Consultant diabetologist-led inpatient multidisciplinary diabetes foot service

Abstract

Introduction: Most hospitals in United Kingdom are spoke sites for vascular surgery with inhouse orthopedic services. In many hospitals, patients with diabetes foot disease are under various medical teams, potentially delaying optimal management. We sought the views of consultant physicians about the consultant diabetologist-led inpatient multidisciplinary diabetes foot team (MDFT). Materials and methods: We have sent an online questionnaire to consultant physicians and sought their experience of the MDFT, the referral process, frequency and reasons for referral and suggested areas for improvement. Results and discussion: We have received 23 responses from consultant physicians, of whom 87% had previously referred patients to MDFT. Over three quarters (78%) were aware of the electronic referral system and most (95.2%) found the process user-friendly. Common reasons for referral were foot ulcers (65.2%) and osteomyelitis (26.1%). Under half (42.9%) referred a patient approximately once a month. Over two-thirds (71.4%) felt that their patients were reviewed within 24–48 hours of referral. A significant proportion (74%) were unsure where the ‘inpatient diabetes foot pathway and care bundle’ were on the intranet. 60.9% of consultants felt that they would benefit from further education on diabetes foot disease management. 95.5% felt that the service was good to excellent. Suggested improvements included early triage of patients to the diabetes ward and delegation to other members of the MDFT to improve response times. Conclusion: Consultant diabetologist-led MDFT provides timely review of inpatients with diabetes foot disease, in a ‘spoke’ vascular surgery site. Inpatient multidisciplinary diabetes foot pathway and care bundle must be easy to access.