Podiatry Community Service: WH

Provided By

The Whittington Health (WH) podiatry service is a community-based clinical service for adults and children. The service aims to improve the foot health of the local population by providing a comprehensive range of podiatric advice and treatment according to assessed clinical need.

The service specialises in assessing and treating problems of the lower limb, particularly the foot and ankle. Podiatrists aim to maintain and promote good foot health within the population of Islington and Haringey in order to help sustain mobility, independence and reduce pain.

To avoid wasted time in referring a patient unnecessarily, the Community Podiatry service cannot see or treat certain conditions. Please do not refer patients for the below.

Toenail cutting

The community podiatry service does not offer nail cutting for those who do not meet a medical risk criteria i.e. the foot is at risk of ulceration and therefore requires NHS Podiatry care. The service also does not offer treatment for non-pathological toenails (not gryphotic, involuted or requiring nail surgery). If nails are pathological in nature, please ensure that this is clearly documented on referrals.

Toenail cutting is social care, like brushing your teeth and as such is not a standard NHS provision. If the patient is in a nursing home or care home, toenail cutting is a part of social care of the resident, not medical care, and should be carried out by the care staff or patient care allowance can be used for private service attending the home.

Fungal nail

The services is also not commissioned to treat fungal nail infections, which should be managed by GP or dermatology, unless patient is requesting permanent removal of toenail through nail surgery, in which case please refer the patient, being clear on the referral that the patient understands that it is only possible to have toe nail surgery.

Corns and calluses

The service does not offer removal of corns/calluses for patients with insufficient medical history that could predispose them to ulceration, please consider referral to private practice.

Verrucae

The service is not commissioned for treatment of verrucae - patients should be signposted to pharmacy, dermatology, or referral to private practice.

Patients are only accepted into the service if they have both a medical condition and podiatric need. The team aims to assess a patient's foot problem and provide treatment and self-care advice as appropriate to their individual needs.

The Podiatry Community Service operates across various sites in Islington and Haringey, and patients will be offered an appointment based on their preferred site or earliest available appointment.

Eligibility Criteria

Inclusions

Patients registered with an Islington or Haringey GP that have a podiatric need and a medical condition that puts their foot at risk - see service acceptance criteria (see Downloads), including:

Biomechanical problems, injection therapy and bespoke orthotic provision
Podiatric need e.g. callus/corns (must have medical condition that puts their feet at risk e.g. peripheral vascular disease)
Ulcers (not requiring MDT care)
Ingrown toenails requiring surgery
A limited housebound service is available for those that do not leave home for other medical/social reasons.

Exclusions

For severe infection and suspected critical ischaemia, escalate patient immediately to Royal Free Hospital (RFH) Hot Clinic (see Related Services).

Basic nail care for patients with no relevant medical history (if nail care support is required, please refer to the Nail cutting services information sheet (see Downloads)
Diabetic foot assessments where no podiatry need is present
Verruca/fungal toenail patients
Patients requiring bespoke footwear
Patients requiring walking aids
Ulcers requiring MDT care (ulcers which are infected requiring IV antibiotics, bone probable/visible, those requiring vascular intervention). These should be referred to Whittington Podiatry Clinic 3B on mdtpodiatry.whitthealth@nhs.net or RFH Hot clinic (see related services).