Lord Hunt of Kings Heath – 2014 Parliamentary Question to the Department of Health

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-01-14.

To ask Her Majesty’s Government whether they will issue guidance to the National Health Service on best practice for footcare management.

Earl Howe

Foot care services are commissioned locally by clinical commissioning groups (CCGs), working with local partners and are based on the need of the local population, resources available and evidence based practice. These commissioning decisions are informed by the Joint Strategic Needs Assessment and the local Health and Wellbeing Strategy.

Within NHS England, the National Clinical Director for Rehabilitation and Recovery in the Community and the Chief Allied Health Professions Officer are leading work to improve adult rehabilitation services including collection and dissemination of best practice.

Footcare services for older people, published by the Department in 2009, highlighted five potential models of safe and effective foot care service provision. This includes working in partnership across the health and social care spectrum and may involve training others e.g. within nursing homes or home care agencies to carry out simple foot care. Other models help empower patients to self-care where it is possible and safe to do so.

National Institute for Health and Care Excellence Clinical Guidelines 119 (on inpatient management of diabetic foot problems) and 10 (on Type 2 diabetes foot problems) offer guidance on best practice for foot care management in diabetes. These guidelines are being updated as one document – Diabetic Foot Problems, which is currently out to consultation.

It is not possible to distinguish in Hospital Episode Statistics between “major” and “minor” amputations.

The Health and Social Care Information Centre has calculated the England average rate of amputation per 100,000 population and highlighted the CCGs of residence having rates more than 33% higher than the national average. There are 25 such CCGs which are identified in the attached table. This is not a count of people as the same person may have had more than one episode of care within the same time period.

We do not have information on a comparison of rates of amputation with other European Union member states.