Improving a diabetes foot service to prevent amputations: the Portsmouth experience

Malik A Humayun, Darryl Meeking


Diabetes-related amputations have a dramatic effect on quality of life and life expectancy and are also a huge financial burden to the National Health Service (NHS). The city of Portsmouth had the second-highest amputation rate in the country from 2007–2010, according to data published in early 2011, leading to a restructuring of the foot care pathway in the area. Over a three year period, the rate of major amputations in people with diabetes in Portsmouth has fallen from 2.3/1,000 to 1.4/1,000, compared with the national average of 1.1/1,000. Repeat hospital admissions for diabetic foot disease are comparable to the national average for the first time. We continue to identify areas of improvement needed for our patients with diabetes and hope to continue to improve foot outcomes for our patients.

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International Diabetes Federation/International Working Group on the Diabetic Foot. Diabetes and foot care. Time to Act. A joint publication of the International Diabetes Federation and the International Working Group on the Diabetic Foot. (accessed May 2015).

Diabetes UK. Putting feet first: Fast track for a foot attack: Reducing amputations February 2013. Footcare for people with diabetes.pdf/(accessed May 2015).

The Information Centre for Health and Social Care. Hospital Episode Statistics 2007/08–2010/11. q=title%3A%22Hospital+Episode+Statistics%2C+Admitted+patient+care+-+England%22&size=10

National Cardiovascular Intelligence Network. Diabetes footcare activity profile. August 2011. http://www. (accessed May 2015).

Goulder T, Kar P. Facillitating diabetes care - a community approach. BMJ Qual Improv Report 2013;2.

Portsmouth Diabetes. May 2015. Guidance charts for diabetic foot care: Diabetes Foot Referral Pathway, Diabetic Foot Management Guideline, Charcot Alert. Available at (accessed May 2015).

National Cardiovascular Intelligence Network (NCVIN). (accessed May 2015).

Diabetes footcare activity profile; March 2014. (accessed May 2015).



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The Journal of the Association of British Clinical Diabetologists