Priority 4 from the Foot Health PSP

UNCERTAINTY: What is the impact on health and social care services when known foot health problems are neglected? (JLA PSP Priority 4)
Overall ranking 4
JLA question ID 0092/4
Explanatory note With access to foot health services within the NHS becoming more and more restrictive, the potential for a far reaching impact on the wider health and social care services is increasingly likely. Understanding the consequences of not managing foot health problems in a timely way is therefore a critical issue, so that future foot health service development can be designed to avoid the risks of foot health neglect and potentially redice the financial, clinical and health burden on NHS and social services
Evidence

Maturitas. 2018 Dec;118:7-14. doi: 10.1016/j.maturitas.2018.10.001. Epub 2018 Oct. Foot problems as a risk factor for falls in community-dwelling older people: A systematic review and meta-analysis. Menz HB(1), Auhl M(2), Spink MJ(3). van Acker, Kristien, Leger, Philippe, Hartemann, Agnes, Chawla, Abhineet & Siddiqui, Mohd. (2014). Burden of diabetic foot disorders, guidelines for management and disparities in implementation in Europe: a systematic literature review. Diabetes/Metabolism: Research & Reviews, 30, 635-645. doi:10.1002/dmrr.2523
The review concludes that diabetic foot disorders demonstrated substantial economic burden and have detrimental effect on quality of life, with more impairment in physical domain. Implementation of the guidelines and set-up of multidisciplinary clinics for holistic management of the diabetic foot disorders varies across Europe and remains suboptimal. Hence, guidelines need to be reinforced to prevent diabetic foot complications and to achieve limb salvage if complications are unpreventable.
Health Research Classification System category  Generic health relevance
Extra information provided by this PSP
Original uncertainty examples What is the impact on the individual and society in terms of days lost from work, loss of activity and function (leading to sedentary behaviour) ie socio economic consequences? ~ ...and is there an increase in the number of elderly patients being admitted to hospital with neglected foot care compared to areas where the service is offered? ~ Why are commissioners/acute trusts not more aware of the potential savings they could get from good foot health? 
Submitted by  Healthcare professional x 11, Patient x 3, Other x 1
PSP information
PSP unique ID 0092
PSP name Foot Health
Total number of uncertainties identified by this PSP. 30  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 26 September 2019