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FHPs invited to join the Royal College of Podiatry?

Discussion in 'United Kingdom' started by jabr, Oct 29, 2021.

  1. jabr

    jabr Active Member

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    Divining a qualified podiatrist is still very, very confusing for the public but when they closed the profession it at least became illegal for those not trained and qualified as podiatrists to call themselves podiatrists. But great news for anyone wanting to mislead the public, soon people might be able to knock off their couple of weeks of FHP practical training and advertise as

    "Joe Bloggs FHP, associate Member of the Royal College of PODIATRY".

    Here's how they disingenuously broke the news:
    How is the time now right? Now that they've got the royal approval for representing the most professional end of footcare they feel its time to legitimize people offering the same specialist medical services as podiatrists after having only a week or 2 of practical training??

    The council feels? I doubt this, I bet this idea came from the unionista staff, unless the council are overwhelmingly NHS workers at the moment, that could be it. But members should certainly have a right to know which council members approved this idea before any future elections.

    How many vascular surgeon's do they actually think will want to become members? They must know its zero but its the sort of thing a conman might try, to flannel someone they think is an idiot before they cough behind their hand "and foot health practitioners" hoping its missed. Tacked on at the end of the list as though an afterthought when clearly it is the only group (slightly) likely to be interested for dubious benefits. If it was put to a vote of members it will be worded as though to deny the motion is holding back a flood of surgeon's and diabetes specialists. Slip the FHPs in how unpopular policies are slipped in bills with popular ones to get them passed.

    Clearly they know its certain to be controversial with their members who put in 3 years training and have spent a career having to convince patients that the money they previously wasted on years of ineffective monthly treatment which has made their condition hopelessly chronic isn't because podiatry is rubbish but because they weren't seeing a podiatrist. That sort of thing. CPD will not turn any FHP into a podiatrist, if it did why isn't that a route into the profession? There is no logical or ethical rationale for allowing FHPs to advertise as members of the college of PODIATRY. And I can't imagine this being a thing: "We value you not just your subs, but remember you're not allowed to mention your membership anywhere in your advertising or website, OK". Of course they'll use it.

    There is no insurance cover on offer so they won't be joining for that. Nothing obligatory about the courses but access to that will be what the college will claim is the ethical reason to invite membership. Here are the only benefits according to the website
    That's it. Is that worth £80 a year? Trade union support is irrelevant for private FHPs. A magazine, a few articles on a website. But £80 a year to be able to advertise as a podiatrist? Now thats a bargain. Even now people can't tell the difference so being able to use the word "podiatry" near their name and cleverly in their adverts will be more than enough to convince most of the public who won't dig into how ludicrous it would be if someone offering podiatry treatments and who is a member of a Royal Podiatry College can possibly be not a podiatrist.

    Of course for the college staff its more money for no more work. More bums on seats, more footfall for traders at conference, more claim to have reach when advertisers buy space on the website and the near daily spam emails. Sorry guys but if its money you're short of a few of you on London wages will have to go. I know council are your buddies etc but this is really going too far to keep you in work. Or move the office to Manchester like the BBC did.

    But then I think they have only ever really been interested in the trade union side of things. Private practitioners are very much a secondary concern it has always seemed to me. Not the high end glory work is it. We're not up to our elbows in severe ulcers that wouldn't exist if the patients had just had decent regular podiatry by someone who knows what they are doing. This idea only makes sense if the college only pretend to be interested in private practice to get our money and numbers, then what does it matter if they bolster the coffers and numbers with more non-NHS types which only effects the non-NHS members and non-NHS patients?

    And laughably it becomes so clear how distant they are to members. "uniquely and for a limited time only you are deigned to have a small window of opportunity to ask questions directly to [some lower ranking person in] the organisation who will [file your negative response in a bin and] count up all the positive responses." There is zero need to have a consultation as there is no good reason to do this, the only incentive for them to do a consultation is so they can pretend they listened and heard our rapturous approval. Will members have access to other members responses? "Data protection old chap sorry no can do". So if the response comes back positive we will only have their word for it. I for one won't believe it. What possible benefit can it be to podiatrist members? Zero. NHS podiatrists will say "whatever", most members won't respond and the awkward ones who can't see the vast wisdom in it will be ignored.

