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Discussion in 'United Kingdom' started by sister, Jan 22, 2010.

  1. sister

    sister Active Member


    Members do not see these Ads. Sign Up.
    Please take the time to read this reply that isent to an earlier question as I would appreciate the feedback.

    Thank you all so much for taking the time to reply to my question, in response to your advice I have spent a lot of time reading the threads on this site [ and regrettably looking at another site ] and would like to make the following points;-
    The degree option for people like me i.e. - age, location, time available etc is not, unfortunately, always the best option- by the time I qualified it would nearly be time to retire!
    I live in a VERY rural part of the country, chiropodists are available but if you live within one of the many small villages that have no access to public transport then relying on volunteer drivers is difficult and taxi charges on top of treatment costs prohibitively expensive.
    I would love to do a shorter - nationally recognised qualification in foot care that would be acceptable to chiropodists /podiatrists and would open NHS and PP doors for me as an assistant- but there isn’t anything like that available.

    ‘SO WHY NOT START ONE?’

    Couldn’t you, after consultation with all parties concerned, design an appropriate course that laid out the minimum standards that students had to fulfil to qualify?
    All the issues that cause concern could be addressed, the professionals would know exactly what standard carers would be qualified to, FHPs would have the option to be included [With top up training as required] and all training schools would either have to meet the criteria or bow out.
    If a new job description was picked e.g;- ‘Chiropody Technician’ then it could be protected and you would have to be registered to use it.
    As a former nurse I totally agree in accountability and having professional qualifications- but if there is nothing between two days on an NVQ nail technicians course and a podiatry degree where do I go?
    Nurse practitioners work unsupervised and gain extended role certification through clinical assessments and written exams, if this example was used as a role model it would negate the word ‘assistant’ which would allow people to retain their own practice.

    If confusion arises in the public mind as to which organisations are professionals, what qualifications mean etc then I would suggest a ‘full on’ advertising campaign by your professional bodies.

    I am a middle aged woman with many skills to offer looking for a health related occupation – but until a suitable course is available I will just have to see if Tesco need anyone on the checkout.

    Again thank you to the people who took the time to reply to me and to anyone else reading this – please consider the points I have raised.
    Sister
     
  2. cornmerchant

    cornmerchant Well-Known Member

    Sister
    Why not come out of the closet and declare your interest?

    Cornmerchant
     
  3. sister

    sister Active Member

    I am called Trudi and I had registered under a pseudonym as reading forums on another site that was supposedly for professionals and considering the vitriolic comments that were available to be read by the general public, did not want to subject myself to abuse. Thought I could get sensible replies on this site, also thought I had made some valid points but apologise for apparently wasting your time.
    By the way I have no affiliation to any school/ training college it was a genuine point of view, and speaking of closets, WHO ARE YOU?
     
  4. cornmerchant

    cornmerchant Well-Known Member

    Trudi

    Thank you for your honesty, I have obviously mistaken your naivety for something more contrived. I really do think you need to read a little more around the controversial subject of FHPs in the UK. As a professional yourself, you will appreciate the regulations which govern us- the FHP sector works outwith those regulations and therefore practise undeterred whether they are competant or not.
    In my opinion , there is not a need for further dilution of the profession with yet another level of foot providers as you suggest. Pods in private practise are more than happy to work with all foot conditions including palliative care.

    Once again, I apologise for any offence caused, and for my own reasons prefer to post anonymously.

    Cornmerchant
     
  5. sister

    sister Active Member

    Cornmechant- apology accepted.
     
  6. Dido

    Dido Active Member

    Hello again sister,
    I don't wish to rain on your parade but please consider the following -

    In the Uk at the moment we have, in the regulated sector:-

    numerous orthopaedic surgeons

    13 universities training chiropodists (who can go into private or public sector)

    podiatric surgeons

    physiotherapists who deal with some foot problems

    a Society of Chiropodists & Podiatrists approved course for Chiropody assistants.

    in the unregulated sector :-

    sports therapists

    massage therapists

    5 (that i know of) private training schools producing FHPs

    the British Yoga Society running a "non-surgical footcare course"

    commercial organisations running 'nail-cutting services' for the elderly using lay people

    beauty salons doing pedicures

    retired district nurses going about providing nail-cutting for the old dears in the village for £5.00 a pop

    So why in the name of sweet reason do we need yet another course about feet ?!

