Brent CCG leads the way in low amputation rates in England

2 March 2017

Excellent specialist foot services in Brent for people with diabetes mean our borough has some of the lowest levels of foot amputations in the country. The services have also cut the numbers of ulcers for those with diabetes and helped make significant cost savings.

Brent CCG and London North West Healthcare NHS Trust run a team of diabetes experts in a multidisciplinary specialist diabetes foot care team (MDFT). There are two consultant-led clinics a week and an emergency service five days a week. The specialist service has close links with primary care and community services which can refer patients directly and allows patients with recurring ulcers to self-refer.

The MDFT also prevents admissions to, and supports discharge from, hospital by working closely with our community-based Short Term Assessment, Rehabilitation and Reablement Service (STARRS).

Dr Wing May Kong, who leads the multidisciplinary specialist foot care team, says:

“Since 2004 we have provided an integrated foot service that works across community and secondary care. We work as one team with a shared pathway and simple traffic light referral criteria.

Diabetic foot complications have a huge personal cost to patients and early multidisciplinary input can prevent amputations. Our core approach is patient-centred care with a service that is easy to access. We are working with a range of teams, including STARRS, GP surgeries and hospitals, and the district nursing team, to give people prompt access to the best care.”

Brent CCG’s specialist footcare services were recently highlighted as an example of best practice by Diabetes UK. It is one of three CCGs the charity praised for having foot services that improved care, and helped to save the NHS a combined total of £1.5million. If every CCG followed best practice, Diabetes UK estimate it would save the NHS £250 million a year.

Brent CCG estimates that without the specialist service, the NHS would spend five times more money on amputations and recovery in hospital beds for a CCG with a comparable population.

What progress has been made on the rate of diabetes amputation in the borough?

  • Brent CCG now has the lowest diabetes amputation rate in England.
  • The major amputation rate in Brent is 71% below the England rate, and 55% below the rate for demographically similar CCGs.
  • The number of days in hospital for diabetic foot disease is 26% below the level in England and 22% below the level for comparator CCGs.