Service overview

Podiatry aims to improve patients mobility and keep patients' feet healthy and pain free, thereby enable patients to remain mobile, independent and active for as long as possible and reduce the number of hospital admissions.

Accessibility / acceptability

The principle is to provide high quality care of patients with significant foot conditions. This is irrespective of age, gender, ethnicity, religious belief and which respects the individual's needs and preferences. Referrals to our service are via a GP or other Healthcare Professional. Access criteria must be met for the referral to be accepted.

Population served

We only accept patients with a significant foot condition. These patients will include young people from the age of 8 years for certain treatments.

The service is open to local residents and those patients who live on the borders of Herefordshire. 

The team

The service is delivered by a team led by the Podiatrist working together across a range of settings including Community Hospitals, Health Centres, GP practices and patients homes.

Our team is made up of 6 Podiatrists, which includes a Podiatric Specialist in Diabetes who works as part of our multidisciplinary team, plus Podiatry Support Workers (PSWs) and administrative support.

The service is delivered in accordance with the guidelines of the Society of Chiropodists and Podiatrists.

A Professional Head of Service provides leadership and also carries a clinical caseload. They are responsible for the delivery of a high quality service, monitoring Clinical Governance, Clinical Professional Development, organizing training and ensuring standards are maintained across the county.

Once a referral is accepted patient attends for initial assessment following which the treatment plan is established. This may include levels of intervention:

• Routine treatment from a podiatrist (intensive, short course or variable long term)
• Treatment from a Foot care Assistant for basic foot care
• Referral to specialists within our department e.g. nail surgeon or Podiatric Specialist in Diabetes
• Referral outside the department e.g. Podiatric Surgery, nurses for dressings, GP for further treatment eg antibiotics or investigations

General podiatry assesses, diagnoses and treats a wide range of, usually painful, foot pathologies including foot deformities such as hammered toes, clawed toes, pes cavus, bunions, valgus feet. We provide debridement of ulceration, corns and calluses, and provide pressure relief. By off-loading an area healing time is decreased and lesions can be reduced or resolved.  Off-loading can be achieved by with either temporary padding or semi permanently with chairside orthoses or simple insoles. Advice on footwear is also key to reducing lesions.

Nail surgery is the removal of either part or all of a deformed nail under local anaesthesia. It is often the treatment of choice for ingrowing toe nails. The nail may be allowed to regrow (where there is concern about extended healing time) or, in most cases, the nail bed is destroyed with phenolization to prevent either part or the total nail regrowing. This is usually a permanent solution to a very painful condition.