    Dido
     
  7. sister

    sister Active Member

    Dido, I again appreciate your comments,
    Why do you need another course?
    To me, as a totally un- involved outsider, when there are so many people in the unregulated sector practising a great range of foot therapies, then the answer is -regulate them! BUT you need a mechanism to do this.
    With all of the professions you listed there are good and bad training institutions. It just seemed to me, if you want to protect the public and educate them as to the differences in standard of care- then podiatrists should be involved in raising the standards.
    Sorry - I'll shut up now!
    thanks again Dido
    siser
     
  8. Dido

    Dido Active Member

    Hello again sister,
    You said
    We have a mechanism and it's called the Health Professions Council which is the government regulator.

    And they have no plans to regulate any of the unregulated footcare groups in the future. At the moment they are involved with regulating aspirant groups such as practising psychologists and sports therapists. The process could take at least a year, if not longer.
    Even if regulation was brought in for the different unregulated footcare providers and a new protected title created it would be a waste of time. The private trainers would just think of another title and keep on training as they have a finacial interest in doing so.
    We already have posters on this site who are extolling the benefits and the freedom of non-regulation, who would not agree with your ethos.

    I don't understand what you mean when you say
    perhaps you could enlighten me ?

    Dido
     
  9. sister

    sister Active Member

    Hi Dido
    Thats why i suggested a new qualification, somewhere inbetween, that is acheivable, and if podiatrists were involved in setting the format then surely the level of training that is given would have to rise.
    The more reputable schools/ training establishments -[if included in discussions on the format]- then could adjust their syllabus accordingly, which would mean no loss of income to them.

    Sorry this has probably all been said before by others, I also apologise if i have offended you .
    This is a minefield isn't it?
    Again thank you Dido
     
  10. George Brandy

    George Brandy Active Member

    Sister/Trudie

    It seems you bring a knowledgeable voice to the Podiatry Arena Forum?

    I agree with you.

    Nurse Practitioners work unsupervised.

    They also have a 1st degree and more probably they now have advanced study such as an MSc perhaps researching their area of special skill. We already have this situation with Podiatrists who have a 1st degree, who have then continued to MSc level and have specialised in an area of Podiatric medicine in which they have excelled. They may then use the title "Advanced Podiatry Practitioner...."

    So I don't follow your reasoning that using this example as a role model would negate the word "assistant" and allow people to retain their own practice?

    Nurses are permitted to use the title Nurse Practitioner or Advanced Nurse Practitioner as they have advanced their skills by a recognised educational pathway which also includes practical skills. They are rigerously regulated, which is much more effective than the HPC.

    Your plan seems to offer a desire to beef up the Foot Health Practitioners course and make it a recognised qualification betwixt and between the Podiatrist and FHP, yet with a title reserved for those with skills beyond the BSc qualification. I do not understand your desire for regulation. This does not offer you an advantage, it is there to allegedly protect the public. It does not improve your ability to trade in the free market, it actually makes it harder.

    So Sister what is the point you are making and why?

    GB
     
  11. sister

    sister Active Member

    Hi George,
    I qualified in the days when most nurses were SRN or RGN very few had degrees, we had to do in- house training or apply for external courses to extend our role. The ridiculous thing was unlike CPD today if you 'did too many' you were known as a 'course hopper!'
    Considering doing an FHP course was what put me on this path, and reading the comments on various sites made me realise what a diversity of choice was available, and that the major concerns of podiatrists was lack of regulation.
    'Beefing up FHP courses' - I was trying to suggest a course of action that was beneficial to all.
    Will bow out gracefully.
    Trudi
     
  12. George Brandy

    George Brandy Active Member

    Why bow out?

    The whole point about engaging with Podiatry Arena is to access an international diverse pot of knowledge - to add to it and to take from it. It is a forum for debate. Sometimes you are successful in debate and sometimes you are not.

    I think your suggestions are naive or ill informed. I am not necessarily right; bowing out at this stage indicates defeat or have you established what you wanted to know?

    So what do you know about Skills for Health?

    GB
     
  13. Dido

    Dido Active Member

    Hello sister,
    No, you haven't offended me but I think some of your ideas are a bit naiive, and I mean that nicely.

