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Hi, I'm new to the site

Discussion in 'Introductions' started by carolh, Jan 21, 2009.

  1. carolh

    carolh Member

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    Hi, I'm new to the site and work in Norfolk. I am a retired district nurse with many years experiance, I am still registered with the NMC and keep up the study required to retain registration. I work as a FHP and am a safe pratitioner in that I know my limitaions and when to refer on. I really value this type of site as it offers discusions on clinical issues. I am aware that FHPs are not always well received and I understand why but feel that the service I give to uncomplicated clients is both safe and valued and frees those more qualified to care for those with more complicated conditions.
  2. twirly

    twirly Well-Known Member

    Hi Carol,

    :welcome: to Podiatry Arena.

    May I enquire what generated your interest in the field of foot care following your retirement?


  3. carolh

    carolh Member

    the reason I became interested in foot health was because I have spent the last 22 years caring for patients with lower limb problems, who were housebound, more than often they needed foot care too which we were not allowed to do and I frequently couldn't find anyone to help. The local DN team now refer to me and I refer on if the patient has a problem that I can't cope with. Our NHS services are pretty sparse but I do know the NHS team and they will take my referrals. I have trained for years to look after people at home and now have the priviledge of carrying on that work at a pace that I can dictate, to a standard that I set instead of being asked to cut corners by an increasingly overstretched community NHS team.
    Why do you ask?
  4. twirly

    twirly Well-Known Member

    Hello again Carol,

    No ulterior motive I assure you.

    My enquiry lies in understanding why a professional nurse who has attained knowledge & many years experience in their professional field of expertise would choose not to complete the podiatry degree as opposed any other recognised qualification.

    Kind regards,

  5. carolh

    carolh Member

    Hi, Interesting question! I would if it were possible. I live in North Norfolk the nearest places offering a degree are Northampton (2 1/2 hr journey) and London
    (3hrs), these are full time courses and would cost a fortune, I'm 53 have already done a MSc at Leicester which was almost impossible because of the distance and that was part time over 4yrs. Had I been given the chance to take early retirement 10yrs ago it would have been different, but the logistics are just not possible.

    It's also an interesting question because I have explored the possibilities and my motives on many occasions. Having done masses of study in the past to be clinical lead for a team of almost 100 community nurses to know so little is frustrating. However, I console myself in knowing that I know loads more than some FHPs, having studied such things as diabetes, lower leg management, wound care etc at level 3 but more importantly I know what I don't know and refer anything on that I feel is needed.

    I am delighted to find a site like this where I can glean more insight into the world of podiatry and learn from the discussions. I miss the peer support of bouncing ideas and problems and hope that you will all be tolerant of the fact that I am the equivalent of a nursing assistant working in a world of qualified nurses definately NOT passing myself off as a podiatrist but delivering basic care that is safe for the patients I see.

    Thanks for your interest
    Best wishes
  6. Dido

    Dido Active Member

    FHPs referring to AHPs

    Hello Carol,
    I have just read your post and was interested in what you say about being a safe practitioner and referring on to others as necessary.
    Can you tell me what you were taught, as an FHP, about referring on and what conditions were considered outside your scope of practice?
    There is a two-fold reason for my asking this question.
    Firstly, I am unable to find any information as to the Scope of Practice of an FHP (unlike Chiropody/Podiatry which has nationally set standards by the HPC, which are in the public domain and can be accessed on-line from www.hpc-uk.org )
    Secondly, since FHPs came into being I have only ever had one referral from one. This is despite the fact that I am the only Chiropodist in the area that can provide nail surgery.
    Maybe you can shed some light on this?
    Last edited: May 16, 2009
  7. carolh

    carolh Member

    Hi Dido, Unfortunately I was taught very little about referring on during my FHP training and as far as I know there is nothing like scope of practice published anywhere for FHP's. I am aware of my limited capabilites and do refer to qualified and registered pods all the time. I am very aware of scope of practice and professional accountability. I am a qualified nurse, district nurse and nurse prescriber and am still registered with our governing body the NMC so have that philosophy and requirement. Maybe I am being naive in thinking that if an FHP does not have the training and capability to help someone they would then suggest a qualified pod or ref in to the NHS, having worked with the NHS pods I have a good relationship and they are happy to take my referral.

    I am fully aware of the frustrations of podiatrists when faced with an FHP who knows very little and appears to have no regulatory requirements it is something that nurses also have to try and come to terms with. I am fortunate in my background but also in the links I have with both qualified pods in private practice and the NHS.

    Regards Carol
  8. Julian Head

    Julian Head Active Member

    Hi Carol - and welcome!

    I must confess I struggle with the concept and reality of FHPs. I am sure you are aware that many of us consider FHP was a way around HPC new laws and the HPC grandparenting system. Many previously State Registered Chirops/Pods voted for grandparenting assessment standards to be equal to our final year exams - the arguement being that if you took them and passed then what is the difference - you are as good? Instead only a few essays were demanded and a brief clinical assessment on a few individuals chosen at random (certainly not the 1000 hours of clinical training we had to complete at undergraduate level).

