The Royal Free podiatry service for acute diabetic foot disorders offers specialist assessment, treatment, and referral to appropriate foot care pathways.

Clinical advice is available for NCL healthcare professionals managing patients with diabetes-related foot conditions, including ulceration and infection.

Eligibility Criteria

Inclusions

Diabetes, renal, vascular and one or more of the following active foot complaints:

• new onset foot ulcer
• current foot infection
• deep tissue / bone infection
• chronic limb threatening ischemia (refer to vascular pathway)
• gangrene
• suspicion of acute Charcot arthropathy - red, hot, swollen foot (with or without pain).

Note: The above patients should be referred to a member of the foot MDT within 24 hours, and if they attend A&E, refer as soon as possible.

Exclusions

• routine nail care
• routine callus/corn removal
• in-growing toenails
• low-risk patient with wound or burn on the foot.
• missed routine community podiatry appointment 
• systemically unwell (should attend A&E who can call podiatry to attend if a foot problem or see on ward if patient admitted)
• critical limb ischaemia (send direct referral to vascular department)

How to Refer

Referral are accepted from healthcare professionals only.