Should the NHS do routine nail cutting?

I work in the NHS and in private practice, the issue of routine nail cutting is not black and white.
Routine nail cutting should be available on the NHS if it falls into the following criteria
1. The nail care you provide will prevent/reduce risk of ulceration/infection (if patient at risk)
2. The patients nail conditions increase the risk of ulceration/infection (if patient at risk)

In my experience I have found some NHS pods think nail cutting is beneath them and find that to be a terrible attitude to take.
However the NHS is backlogged with patients who have been coming for years to "get their nails done" who have no clinical or medical need. It brings up the issue of "cut and come again Chiropody" which just cant be justified on the NHS.

This I feel will always be a thorny issue, and people do get quite jobsworth about what they do and start flashing titles to show their self importance.

What is in the best interest of your patient?

Dare i say more clinical assistants to meet the demand of social nail care and less podiatrists?

 

Rosspod,
You are free to say :-

if you can face being boiled in oil by all those new graduates who can't get jobs ...........

Catfoot

 

Ah the truth hurts Catfoot

 

Its not a simple debate :-/

The fact is, the NHS has finite resources. We can't do everything for everyone. I'd like nothing more than to offer a nail care service to everyone. Sadly, thats igs:. If you have one podiatrist contact to offer and have to choose between a nail cut, a 25 year old with heel pain and a Rheumatoid with massive plantar callus, you simply have to go with the one which is most likely to go runny if you don't do it.

That said, if a magic wand was waved and our budget was tripled, we'd be faced with another problem.

In the blue corner we have people who think

And we've all seen perfectly non pathological nails become patholgical because somebody clueless has made a pigs **** of cutting them.

But then you have people who think

And thats a problem I have as an employer of podiatrists. They all want "specialist work" as soon as they hit the clinic and look askance at "cut and come again" as beneath them. Which is a shame because I find that the standard of that side of the work has decreased in the last 10 years. Those oil boiling graduates who don't want anyone else to cut nails tend also to complain long and bitterely if you ask THEM to do it.

It comes back to the schizophrenic thing we have going on as a profession. We want to be the "experts" and be lauded as such and consider nail care as beneath us. But at the same time we will fight to the death to prevent technicians or anyone else doing them. As a profession, we need to make our minds up because we can't have it both ways.

For myself, I think we need to get over ourselves. There is absolutly no shame in doing "technical" work. Cut and come again podiatry probably does more good to patients (in terms of pain reduced in number of patients) than all the specialisms combined!

But the NHS? It will simply never get the funding for it.

 

Agree with all of that especially

.

Isn't it time the profession came out of the NHS completely and organised the foot health market properly? The dental profession managed it and the profession has moved on considerably. One of the primary problems the NHS has is that over the years, with the focus on cost of interventions - is that the patient is regarded as a liability (and often treated accordingly) whilst in PP the patient is very much an asset (and ususally treated accordingly). Factor in a profession-orientated insurance scheme and set up a new professional body with a dedicated practice faculty and you'll go much of the way to elevating the profession along side our dental colleagues once more.

 

Attendance allowance is not automatic therefore the majority if over 65's do not recieve it unless they have assessed as needing assistance with everyday tasks.

I do cut nails and reduce callus within the nhs and will continue to do so. I do think that the delegation of nail care to Footcare Assistants is a great thing. I only keep on people with a medical need or inability to self care and in doing so have my time freed up to concentrate on more specialised tasks but to me the nhs is there to help everyone who needs it. I think the word need is the issue if the person has no medical condition or pathological need then they should self manage.