In April 2022, the UK’s NAPCHD (National Advisory Panel for Care Home Diabetes), chaired by Professor Alan Sinclair published their “Strategic Document of Diabetes Care for Care Homes”, looking at how to best support the estimated 25% of the UK care home population diagnosed with diabetes.
The report looked carefully at how:
“our teams in care homes can be clinically supported but alongside that consider other perspectives relating to health and social integration which will ensure that those living with the condition can benefit from a model which looks at the whole, not just part of the impact of Diabetes on them”.
The report identified four major gaps in knowledge and services:
- Delay in identifying foot at risk, delay in referring appropriately to the secondary care or podiatry and inadequate expertise in supporting ‘at risk’ feet are some of the issues that contribute to high rate of amputation in some areas in the country.
- Late admission with foot ulcer is associated with higher mortality and the opportunity is often missed to improve care of the person at the time of this episode.
- Lack of podiatrists that provide point of contact assessment and treatment in care homes. Residents are often forced to pay for private podiatrists which adds to the already heavy burden of fees that many residents and families are currently paying.
- Inadequately trained staff that fail to recognize the early warning signs of foot ulceration or skin damage.
Among the key steps to bring about worthwhile change, the following recommendation is made:
Simple methods to document early signs of neuropathy such as the Neuropad® 10-Minute Screening Test® … should be widely taught and implemented in care homes.