    With FHPs there is no nationally recognised framework for training and assessment that I know of no body that maintains standards from school to school or year to year. There appears to be no national training syllabus or limitation of scope of practice apart from the lack of access to POMs and people willing to train them....am I correct in this assumption? Is this changing? Is there a body you as FHPs can influence to undertake this to improve your status?

    I would love to see inclusive regulation of all levels of health care providers (which would include FHPs) to maintain standards of care and safety for the public. Sadly, I feel FHPs (not you specifically but many of those I have come across) seem to think they are trained to same standards as Podiatrists and see our questioning of their training and skills as predatory and with ulterior motives.

    This really concerns me, any practitioner "worth their salt" should welcome being questioned as this is key to maintaining standards and motivates many to undertake CPD which they would otherwise not bother with. We should all be on a learning curve and aiming to improve continuously. We are all "only as good as our last patient".

    I look forward to hearing your thoughts


  9. carolh

    carolh Member

    Hi Julian, I agree with you. the schools do not have a standard syllabus and each feels as though their course is the best.

    I know little about the grandparenting process but it seems clear that someone undertaking a BSc with the rquired clinical hrs has a superior qualification to those who have not.

    I definately do not think I am on a par with a podiatrist and feel concerned that an FHP should.

    I feel that there should be a way of regulating all health professionals but have idea how to go about it. The HPC was not helpful when I spoke to them.

    CPD is very important and something I struggle with, my registration requires me to undertake a certain amount of study per year but I am finding it very difficult to find relevant study sessions where I am welcome.

    I understand your and others frustrations and would welcome the opprtunity to register and receive the support of a relevant body.

    I would be interested to hear others views on how this could be acheived.

  10. Dido

    Dido Active Member

    Hello Carol,
    My question is very simple and would apply to all FHPs, not just yourself.
    If you do not know what your scope of practice is, as an FHP, then how do you know if you have gone beyond it?

    If you look at an example of an FHP's website that I posted on another thread you will see why I ask this question.

    As for registration, or more correctly, regulation, I am sure you were aware that the FHP qualification would never lead to regulation under Statute, but chose to take the course regardless. I do not know what your CPD requirements are, but I would have thought that your training body would provide suitable seminars/trainiing days etc. ?
    Last edited: May 17, 2009
  11. carolh

    carolh Member

    H Dido, I am very clear on my scope of practice as my registration with the NMC explains it very clearly, I don't know how unregstered FHPs know when and if they have gone beyond it!
    Cheers Carol
  12. Dido

    Dido Active Member

    Hello Carol,
    I have no doubt whatsoever you are clear on your nursing scope of practice!
    However, if you are practicing as an FHP then surely you are performing techniques that are not covered by your nursing insurance, such as scalpel work?
    How then do you know whether or not you have exceeded your FHP's scope of practice if you are not sure what it is?
  13. cornmerchant

    cornmerchant Well-Known Member

    Hi Carol

    It seems to me from the tone of your posts that you do not hold fellow FHPs in very high esteem if they have not had a medical background. You know how we as fully paid up pods feel then!
    While I can see exactly where you are coming from , is a little bit of knowledge a dangerous thing? Do you have the perception that you have safe practice because of your nursing background? Does that mean you would perhaps do more than say one of your non-medical FHP peers? And if so, is that in your remit? Or does that put you into a whole new category?
    So many questions I know, but it is an interesting situation, and I can see how you must feel between a rock and a hard place especially when you have a good career record behind you.

    I am glad to hear that you refer on to pods when the need arises. I cannot advise on CPD other than through your own professional body, in my experience mixed seminars do not work.

    I wish you well in your career and hope that it is as lucrative as you hoped when you gave up an established income with the NHS.

  14. Dido

    Dido Active Member

    Hello again Carol,
    Cornmarket has some interestings questions about scope of practice, which I would also like to have answered. It seems that this is a area that even FHPs themselves are unclear about!
    I am always puzzled by the insurance aspect of hybrid practitioners such as yourself.
    In the unlikely event of a claim how would you know which insurer to refer the claim to?
    I hope you will be able to clarify what seems to be a bit of a grey area to me.
    Last edited: May 18, 2009
  15. Soux

    Soux Member

    Hi everyone.
    I have come across a foot care assistant in private practice who is studying for a degree in psychology & was trained to give foot care by a retail manager. This FCA feels that she can give advice & make Otoform props to patients. Is this right?
  16. Dido

    Dido Active Member

    Hi Soux,
    The short answer to you question is - No, it's not right IMO but providing she is not calling herself a chiropodist or a podiatrist then it is probably legal.
    I wonder if she has any insurance and if so from whom?
  17. Soux

    Soux Member

    Hi Dido,
    I'm sure she doesn't as she is a part time worker, just filling in her time whilst studying but the company seem to like this.
    I feel it is very depressing as we did 3 years of such in depth studying and continual studies, then to see someone treat one of your treatment regimes like play doh!
    Very disrespectful!
  18. Dido

    Dido Active Member

    Hi Soux,
    I couldn't agree more, but as long as we have Protection of Title and not function this will continue to happen.
    Examples like this make a nonsense of HPC regulation as the public are not being protected. This person is being is being very reckless if she has no insurance and I bet you, her employer would drop her like a hot potato if there was a claim.
    You could try a call to the the Local Trading Standards Department, to see if they would investigate?

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