    You say about this proposed new course -
    Chiropodists/Podiatrists are already involved in training in the unregulated sector and they still produce practitioners with very minimal qualifications.

    You also said -
    Now why would they want to do that? What's in it for them? When they can make money by using the format they have, why go to the time and trouble of upgrading as there is no monetary advantage to them? In addition they would then have to be regulated trainers and this would not suit them as they are quite happy with the in-house situation that they have.
    I can sort-of see where you are coming from, but as George Brandy says there would be no advantage in the market place which is already overcrowded, despite what the private trainers would have us believe.

    And yes, you have just stepped into a minefield !

    Dido
     
    Last edited: Jan 24, 2010
  14. sister

    sister Active Member

    Hi George and Dido
    Bowing out /admitting defeat!

    Skills for health - good if i was looking at being an assitant, job spec etc great.

    Started out on this path as wanted to work for myself, 22 miles to nearest hospital -so BIG chunk of wages just getting there, and had this daft idea i could cut toenails! It was part of my introductary nurse training and the most important thing we were told was to be very careful if the patient was diabetic! So you can see why I thought a course was a good idea.

    Personally i would always recommend people to get a specialist opinion if i saw something to concern me.

    I think thats all i can say apart from I am surrounded by villages /all of my family live in villages and we have never seen an advert up from a podiatrist in the village hall/corner shop offering a toe nail cutting clinic once a week , which was my basic idea.

    I do thank you all for your comments, Well the nice ones anyway!
    sister
     
  15. Dido

    Dido Active Member

    Hello sister,
    You said

    So ask yourself why it has not been done? :confused:

    Could it be that it is not commercially viable?.


    Dido
     
  16. sister

    sister Active Member

    Hi dido,
    Checked y.pages. One podiatrist approx 8 miles one direction Two in approx 13 miles in other, one Fhp 3 miles in a third direction. That leaves a lot of villages uncovered or not financially viable to some professionals. So surely it is better to have people out there, with a sound basic knowledge, who can not just cut toenails but also refer on to a professional colleage?
    Seen Quite a few foot infections/ gangrene in my time because old country folks 'didn't want to be a bother'
    That is before you even start on the financial implications to someone who has spent their lives working for minimal wages on a farm because their tied cottage is classed as part of their salary. [Seperate political issue]
    Sorry Dido but I did say very rural, so I know from previous work life and work experience that a call out fee to professionals such as yourselves that may seem very reasonable, is a major consideration to some. [ Round here for example;- a plumber won't even get in their van for less than £65] When you are faced with those sort of prices it would make many reluctant to pick up a phone for what they see as a minor problem.

    Sister
     
  17. Dido

    Dido Active Member

    Hello sister,
    Whilst I applaud your desire to help those who appear disadvantaged, I do feel you are being incredably naiive.

    You can't base a career change + new business start-up on the fact that some villages don't appear to have a foot care service. The distances you quote are minimal for those used to living in a rural area. I also live in a rueal area and those outside the towns have to travel much further to access even basic services.

    How do you know that there isn't anyone already working in the area? Some FHPs work "below the radar" as it were, using a mobile 'phone, don't give receipts and don't advertise. One can only speculate as to the reason for this desire for anonimity and the state of their tax affairs. This is why they engender such hostility from some pods.

    I would suggest you draw up a business plan (Alliance & Leicester used to have one on their website that you can use) and thoroughly research the available market to find out your costings and how long it will take you to get a return on your initial investment. A good rule of thumb is to say that you will get one full day's work a week for every year of trading. So it will take you about 5 years to be F/T.

    You said :-

    So aren't you going to be a "professional" then ? !

    So you think you can do it cheaper?

    OK - if you are going to be "professional", you will find that your costings will be pretty much the same with regard to stock, medicaments, maintainace of autoclave, uniforms/stationary, liability insurance, vehicle maintainance/insurance, accountancy as the pods 8/13 miles away. Your fuel costs will be comparable to the FHP 3 miles away if you only want to operate within say 5 mile radius.

    So why not have a chat with these practitioners in the area and find out how the land lies? You'll have to speak to the pods sometime to make sure they will take your referrals for nail surgery etc. and those patients who have Health Insurances who don't recognise FHPs as health care providers.

