INITIAL RESULTS OF A SURVEY OF CURRENT NHS PODIATRY ACCESS CRITERIA

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INITIAL RESULTS OF A SURVEY OF CURRENT NHS
PODIATRY ACCESS CRITERIA

• David Milns Lead Practitioner Podiatry Department
  East Cambs and Fenland PCT

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Background

• Involvement in research concerning the outcomes
  of a decision to deny defined low risk elderly
  patients access to NHS podiatry services
• What access criteria is currently in use within
  NHS Podiatry services?

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Methodology

• Snapshot of criteria in use in September 2001
• 150 FOM members managing Podiatry Services across
  the UK contacted
• 90 responses received - a return rate of 60
• England 75, Ireland 3, Scotland 9, Wales 3

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Survey Results

• Broadly broken down into four groups
• Open access - no defined criteria, no
  prioritisation and including social care 15
  (17)
• England 10, Ireland 0, Scotland 3, Wales 2
• Open access including social care but with some
  prioritisation of waiting lists12 (13)
• England 8, Ireland 1, Scotland 3, Wales 0

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Survey results cont.

• Service based on old priority group
  definitions 20 (22)
• England 16, Ireland 1, Scotland 2, Wales 1
• Service based on meeting defined needs with
  patient prioritisation 43 (48)
• England 41, Ireland 1, Scotland 1, Wales 0

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Services with restricted access based on
prioritisation of need

• Formed 48 of the returns
• Two main groups
• Departments using scoring systems to determine
  access (20)
• Departments using risk definitions to determine
  access (23)

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Risk definitions

• Many variations
• High Risk eg diabetes, ischaemia, RA, infection,
  ulceration, painful lesions
• Medium Risk eg biomechanical conditions, corns,
  callous, nail conditions. Conditions requiring
  intensive treatment and discharge
• Low Risk cutting of normal nails, verrucae,
  patients requiring treatment for chronic
  conditions

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Summary

• Wide range of access criteria currently in use
  with considerable variations in risk definitions
• Some evidence of local political pressure
  influencing criteria
• Little evidence base apart from local clinical
  consensus. Often determined as a result of
  financial and waiting lists/times pressures