Delays in getting to specialist care for people with diabetes and foot problems. What are the delays and how can we reduce them? A Position Statement from the ZAP Amputation group of FDUK (22 December 2023)

Summary

A crucial barrier to effective diabetic foot care is the delay in accessing specialist care. Delays can take place in three situations:

1. Delay by the person with diabetes in seeking care. A lack of knowledge in the person with diabetes can lead to a lack of urgency in seeking help from a healthcare professional.
2. Delay by healthcare professionals in referring to specialist care. When a person with a foot problem seeks advice, there is sometimes a delay due to failure of a healthcare professional to make a diagnosis .
3. Delay in accessing care related to the multidisciplinary diabetic foot team.

Content

Referrals from primary and community care to the multidisciplinary foot team are difficult if it meets infrequently or does not exist and that is the situation in some Hospital Trusts in the UK. Four recommendations to reduce delays are put forward:

• Formation of a credible multidisciplinary diabetic foot team.
• Organisation of efficient referral pathways.
• Establishment an advanced/consultant podiatrist role.
• Utilisation of the ACT NOW acronym as a triage tool to highlight warning signs leading to amputation.