    Dido
     
    Last edited: Jan 25, 2010
  18. sister

    sister Active Member

    Hi Dido,
    Thanks for the advice, have done some research on business side of things but your comments were very helpful.
    Looked also at Local council and NHS sites both who are beginning to offer toe nail cutting services in the community but neither states who by.
    The only other group offering this service state that they use fully Qualified volunteers!
    Doesn't this take us back to the minefield?
    Sister
     
  19. cornmerchant

    cornmerchant Well-Known Member

    Sister

    can you enlarge on the " Local council and NHS offering nail cutting services"?

    Cornemerchant
     
  20. Dido

    Dido Active Member

    Hello sister,
    I was just wondering where you are in Lincolnshire as my parents went to retire there.
    Sadly they separated and my dad ended up in Lincoln and my mum in Boston.

    Me I'm a NW girl !

    Dido
     
  21. sister

    sister Active Member

    Hi Dido
    I'm in Nth Lincolnshire, Have you visited Lincoln a lot? We had Dutch friends staying over Xmas so treated them to Steep Hill, which was extra fun with all the snow and ice!
    sister
     
  22. sister

    sister Active Member

    Cornmerchant
    No problem! Google- 'Social toe nail cutting'
    I think you will find more than enough PCT and County council sites[look under social care]
    that offer this service, many of whom mention on their websites Help the Aged trained volunteers.
    Start with my local ones ;- NELCTP and North Lincolnshire council [Fresh Start]
    Thought East Cheshire Nhs Trust amusing;- The way it reads Podiatry on the nhs only available if you have an underlying condition! [foot problem not enough??]
    Knock yourself out
    sister
     
  23. Dido

    Dido Active Member

    Hello again,sister,
    I remember going into Lincoln once with my dad for an concert at the Cathedral. I remember the parking was horrendous (and expensive) and we didn't attempt Steep Hill because of his arthritis.

    But back to the minefield.

    As I said on another thread/post, with the NHS offloading a lot of "low-risk" cases into the charitable sector, and the number of organisations/practitioners of various sorts involved with feet, what makes you think there is a market for simple footcare?

    Dido
     
  24. sister

    sister Active Member

    Hi Dido,
    There obviously is a need but that is a far cry from a market.
    I still think podiatrists Have missed an opportunity to be involved with training [to a national educational standard] and regulating their own assistants [ just stepped on another one didn't I?]
    There was a similar thing in nursing many years ago when they [the powers that be]decided to abolish SENs so when they [tptb] realised there was no one at Grass Root level to practice a high level of nursing care , NVQs started appearing. Needless to say all lot of us at the time felt they were getting someone to fulfil the SEN role on the cheap.
    I bring up this point as a cautionary tale! As the NHS is obviosly going to recommend the Help The Aged route to the public more and more.
    As with fhps are these volunteers going to be regulated or accountable?
    sister
     
    Last edited: Jan 26, 2010
  25. Graham

    Graham RIP

    Here in Canada we have a National Nursing Foot Care Association and most provinces have something similar.

    In Ontario we have NEFCA - Nursing Entripanerial foot care Association.

    Nurses first - Recognised foot care training with established criteria from the College of Nurses and the Nursing Associations.

    This was a nursing initiative. Don't look to Podiatry to do this. You'll have to do it yourself! Just seems to be the way it is!

    Regards
     
  26. Dido

    Dido Active Member

    Hello sister,

    This would never have been a possibility in a profession where there were such diverse training levels.
    Years ago to be Chiropodist there was a choice between a 3 F/T course to become State Registered and a correspondence course. Now the only way to become a Chiropodist/Podiatrist is an University degree, so at least now we have a bench mark for the profession.

    I'm not sure that I would agree that FHPs are either regulated or accountable as the title FHP is not protected and can be used by anyone regardless of training levels. The retired District Nurse that travels around my area cutting old folks toe-nails for a fiver can call herself a "Foot Health Professional" quite legally.

    If people are working as volunteers and there is no contact of employment then I can't see how they would be either regulated or accountable but Age Concern themselves would be better placed to give you the answer.

    Dido
     
  27. sister

    sister Active Member

    Hi Dido,
    Sorry didn't make my point very clear did I?
    When I was referring to fhps i meant that if they are not regulated or accountable by/to a national body, then what is going to happen with volunteers?[Rhetorical question]

    Sister
     
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