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.
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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!
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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.-
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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. -
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 ? -
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! -
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 !!! -
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! -
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 -
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!!!
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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!
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Mark, I understand where you are coming from. The Patients are not protected either!
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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?? -
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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-
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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). -
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-
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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.
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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 ...
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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 -
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Well this is amazing but many are still confused between podiatrist or chiropodist
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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. -
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.-
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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.
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