    One thing I can say for sure is if this goes ahead they're losing my subs. I'd guess it will be a one in one out ratio, when even a 5 in 1 out ratio would see no net gain. Great maths guys. Fortunately there are plenty of cheaper alternatives who mix in FHPs if we're not going to be discerning anymore.


    or just get insurance


    But note how they are closing the consultation on the day before they take the next years subscriptions. As soon as the money is in the bank and people are tied in for another year they'll announce its going ahead, in the hope that most people will have forgotten about it before the next renewal time. For this crass move alone they deserve to lose members. It is worth noting that cancelling your direct debit will not terminate your membership or liability insurance. They will chase you well into next year before they give up on that no doubt. So cancel it with the bank and wait to see if they go ahead with this. Or at least swap to a monthly direct debit which you can cancel any time without having to pay the whole year on Jan 1st.

    But why bother being a member at all. The college have sat back and done nothing while watching the destruction of podiatry in the NHS, now little more than a patch up service for failed footcare in diabetics. Every ulcer is a testament to the failure of podiatry in the UK not a reason to celebrate how marvelously surgical podiatry is getting. I've seen NHS podiatrists feeling pride that they have to dress in scrubs. "We're so medical! Not like those lowly private podiatrists cutting toenails and keeping people from ever needing more than basic care. Our NHS patients are constantly getting chronic ulcers because we're leading the profession in the right direction!". Giving each other titles such as "Advanced Podiatric Specialist in Woundcare" for wounds that 99% of the time wouldn't exist if patients had had proper regular routine podiatry by a properly trained actual podiatrist. No wonder if the NHS lifer council members can't appreciate the value of the private sector, they think the reason we don't spend all day doing ulcers isn't because we're skilled at preventing them, no they assume we just coincidentally all have only easy patients; that its all non-advanced work which anyone can do. So what does it matter who non-NHS patients see, or if the public can tell a FHP from a podiatrist.
  2. jabr

    jabr Active Member

    more from the college. Seems they have swallowed a woke American. They claim they want "to be more inclusive", They talk about "the wider family of foot health occupations", "we think now is therefore the time to welcome the whole foot health community into membership of the College", "it is fitting that we embrace the wider foot and lower limb health community."


    But among the guff they don't mention the real reason "We've overseen a decrease in people wanting to be podiatrists over the years and now we're overseeing FHPs taking podiatry jobs in the NHS". They just about allude to it and we're expected to do our own digging.
    They even forgot to take credit, graciously making it sound like it was all the genius of HEE. Come on credit where its due, it was co-authored by Steve Jamieson CEO and General Secretary, The Royal College of Podiatry.

    Have you ever seen promotion of the podiatry profession? I've had school leavers tell me they were just about press ganged by promoters of dentistry and physiotherapy at careers fares while no one was there representing podiatry. I've personally succeeded in encouraging 2 patients and one relative to train to be podiatrists and they're very happy I did. None of them had seen any promotion of podiatry as a career during their school leaving period and that is where they need to see it, when they expect to put 3 years in at Uni and don't have prior commitments. Neglecting that and trying to sell it to mature people with commitments is a whole harder game. Again I believe all the college focus is on being a union, not promoting the profession.

    From the Standards for the Foot Health Workforce (hee.nhs.uk) it is clear as a bell that having failed to promote podiatry, this whole thing is a way to get FHPs into the NHS.
    Damn just yesterday I said this "CPD will not turn any FHP into a podiatrist, if it did why isn't that a route into the profession?" and today I see thats exactly what they have in mind.
    And then get a job in the NHS presumably while continuing to offer a private podiatry'esque service with the advert including that they are a member of the royal college of podiatry and works as part of the NHS footcare family. False confidence inspiring it will be.
    I know one FHP who presumably had a glimpse of what she didn't know and went on to qualify as a podiatrist but its a rare path. As students even in the third year we weren't allowed to treat people privately. This route seems to allow for people to treat privately from the beginning and then do as much or as little progression as they like while having all the legitimacy it affords. A clearly disincentivising retrograde step.
    Or do a week of practical training which isn't all clinical and be a FHP, there is no number of hours specified in the standards. OK when working in the NHS you can control what they do. What about outside NHS time, it won't be attractive to tell a FHP "come and work for the NHS but then you can't do any private work". Of course they will still offer a full podiatry service but now with added legitimacy. OK maybe they will work with some more knowledge of what they should pass on but will they? Who can say.

