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Clinical audit of core podiatry treatment in the NHS

Lisa Farndon1*, Andrew Barnes2, Keith Littlewood3, Justine Harle4, Craig Beecroft5, Jaclyn Burnside6, Tracey Wheeler7, Selwyn Morris8 and Stephen J Walters9

Author Affiliations

1 Podiatry Services, Sheffield PCT, Jordanthorpe Health Centre, Sheffield, S8 8DJ, UK

2 Podiatry Department, Barnsley PCT NHS Trust, New Street Clinic, Upper New Street, Barnsley, S70 1LP, UK

3 Podiatry Department, North Lincolnshire & Goole Hospital NHS Foundation Trust, Diana Princess of Wales Hospital, Scartho Road, Grimsby, DN33 2BA, UK

4 Department of Foothealth, Bassetlaw PCT, Retford Hospital, North Road, Retford, Notts, DN22 7XF, UK

5 Podiatry Department, Ashfield Health Village, Kirkby-in-Ashfield, Notts, NG17 7AE, UK

6 Podiatry Department, Nottinghamshire County Teaching PCT, Park House Health and Social Care Centre, 61 Burton Road, Carlton, Nottingham, NG4 3DQ, UK

7 Podiatry Services, Doncaster PCT, East Laith Gate House, East Laith Gate, Doncaster, DN1 1JE, UK

8 Lincolnshire PCT, Podiatry Department Marisco Medical, Stanley Avenue, Mablethorpe, LN12 1DP, UK

9 ScHARR, University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK

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Journal of Foot and Ankle Research 2009, 2:7  doi:10.1186/1757-1146-2-7

Published: 13 March 2009

Abstract

Background

Core podiatry involves treatment of the nails, corns and callus and also giving footwear and foot health advice. Though it is an integral part of current podiatric practice little evidence is available to support its efficacy in terms of research and audit data. This information is important in order to support the current NHS commissioning process where services are expected to provide data on standards including outcomes. This study aimed to increase the evidence base for this area of practice by conducting a multi-centre audit in 8 NHS podiatry departments over a 1-year period.

Methods

The outcome measure used in this audit was the Podiatry Health Questionnaire which is a self completed short measure of foot health including a pain visual analogue scale and a section for the podiatrist to rate an individual's foot health based on their podiatric problems. The patient questionnaire was completed by individuals prior to receiving podiatry care and then 2 weeks after treatment to assess the effect of core podiatry in terms of pain and foot health.

Results

1047 patients completed both questionnaires, with an age range from 26–95 years and a mean age of 72.9 years. The podiatrists clinical rating at baseline showed 75% of patients had either slight or moderate podiatric problems. The differences in questionnaire and visual analogue scores before and after treatment were determined according to three categories – better, same, worse and 75% of patients' scores either remained the same or improved after core podiatry treatment. A student t-test showed a statistical significant difference in pre and post treatment scores where P < 0.001, though the confidence interval indicated that the improvement was relatively small.

Conclusion

Core podiatry has been shown to sustain or improve foot health and pain in 75% of the patients taking part in the audit. Simple outcome measures including pain scales should be used routinely in podiatric practice to assess the affect of different aspects of treatments and improve the evidence base for podiatry.