Foot ulcers and amputations can lead to morbidity and disability and are an emotional and physical burden for people with diabetes. Early recognition and management of independent risk factors for ulcers and amputations can prevent or delay the onset of adverse outcomes. All individuals with diabetes should receive an annual foot examination to identify their risk stratification and appropriate referral to specialists if required. In addition, all patients should be educated regarding foot care, the importance of the annual foot screen and its findings along with the management they may require. The Model of Care for the Diabetic Foot (HSE, 2011) provides guidance on foot care within an Irish context. You can read below to see how these guidelines are applied in Community Healthcare East (CHE).
Information on where foot care is provided in CHE as per the national model of foot care for the diabetic foot.
We have 4 senior diabetes podiatrists. Three are hospital-based and one is community-based.
Anita Murray, St. Columcille's and St. Vincent's University Hospitals
Anita has worked within the Foot Protection Services for the past 11 years. After training in the University of Brighton she joined the Diabetes wound Care team in the Queen Elizabeth Hospital, London. From there she led an Integrated Long Term Conditions team of Podiatrists and District Nurses in Oxleas Foundation Trust, Greenwich. She was responsible for staff and student development programmes.
Upon returning from the UK in 2016 her role has been to develop, as part of an integrated team, the Foot Protection Services in St. Columcille’s and the surrounding area tailoring the National Model to the local population needs. Through working together closely with St. Vincent’s Clinical Specialist Edel Kelleher, the Endocrinologists, Community Diabetes Nurse Specialists, Physiotherapists, Dieticians, GP’s and Public Health nurses and through listening to our patients the overall foot services throughout the area have been enhanced – ‘who’s responsible for the diabetic foot – we all are’.
Anna Doherty, Community Diabetes Podiatrist Wicklow Area
Edel Kelleher, St. Vincent's University Hospital
Veronica Smith, St. Vincent's University Hospital
Service Pathways and Referrals
Service Development Projects
2) Improving Ulcer Preventative Offloading Care for the At-Risk Diabetic Foot – an integrated approach (placed 3rd in the Quality, Clinical Risk and Patient Safety Conference 2017 and shortlisted for HSE Excellence Award)
Education and Training Tools
HSE Chiropody Card Eligibility Criteria
Throughout CHE there are some variations in HSE chiropody card eligibility criteria for people diagnosed with diabetes. In Wicklow and Clonskeagh all people holding a full valid medical card with a diagnosis of diabetes are eligible to apply for a HSE chiropody card. The Long Term Illness (LTI) and GP Visit Cards do not qualify. In Dun Laoghaire, all people with a diagnosis of diabetes are eligible to apply for a HSE chiropody card.
All Chiropody forms must be signed by a medical professional