Quality and Productivity case study

Community and Primary Services, Sheffield Teaching Hospitals NHS Foundation Trust
Publication Date
01 Jul 2015
Publication Type


Many surveys have reported a high number of people suffering from foot problems. According to Farndon et al (2006) the type of foot conditions considered to be appropriate for patient self-care are small areas of callus or dry skin, thickened toenails or 'normal' nails which patients may be unable to cut easily as the nails may be hard and thick or they may have mobility issues. One survey conducted in 1995 with independenly living over 75s found that 96% reported having problems cutting their toenails (Crawford et al, 1995). Another survey in 1998 of the over 65's found 29% reported thick nails and or skin problems on the feet (Munro and Steele, 1998). There is evidence that many conditions that patients present with could be safely and appropriately handled by the patients themselves once they have the confidence, skills and knowledge. Some of these common foot problems have previously required podiatry treatment from NHS podiatry services. Empowering patients or their carers to deal with their own minor foot problems (like nail care) reduces the burden on NHS podiatry services, and in turn saves money. This also allows NHS podiatry services to concentrate care on those with the greatest need and highest risks, such as people with diabetic foot problems for instance. This project was designed to identify and train patients suitable for self-care, so they can be discharged from the service. This helped to ensure that podiatry care is targeted at those with the greatest need.