Community Podiatry services are ideally placed to form and coordinate the Diabetes Foot Protection Team (DFPT). This team needs to be fully integrated with Primary Care and support the delivery of the Quality Outcome Framework (QoF).

It is clear that podiatry plays a significant role in the management of the diabetic foot and podiatry services should be commissioned with a focus of delivering a dedicated diabetic foot protection team (DFPT). Review of the Allied Health Professional (AHP) toolkit (2012) that was developed for diabetes foot care clearly outlines the pathway and the benefit of Podiatry and other professions in the management of diabetic foot disease. Allied Healthcare Professionals include a number of professions who work both in uni-professional teams and often show their strengths in diabetes care as part of a Multidisciplinary Team (MDT) – should say which professions AHPs include? – isn’t this mainly orthotists, podiatrists [8].

The DFPT should use the TRIEPodD-UK Podiatry Competency Framework [9] that clearly describes the skills, training and competency the DFPT require to deliver the correct intervention, assessment and education. All bands of clinical staff can be utilised in this team, which supports primary care and the hospital multidisciplinary team so that there is a comprehensive and seamless pathway in place for any patient with diabetes who presents with a foot concern or problem. This structure and information on how to access the team should be widely publicised so that all patients and members of the health care team are aware of who to contact for varying degrees of foot problems. Many services are not available out of hours and at weekends. This can cause problems, as patients may require help and advice during these times. It is likely that services will be challenged to address this with increasing pressure for health care in the UK to be provided 7 days a week.

The rapid increase in the diabetic population is stretching existing diabetes foot services and an increase in the multi-disciplinary workforce may be required to meet demands. There are considerable efficiencies to be achieved in good team working, ensuring there is no duplication of activity. Information technology too may be harnessed to enable information about the patient and their condition to be available to the foot care team across primary and secondary care. Of course the real gain is that well organised foot care services not only benefit patients by reducing amputation rates and improving their quality of life but benefit health care systems due to decreased costs.