    Reading through the "standards for foot health workforce" reinforcing what a FHP scope of practice should be seems positive but this is only for the few who are enticed to work for the very minimum wage offered by the low grade in the NHS (seriously why would they?). In reality they won't give up whatever work they come across privately and all that will have happened is the NHS expectation of a cheap footcare workforce being reinforced and more ability for private FHPs (which will always be the vast majority) with far less training than a podiatrist to look much more like one by joining the college. It will also make a podiatry degree less appealing in comparison. Why bother when you can do a quick FHP course, join the college of podiatry and start up privately with an option of NHS work if desired.

    Ultimately this comes down to an ongoing failure of the college of podiatry. Rather than grasping the nettle decades ago and pulling out of the NHS as dentists did, when NHS podiatry offered no more than 50% of what a podiatrist should do and even what it did offer was so reduced in frequency thousands started getting chronic ulcers and amputations, instead of coming out at that point and developing podiatry into a respected profession outside of a broken NHS it has come to this. Fast tracked footcarers because NHS management don't give a s*** who does it as long as someone is there looking like a podiatrist. The current outcomes are so dire maybe they think it couldn't get worse. Thats how under sold podiatry is.

    So over the years the college failed to promote podiatry, failed to maintain it as a complete profession in the NHS, failed to take any action over its degradation (oh there was one short strike over pensions while the profession burned around them), and now it is welcoming FHPs to fill the void created by their negligence. I can imagine why. Many senior NHS podiatrists see themselves as above routine care, not seeming to realise that is where our value to people truly lies. Prevention being better than cure. They will be happy for FHPs to come in and poorly manage the pre-ulceration stages of peoples road to foot disaster. They've been fobbing people off onto Age Concern for years after all, it speaks volumes. Meanwhile they can go to international conferences about wound management with third world colleagues (who at least have an excuse) and feel cutting edge and important.

    I remember one particular patient who presented with a neuropathic ulcer. She'd first gone to her practice nurse who had assured the patient it was a VP and that she should put bazooka on it. After a month or 2 of bazookering that ulcer she went back and some genius realised it was a hole not a growth and they referred her to NHS podiatry. Hearing nothing for weeks she came to me privately. When it was nearly healed NHS podiatry phoned her, I'm told they were aghast that she was seeing a private podiatrist, they said "but you have to come to us! We're medical!!". This is the contempt NHS podiatrists tend to have for the private half of the "foot health family".

    I spent a decade in the NHS patching up the result of neglect, passing them back to community NHS podiatry where they would be discharged and 6 months later they re-present with the same ulcer as though thats a surprise. And repeat until the delay in getting back into the system leads to infection and amputation. Privately I am able to provide a gold standard of continuing care with appointments somehow costing a third less than the cost of a patient contact in the NHS. Over the years in private practice I've prevented 100% of my high risk patients having chronic ulceration let alone amputations. A fair number get repeating breakdowns due to issues they have but they know who to call to have it nipped in the bud. Podiatry in the NHS is a disgraceful failure and yet most NHS podiatrists and the college seem to be quite chuffed with themselves about how its going. We should have all come out of the NHS years ago and got back to doing podiatry as we used to all know how it should be done. Instead we have come to this downward spiraling very regrettable mess.
  3. Sharon Smith

    Sharon Smith Member

    Many like myself trained as a FHP and have no interest to fool people or advertise as a podiatrist, I definitely would join .
  4. Catfoot

    Catfoot Well-Known Member

    I'm maybe a bit late to this party but I'll put in my 6penneth anyway.

    I really can't see this flying.

    FHPs are trained to be stand-alone practitioners. This is how they are promoted. The idea of clinical autonomy, freedom to work as much or as little as they like. They are told they can earn £30 for a half hours treatment or £60 an hour doing 4 x 15 mins nail cuts @£15.00 each.

    NHS salaries won't match these.

    I just can't see them wanting the rigid structure of NHS work with the mountain of paperwork created by all the Trust's procedures and protocols as well as being answerable to a Podiatrist.

    Just MHO
  5. jabr

    jabr Active Member

    I agree as far as existing FHPs go, they would know it would be insane to work for the NHS. But I expect the plan is to train new ones, have a fast track route for cheap workers to replace "over qualified for what we think they do" podiatrists. A lot of people are inclined to think a steady job with sick pay, holiday pay and a pension arranged for them is somehow better than making 5x-6x more £ per hour privately while being autonomous and not having a boss. Clown world. But people will fall for it. I can do a 1 day working week and have a 6 day weekend and earn what an NHS podiatrist earns for a 5 day week. So I can do a 2 day week and that takes care of pension/sick/holiday difference. Or do a 5 day week and have a really decent income.

