Determining local service levels for a foot care service for people with diabetes
Benchmarks for a standard population
Available data suggest that the number of people with diagnosed diabetes is 5.5% or 5,500 per 100,000 population aged 17 or over. Of whom, 100% will require foot care management including education.
Of these, approximately 193 per 100,000 may be expected to require emergency foot care treatment, and 2008 per 100,000 may require foot care and reviews at frequencies based on their elevated (increased or high) risk level.
Table 1 provides estimates of the numbers of people with diagnosed diabetes who are at elevated risk (that is, ‘increased' and ‘high' risk), and the likely number of appointments that may be required according to the recommended frequencies of review in the NICE clinical guideline CG10 on type 2 diabetes - foot care. The full guideline on Type 1 diabetes in adults recommends ‘following the type 2 diabetes guideline for foot care' in the management of foot ulceration and associated risk factors.
Table 1: The number of people with diagnosed diabetes and frequency of reviews
| Risk level | Proportion of diabetes patients | Frequency of review (annually) |
| Low Risk | 60% | 1 |
| Increased risk | 26.50% | 2-4 |
| High risk | 10% | 4 -12 |
| Likely to Require Emergency foot care | 3.50% | n/a |
This service is likely to fall under the programme budgeting category 4A (endocrine, nutritional and metabolic problems - diabetes).
Examine the assumptions used in estimating these figures.
Use the foot care service commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data
Further information
Sources of further information to help you in assessing local health needs and reducing health inequalities include:
- National Diabetes Information Service (NDIS), where you can find a comprehensive range of diabetes data, tools and information via one web portal
- NHS Evidence is a service that enables access to authoritative clinical and non-clinical evidence and best practice through a web-based portal.
- NHS IC Indicator Portal website gathers together a number of health and social care indicators.
- NHS Atlas of Variation 2011covers 71 indicators and 15 Programme Budget categories
- NHS Comparators provides comparator data for NHS commissioning and provider organisations to enable users to investigate aspects of local activity, costs and outcomes
- The Disease management information toolkit (DMIT) is a good-practice tool for decision-makers, commissioners and deliverers of care for people with long-term conditions
- Disease prevalence models produced by the Association of Public Health Observatories provides primary care trust-level prevalence estimates by topic. (including diabetes)
- The Diabetes Community Health Profiles bring together a wide range of data on diabetes in adults into a single source for the purposes of benchmarking. The tool allows you to download a diabetes profile for each PCT in England.
This page was last updated: 03 April 2012
- Foot care service for people with diabetes
- Commissioning a foot care service for people with diabetes
- Specifying a foot care service for people with diabetes
- Determining local service levels for a foot care service for people with diabetes
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance
