIL SURGERY TO BE DONE BY PODS. Not by GP's Hospital Consultants

Most wound care to be done by Pods

Pods in Vascular, Diabetic , Rheumatology , Dermatology etc etc clinics

Our NHS Role is to reduce the burden on Hospital admissions

Establish a better working relationship with P/P. This worked well in Sydney Australia where I worked 2006-2010.

In P/P in Aus the practice I worked in did a lot of very high risk wound care in partnership with the 2 local Acute Hospitals.

We did most of the local Nail Surgery

We did a lot of preventative high risk pt management.

In Aus you have a better Health Insurance System, also there was Medicare subsidy for at risk pts in P/P.

So I will still say the only way to take on new pts is to DISCHARGE Current Caseload and have a clearly defined treatment plan. with a beginning middle and an END.

Otherwise there will be waiting lists ad infinitum and will continue to be Dead Mans Shoes.

After 27 years in practice there has not been much change in the NHS Model.

Physio have however achieved change and do not provide the service they did 10 years ago. Most pts get an assessment and an exercise plan and a 3 monthly review to see if pt has been doing the plan. No more 3 times weekly rubdowns for 6 weeks.

Same with stroke management. Just look at the recent comments by the broadcaster Mr Marr. He expected more from the community OT and Physio depts.

Ho HUM

David:drinks

 

David you are quite correct in your approach. We discharged 1200 pts from Liverpool NSW to establish the now World renowned High Risk Foot Clinic. Surprisingly we only had 6 complaints mainly because the pts didn't feel "dumped". They were all assessed for "risk" and given a list of alternative venues for care. Now 17 years later patients can get some Medicare funding to help with routine care but not then. Liverpool is a very low socio economic area with one of the highest concentrations of DM T2 in Oz. Patients with severe foot pathologies could access the HRFC with no waiting thus preventing admissions and amputations.
Ros

 

yes pauline they were referred for a reason they want their nails cut they are old cant bend daughter does not like cutting their nails etc etc etc. they ask gp for a referral who fills it in just to get rid of them . people lie on the forms . for example form says heel pain when the patient presents they say no heel pain i need my nails cutting. Private practice can cope with all these people if they pay. Expand employ young chiropodists who by all accounts cannot find work run shift patterns 24 hours a day get rich retire young . its called buisiness. BUT guess what these people dont want to pay so they go back to the gp after being discharged and get re referred wasting gp time secretarial time and the podiatrists time who once again discharges them. the circus continues because the nhs is not forcefull enough , instead of self help sheets and all the pussyfooting about they should be told to go away and pay for a nail trim by pod fhp or beauty therapist . tell them clear and loud it does work.

 

You do get a few pts that "try it on" but one of my tricks was to ring the referring GP whilst the pt was with me and explain in no uncertain terms that this was an inappropriate referral. Apparently GP's didn't like getting interrupted during their busy days work for trivial reasons and neither did I.
Rarely did either parties 'try it on" again. The hospital Pink Ladies had assumed it was their perk to nip in for a quick nail trim, they got a petition together and presented it to the hospital GM demanding their pedicures. GM of course supported me and cracked up with laughter. However for years after that those lovely ladies gave me looks that could kill! All in a days work.
Ros

 

Hi Ros,

I wonder what other services the Ladies in Pink received ???

Funny old world Podiatry is.

I attended an update on management of at risk limbs to be told that after the full assessment that a quickie nail trim would BE NICE and slapping on some loverly cream would complete the experience.

HMMMM hardly the right situation to educate and achieve lifestyle change from the patient.

The lecturer had more qualifications than the average African Military Leader has medals and gold braid.

So the gravitas of the lecture was lost by this statement.

Ho Hum

David

 

Does anyone have a full text of this? http://www.thefootjournal.com/article/S0958-2592(01)90725-4/abstract

 

Check your inbox.

 

No really, it's a pleasure. Enjoy your holiday.