    NHS pods who think they are doing good by staying there despite the massive loss of potential earnings are missing the point that patients are suffering from insufficient care due to thinking they are getting all the care they need because they are "under the NHS". Then they get ulcers/amputations and just assume its due to diabetes not neglect. Now to top it off the NHS pods who have allowed the NHS to keep claiming they offer podiatry are about to downgrade the profession with fast-tracked unqualified podiatrists. Its time for all pods to leave the NHS and do podiatry as we were trained to not just to a level that NHS accountants think they can get away with.

    But Steve Jamieson leading the royal college of podiatry... is a nurse. Nurses won't think outside the NHS box. From his Linkedin "“As well as being an expert in sexual health nursing, Steve is at the top of the game in the nursing industry in the UK – leading the RCN's Nursing Department, working across all nursing fields to strategically deliver the college's wide-ranging objectives." How can this man be trusted to lead podiatry in the right direction? And the council of actual podiatrists are nearly all NHS lifers who must be definition be blind to the solid reasons for podiatry to leave the NHS. No podiatrist should be working in the NHS (apart from the few doing neglect patch up working for endocrinology until podiatrists can actually start preventing ulcers again in private practice) and private podiatrists should leave the NHS focused college of podiatry before they lead the profession into a blind alley.
  6. Catfoot

    Catfoot Well-Known Member

    I agree with a lot of what you say.

    Now I know that Jamieson is a nurse that explains a lot.....

    NHS Podiatry is cr*p - I'm glad I got out years ago.
  7. Sharon Smith

    Sharon Smith Member

    Catfoot I totally agree with what you say and as self employed and working mainly for private sector within care homes this suits me just fine .
  8. jabr

    jabr Active Member

    Most care homes who employ FHPs are committing fraud. They are all (in as far as i've never seen one that isn't) charging the relatives for the care of a podiatrist.

    The homes object to paying over £15 on average even though the resident would be not be able to get it for that outside the home. I did wonder what the relatives are charged but I think its mostly through the system so unlikely to be the staff keeping the difference but why do they penny pinch so much with someone else's money. The relatives wouldn't expect to pay half the price that the person was paying before they went into the home. The fallout from poor care lands on the home so it would be in their interest to get the best for their residents. Needs a cultural shift that one.

    I've managed to get £30 and £35 per resident from a few homes as i wouldn't do it for less or half a job and they must have had no other option so accepted. But I've had a few call-ins where the regular "shuropodist" has neglected the feet and there are ulcers. One where the resident had been paying for monthly care but as the resident had thick nails and the FHP didn't know how to do anything substantial to them she just filed them a bit until one day the resident bumped something and the horn of nail was ripped off. The care home still kept using that FHP as they were cheap and kept charging for a podiatrist as that was on their residents contract of care. I told the manager it was fraud and dangerous for the residents but they didn't care, probably felt loyal to the friendly FHP. Thats what you get when your relative is with a provider running over 250 care homes across the country.
  9. David Tollafield

    David Tollafield Welcome New Poster

    I can certainly see why some might be suspicious of the new RCP arrangements proposed. I decided to try and take a step back and wrote an article "Mind the Gap!" It may not make everyone satisfied but it is a perspective. I suspect decisions made in Council have not been taken lightly or quite as cynically as suggested. My understanding is a survey will help to make decisions and this was an impression I was given when attending the webinar. With a membership of around 10K it is not always easy to achieve universal agreement and this is why members vote to elect the best voices to represent out views.

    Whatever camp one sits in, everyone has a view, but those who feel most vulnerable will naturally be more critical. The SAKS report (also published on ConsultingFootPain website in November) was interesting and for the most part reflective in regard to the many weaknesses perceived in the way the profession of podiatry has been running. This is open debate season and it is healthy that we are at last realising the damage that have dual titles creates.

    Attached Files:

  10. fishpod

    fishpod Well-Known Member

    Thank god i retire soon these new arrangements wont attract doctors or surgeons or nurses just more income bigger pension lower retirement age for the likes of london centric Mr Jamieson and his mates. Its all about the money members are just the daft donors just like trade union members whose leaders have salaries larger than the prime minister grace and favour london residencies. Might as well be an american evangelical church just keep sending the cash suckers.

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