"A hope for change at Bacup Podiatry Department"

As someone who is a champion of the NHS, and has been well served by it, what follows is not a complaint, nor is it intended as a criticism of any individual. I just hope that, by recording my experience with the Bacup Podiatry Department, some aspects of the service provided will be reviewed to the advantage of all users.

In the summer of 2008 I began to suffer from plantar fasciitis and my GP referred me to the Podiatry Department, at Bacup Primary Health Care Centre. In due course, I was told that my name was on the waiting list and that I would be given an appointment as soon as possible. Having heard nothing further for quite some time, and with the pain in my heel increasing on a daily basis, I decided to phone and enquire when I might expect to be seen. It was at this point that I noticed the August letter bore no phone number (and, for that matter, no postal code). Luckily, I have a friend working in the NHS who provided a number - 0845 054 0033 - so I called Reception at Bacup Podiatry. I was told that the Podiatry Department was very busy but that I should expect an appointment in the near future. (I took the opportunity to point out the absence of phone number and postal code on the August letter.)

A follow-up letter (this time with a phone number, but still no postal code) asked me to contact the Department if I still wanted an appointment. As a result, I attended the clinic. When I arrived, having been told how busy the department was, I had expected it to be crowded. To my amazement, I think that I was the only person in the waiting room. On every subsequent occasion that pattern has been repeated, and I can't ever recall seeing more than three patients, if that many, in the waiting room. I was issued with 3/4 length orthotic inserts, built up on the right foot, instructed how to break them in and given an exercise sheet to supplement their use.

I had assumed that I would be called in again for a review of my progress, but heard nothing. Meanwhile, the supplementary lift applied to the right insert had come unstuck. I phoned Bacup and was given an appointment for April 2009. The unstuck item was re-stuck, I was given another set of inserts for spares, and told that I should be all right for another twelve months.

On the next appointment in June 2009, exactly the same problem arose. The glue had melted in the right shoe insert and the lift had come unstuck again. I didn't have an appointment, but went back to Bacup in the hopes that somebody could help. I was told that they were, 'up to their eyes', although there was nobody in the waiting room. Another lady appeared from an office behind Reception. She, kindly, referred the problem to a member of the clinic's staff. Although they could not help immediately because they didn't have inserts in stock in my size, I was told that replacement inserts would be posted to me as soon as the correct size was available. In case of further difficulty, the lady who had tried to help gave me another phone number - 01706 253345.

Unfortunately, nothing had been received in the post by 27th July 2009 so I phoned Bacup. The call was taken by the General Reception Office of the Health Care Centre to which all calls for Podiatry were being transferred. Apparently there was nobody in Podiatry Reception and it was not known when this would change. I tried again a few days later, but with the same result, apparently due to staff holidays. Eventually, I got through to the Podiatry Department early August 2009. The lady who took my call turned out to be the same person who had helped me in June. She was extremely surprised to hear that no replacement had been received by post, but arranged for me to go in the same day at 1pm. This I did, and a member of the clinic staff I hadn't seen before did further repairs to the old insert and issued me with a new set. This lady mentioned that only one member of staff usually dealt with inserts. (I noticed that the lift just covered the heel, rather than the 3/4 length type issued previously, and was held in place by double-sided adhesive tape.) By 11th August, the same problem had occurred again, the heel lift having become dislodged. When I contacted Bacup, I was advised to wait until the podiatrist I had seen originally in October 2008, and who specialised in orthotics, returned from holiday.

At this latest, and last, meeting (when only one other patient was in the waiting room) the heel lifts were installed under my shoe insoles, again using double-sided tape. Apparently, this method had succeeded with other patients presenting with this problem in the past. (I couldn't help wondering why, if this were the case, it hadn't been tried before in my case.) That same evening I went for an hour's walk; both insole and heel lift in my right shoe came away.

The following day I phoned Bacup to explain this latest failure. The podiatrist who had dealt with me was not there but would be at Rawtenstall Health Centre the following Monday morning, and at Rossendale General Hospital in the afternoon. Reception kindly promised to email her and ask that she phone me from Rawtenstall, failing which I should call her there. (In response to my query, they also confirmed that bespoke orthotics could be supplied which, clearly, would obviate the difficulties I had encountered over several months.)

Hearing nothing on the Monday, I duly called Rawtenstall Health Centre mid-morning, but the podiatrist was with a patient. The lady at Rawtenstall Reception assured me that either she or the podiatrist would call me back shortly. By about 1.30pm, having had no call, I phoned Rawtenstall again. The receptionist had passed on my message, and could not understand why the podiatrist had not called me. Perhaps she would call later from Rossendale General? I have heard nothing further to the date of this email. Meanwhile, I went to my local cobbler and had him glue the heel lift back into place under new insoles.

This whole experience has provoked the following queries and comments:

1. Does Bacup Podiatry Department represent an efficient use of NHS resources? I waited for quite a while, in considerable pain, and suspect I only obtained an appointment when I did after finding out a phone number and enquiring. At that first appointment, and ever since, I have never seen above two or thee people in the waiting room. I cannot reconcile this with being told how busy the clinic is, and wonder how many people suffer pain and discomfort whilst this facility remains, seemingly, underused.

2. Is consideration given to a patient's address when making appointments? Perhaps it is necessary to go to Bacup for an initial assessment, but I was surprised to hear that a podiatrist attended Rawtenstall and Rossendale General Hospital. Both are nearer to me than Bacup, Rossendale General being within walking distance. Since I have a car, it's no problem for me to attend at Bacup, but others may not be so fortunate.

3. In my case, although neither system proved successful, the 3/4 length, glued, lift seemed superior to the heel-sized, taped, lift. This, latter, only survived for a matter of days, if that. Perhaps the change was driven by financial considerations, but, if so, this may prove a false economy since the newer system fails so quickly.

4. Given the number of times I have had to trouble Bacup with the identical problem, why was a bespoke solution never suggested?

5. At present, thankfully, I have no pain even when walking around the house in casual footwear without the orthotic supports. Could it be that the plantar fasciitis has gone? I am reluctant to try walking any distance outside without the inserts lest this painful condition reassert itself. The fact that I was prescribed an insert in both shoes suggests that I walk badly, particularly on the right foot, so I probably still need some support. Is the bespoke solution mentioned at, '4', above, the best option (and may I be considered for it)?