25 Feb 2017
People with diabetes are around 23 times as likely to have a leg, foot or toe amputation as those without diabetes. Approximately 8 out of every 10,000 people with diabetes undergo major lower extremity amputation (above ankle) each year, and 18 out of 10,000 have minor amputation (below ankle).
A new report by Insight Health Economics: Diabetic Foot Care in England, An Economic Case Study commissioned by the charity Diabetes UK estimates that the NHS in England spent £972m – £1.13bn on healthcare related to foot ulceration and amputation in diabetes in 2014-15; equivalent to 0.72-0.83% of the entire NHS budget. Around two thirds of this expenditure was on care in primary, community and outpatient settings for the treatment of diabetic ulcers.
Available data suggest that care for the diabetic foot could be improved in many areas. The 2015 National Diabetes Foot Care Audit found that many patients experienced long waits for specialist foot care. Almost a third of patients covered in the audit presented themselves to specialist services without a referral. Of the rest, almost two fifths were not seen by the foot care service until at least two weeks after the first healthcare contact for their ulcer. This is in spite of National Institute for Health and Care Excellence (NICE) guidance which recommends that people with diabetes with an active foot problem should be referred to a multidisciplinary foot care service or foot protection service within one working day and triaged within one further working day.
As in all areas of health care, decisions regarding the introduction of improved prevention and care services for foot problems in diabetes will need to be informed by local data on costs, savings and outcomes. The potential for quality of life gains and financial savings will vary depending on how services are currently delivered, baseline standards of care, and the configuration of proposed new services.
Here at neuropad® we believe that prevention is always preferable to treatment which is why we feel strongly that our NHS needs to improve diabetic foot screening so that it does not just test for sensory and motor neuropathy, but autonomic problems also, which tend to be present at an earlier stage. We also believe that home testing offers a very convenient alternative for those people who, for one reason or another, do not have an annual diabetic foot test. Neuropad® has been designed specifically for patients to use at home: it is both simple and quick, and completely painless. It does not therefore involve a trip to a clinic and people can carry out the test in the comfort of their own homes. Only through improved and earlier screening will we reduce the incidence of ulceration and amputation.