REDESIGN OF FOOTCARE SERVICES PROJECT

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REDESIGN OF FOOTCARE SERVICES PROJECT

• Jamie Quin
• CSM Podiatry
• Care home services

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Podiatry service in GG PCT and now in GGC chps

• 2002 had 65000 registered patients
• Had 15000 NPs per year
• Major Patient complaints about waiting times
• Major Patient complaints about getting access to
  the service
• Major gatekeepers complaint
• Major staff moral challenges
• Just under 90WTE staff

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USER INVOLVEMENT

• PATIENT FOCUS GROUPS- Elderly patients
• QUESTIONNAIRES-Domiciliary / Nail
  Surgery/Biomechanics
• patients

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THE VISION

• SELF REFERRAL
• CALL CENTRE
• APPOINTMENT WITHIN 7-10 DAYS
• ONE STOP CLINIC- 60 Minute appointment
• PACKAGES OF CARE - SHORT AND LONG TERM
• PODIATRISTS NOT DELIVERING BASIC FOOTCARE

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WORK TO BE PILOTED

• SELF REFERRAL
• PiMS
• CALL CENTRE APPROACH

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CALL CENTRE

• Preference to use an existing call centre
• Initially new patients only then existing
  patients
• Initial access 9am-6pm to make appointments

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PILOT SITES

• Clarkston Clinic - Sept 2002
• Possilpark Health Centre - Oct 2002
• Springburn Health Centre - Oct 2002
• Evaluation throughout pilot
• Changes made - roll out across the city
  commencing March 2003 - 1 year

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Introduction of triage

• Average referral numbers increased with self
  referral by 100
• Telephone triage introduced Oct 2003
• Triage clinics September 2004( because of PIMS)

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Patients journey
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SERVICE GAINS FOR USER

• SELF REFERRAL
• INCREASED ACCESS TO MAKE APPOINTMENT
• CHOICE OF TREATMENT LOCATION
• SHORTER WAITING TIME
• ONE STOP CLINIC
• HIGHER PRIORITY FOR THOSE WITH GREATEST NEED -
  MORE FREQUENT TREATMENT
• HELP WITH BASIC FOOTCARE

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SERVICE GAINS

• MORE APPROPRIATE USE OF SKILLS
• BETTER STAFF MORALE
• BETTER USE OF RESOURCES
• RECRUITMENT AND RETENTION OF STAFF
• RAISED PROFILE OF PROFESSION
• JOINT WORKING WITH SOCIAL SERVICES
• BETTER COMMUNICATION - IMT
• MARKET MODEL TO OTHER TRUSTS

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GLOBAL PROFILE RESULTS
Group (1) No Podiatry
need
Other
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Podiatry patient profile groups
Global sample n20,004
Group (4) Shared care
36
Group (2) senior
Podiatrist
21
Group (3) Podiatrist
28
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Percentage of level 1-4

• Level 1 6
• Level 2 33
• Level 3 31
• Level 4 29

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Orthopaedics Foot and Ankle Triage Service
Patient Pathway Referral Guidance
Patient presentation to GP
Orthopaedic Surgeon

• Urgent referrals to
• Orthopaedic Department
• Suspected malignancy, Osteomyelitis,Charcot foot
• Suspicion of ruptured tendons

• Assessed by consultant.

ESP Podiatrist-Foot and Ankle Triage clinic

• Referrals triaged for surgical option.
• Care plans advised and referred onto
• the appropriate health care professional.

• Foot and Ankle Triage Service.
• All conditions normally referred to the
  Orthopaedic department for surgery who are
  willing to undergo surgery for their complaint.

Special attention
Acute/active diabetic foot conditions refer
directly to the hospital diabetic /podiatry
service.( See local referral guidelines.) Acute/
active rheumatoid foot conditions refer directly
to the hospital rheumatology/ podiatry service.
(See local referral guidelines.)
Biomechanics Clinics

• Routine Podiatry Referrals
• All foot /ankle complaints e.g. Corn, callus,
  nails, plantar fasciitis or metatarsalgia. 1st
  line treatment of all foot conditions can be
  treated with appropriate referral to routine
  podiatry.

• All musculo -skeletal conditions e.g.
  foot/knee/hip, where altered foot posture/gait
  may be improved via orthoses /exercise programme.

Contact Information
Elaine Yule ESP Podiatrist 0141 232 1553 Ramsay
Sloss ESP Podiatrist 0141 531 6810 Jenny Ackland
Project Manager 0141 211 3696
Orthopaedics
Biomechanics
ESP
Routine Podiatry
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3 top tips

• Identify you key challenges
• Engage with all stakeholders
• Sell, sell and sell the advantages and
  continuously monitor.