Podiatrists are healthcare professionals who have been trained to diagnose and treat foot and lower limb conditions. Podiatrists provide assessment, evaluation and foot care for a wide range of patients, which range from low risk to long-term acute conditions. Many patients fall into high risk categories such as those with diabetes, rheumatism, cerebral palsy, peripheral arterial disease and peripheral nerve damage.
As the experts in lower limb health and disease, Podiatrists have the requisite knowledge, skills and training to work as first point of contact practitioners in primary care. The College of Podiatry believes that assigning more podiatrists into primary care settings will increase the capacity of both primary and secondary care, improve health outcomes for the population, enhance patient experience and save money. See https://cop.org.uk/ and https://primarycareone.nhs.wales/careers/ primary-care-roles-in-wales/podiatrists/
Working within general practices and across PCNs, Podiatrists are competent to prescribe medicines in two ways, supplementary, using a written clinical management plan (CMP) in partnership with a doctor, or independently, following additional training. This enables the Podiatrist to provide patients with direct access to the interventions they need. This is not only valuable to patients but increases capacity within primary care settings by relieving pressure on GPs and the primary care teams.
As highly skilled healthcare professionals, podiatrists within primary care reduce pressure on GPs through their ability to prescribe independently. This significantly reduces demand for GP appointments and home visits and provides patients with direct access to the medicines they need, when they need them. A fully integrated primary care podiatry service can safely diagnose, manage, rehabilitate and prevent disease related complications of the feet, ankles and lower limbs, particularly around MSK, diabetes, rheumatoid conditions and peripheral arterial disease. They also have a significant role in the public health and prevention agenda specifically around falls prevention, cardio-vascular risk reduction, medicines management and reconciliation, antibiotic stewardship and keeping people mobile and active. Podiatrists have the ability to utilise advanced diagnostic techniques including imaging and can prescribe independently for a range of lower limb conditions saving GP time and resource.
- Must have a BSc to work as a podiatrist in all settings.
- Health Education England Primary care FCP training must be completed as the minimum threshold for entry to primary care and be supported by appropriate governance and indemnity.
- Health Education England primary care FCP training can begin 3-5 years after the completion of a postgraduate degree
Supervision for Podiatrists in Primary Care
Appropriate supervision will be required for all podiatrists working in Primary Care.
Existing GP Educational supervisors are able to supervise podiatrists undertaking FCP and AP roles and do not need to attend additional training.
GPs who have completed the First Contact Practitioner Supervisor Development course can provide clinical supervision to podiatrists undertaking FCP and AP roles.
Benefits to patients
- Access to screening, diagnostics and tailored care plans
- Increased access to the right care, closer to home
- Patients are kept active and mobile
- Support people to manage their condition so that they can recover faster and stay in work and/or return to work earlier
- Receive education and advice on inappropriate footwear, which can contribute to poor balance and an increased risk of certain conditions or risk of falling
- Prevent and correct deformity, relieve pain and treat infections.
Benefits to PCN’s
- Work with other healthcare professionals such as dieticians, GPs, nurses and physiotherapists
- Relieve pressure on other primary care colleagues
- Help reduce patient attendance at the practice by intervening early and helping them stay well
- As highly skilled healthcare professionals, podiatrists within primary care reduce pressure on GPs through their ability to prescribe independently. This significantly reduces demand for GP appointments and home visits and provides patients with direct access to the medicines they need, when they need them.
Benefits to the wider NHS
- Prevention of complications from long-term conditions and reduction in the number of unnecessary referrals made to secondary care
- Early interventions within the community to reduce A&E attendances and unnecessary hospital admissions by facilitating early detection and intervention of potentially lifethreatening conditions.
The role of the Podiatrist may include some of the following activities:
- Work as part of a PCNs multi-disciplinary team to clinically assess, treat and manage a caseload of patients of all ages with lower limb conditions and foot pathologies using expert knowledge of podiatry for specific conditions and topics
- Utilise and provide guidance to patients on equipment such as surgical instruments, dressings, treatment tables and orthotics
- Prescribe, produce and fit orthotics and other aids and appliances
- Provide specialist treatment and support for high-risk patient groups such as the elderly and those with increased risk of amputation
- Support patients using therapeutic and surgical techniques to treat foot and lower leg issues
- Deliver foot health education to patients
- Liaise with PCN multi-disciplinary team, community, and secondary care staff and named clinicians to arrange further investigations and onward referrals as necessary
- Communicate outcomes and integrate findings into their own and wider service practice and pathway development
- Develop, implement and evaluate a seamless podiatry support service across the PCN, working with community and secondary care where appropriate, and aimed at continuously improving standards of patient care and wider multi-disciplinary team working
- Provide leadership and support on podiatry clinical service development across the PCN
- Provide education and specialist expertise to PCN staff as needed
- Ensure delivery of best practice in clinical practice, caseload management, education, research, and audit to achieve corporate PCN and local population objectives