Improvements lead to huge reduction in waiting times for podiatry

A trial that began ten months ago has led to a massive drop in waiting times for community podiatric care in Somerset.

It involved a consultant podiatric surgeon joining clinics run by our podiatrists, with the aim to optimise treatment plans, speed up care, and identify those who could benefit from surgery at a much earlier point in their care.

Anthony Joyce, our podiatry clinical director and consultant podiatric surgeon, explains: “When we first set up the trial of a podiatric surgeon taking part in podiatry clinics, we were aiming to improve the time it takes for patients to get a diagnosis and treatment.

“When I first took over as podiatry clinical director, about 3,000 patients were waiting to be seen, with many of those waiting over 100 weeks, which was really not what they should expect.

“The COVID-19 pandemic meant we were playing catch up for the last couple of years on our waiting times, but our colleagues have been working very hard to reduce this.

“But so far, the trial is really exceeding our expectations, allowing us to develop the best possible treatment plans for our patients, and scheduling them in for surgery, where needed, in our operating theatres at Minehead Hospital, which we currently use every Friday.

“We have been able to identify patients with foot deformities, who either have a history of foot ulcers or are at a high risk of developing them. We undertake the surgery to reduce the risk of a subsequent foot amputation, and we’re seeing excellent results

“Many of these patients have tended to come in for care every couple of weeks to prevent them from getting a wound, and that’s simply not a good arrangement for the patient or the health service.

“Instead of prolonging these appointments, by performing the surgery, we’re getting rid of the underlying cause of the foot ulcers, and it also means the patients need care much less frequently, and in some cases can be safely discharged.

“This not only improves their quality of life, but the demand on the service reduces, with even more patients able to be seen, thus inevitably reducing the waiting times – it’s win-win all round!

“It’s also done at a fraction of the cost, as the surgery is carried out at a community hospital, rather than an acute hospital like Musgrove Park or Yeovil.

“While we’re only able to offer this at Minehead Hospital at the moment, we’re hoping to expand the trial to other parts of Somerset in the future.

“As a podiatric surgeon, being in the clinic environment has meant I’ve been able to train colleagues in sub-specialities, which has meant we’ve almost completely eliminated our waiting times – with only a handful waiting over 18 weeks for treatment last month.

“We’re also using the trial to support some of our new graduates, so having a consultant with 20 years’ experience overseeing clinics is giving colleagues the ability to grow and thrive, in a controlled environment.

“The complex caseloads we have means I’ve been able to run sub-speciality clinics with colleagues who don’t have a great deal of experience in that area, and it has been great for them to gain more exposure in these areas for their career development.

“At the same time, it’s also about coaching colleagues to improve productivity, which is essentially allowing us to upskill colleagues on the job, where we can immediately tackle waiting times, without having to send colleagues away from the trust for lots of training sessions, but instead they’re learning it on the job and applying it very quickly.

“Our service covers wound care, prophylactic podiatry care to stop people getting wounds, biomechanics, and nail surgery clinic.

“Overall, since we set up the trial, our colleague satisfaction has been great, patients are very happy and it seems to be going very well. In fact, one memorable bit of feedback I’ve recently had from a colleague is that prior to this arrangement, they’d go home from work feeling really exhausted, but now they go home and they’re feeling fine.

“It’s fair to say that we now have a very stable colleague turnover rate, which is good news because recruitment is still a huge challenge in this profession.”

The clinics have also taken over a significant amount of the prescribing of antibiotics, which was previously only done by the patient’s GP, so it’s helping to free up time for colleagues in general practice.

Anthony continues: “We now have podiatric surgery cover for five days a week, with my fellow podiatric surgeon, Michael Hutchby, covering Mondays and Tuesdays, while I’m available for the rest of the week, which gives us a lot more scope and flexibility.

“The general feedback from patients since the trial began has been very positive, and I’m very grateful to the team, and am proud of all that they’ve achieved over the past few years.”