"Not getting feet care"

About: Annan Hospital

(as the patient),

I am in my sixties and have diabetes (Type 2), arthritis, enlarged prostate, bad eyesight. I used to go to my local clinic (Annan charles street) to get my toenails cut etc, now they have stopped this and I do not know what to do as I cannot do them myself. I have no friends in my town as I moved here a few years ago, therefore have no friends to help me or relatives. To me this is ridiculous. How do they expect people like me to get my nails cut? I cannot afford to have it done privately.

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Response from Hilary Butterworth, IPIQ Officer, Patient Services, NHS Dumfries and Galloway

Dear gogo06

I was extremely concerned to hear of your problem with foot care and can understand why the situation is causing you such distress and worry.

I will contact some of my colleagues to find out what chiropody services are available in the Annan area.

However I feel the only way I can assist you adequately is if you would agree to contact me. This will allow me to find out more about your personal situation and identify the appropriate people and services to help alleviate this situation.

I would be very grateful if you would contact me with your details. My e-mail address is - hilary.butterworth1@nhs.net

I look forward to hearing from you

best wishes


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Response from Hilary Butterworth, IPIQ Officer, Patient Services, NHS Dumfries and Galloway

For general information

I am pleased to say the person who posted the original concerns about podiatry services agreed to contact me direct and I was able to respond to their issues on a more personal basis. However I am taking the opportunity of submitting some general information for anyone who may have similar concerns and have been waiting to read a response.

In 2013 Podiatry Services across Scotland received guidance from the Scottish Government relating to simple foot and nail care. The guidance explicitly states that personal foot care is not the responsibility of NHS Scotland Podiatry Services. This has obviously impacted on a number of people across Scotland and not just in Dumfries and Galloway, who previously received free simple foot care and toe nail cutting. Neither of these are classed as clinical procedures.

The Podiatry services in Dumfries and Galloway is a small service with limited resources and due to the Governments guidance they had to write to a large number of people across D&G who had previously attended for simple foot care. This was a difficult action and decision for the Podiatry team to make, but they have to prioritise patients with a greater clinical need. There is some misconception around the services and specialist skills of a Podiatrist. Podiatrists help prevent, diagnose and treat a wide range of conditions that affect feet and legs. Many aspects of foot care do not require their specialist skills. Therefore the priority for the Podiatry service is to develop their work around complex diabetic cases, orthopaedic and vascular patient procedures, where podiatrists specialist skills are essential to prevent toe and foot amputations.

In recent years there has been a great increase in people being diagnosed with Type 2 diabetes due to poor diet or being overweight, which inevitably has impacted on the NHS and podiatry services. Diabetes UK act as an advocate for diabetic patients and have recognised and support the importance of the Podiatry services focussing on care of high and moderate risk diabetic patients.

We fully appreciate that physical problems or payment can pose a challenge for some people so NHS Dumfries has been exploring alternative routes for patients to obtain simple non complex foot care and toe nail cutting. A good deal of work and investment is being put in to training and educating staff in the independent sector, voluntary agencies and social care to provide a simple foot care and toe nail cutting service, with a drastically reduced cost.

Low cost foot care services have already commenced in some areas across Dumfries, Stewartry and Wigtownshire. In Annadale and Eskdale the Health Improvement Team based in the grounds of Annan Hospital, supporting the Safe and Healthy Action Partnership (SHAP) have been working in partnership with the NHS Podiatry Service holding ‘Best Feet Forward’ sessions.

I contacted colleagues in the Scottish Health Council to find out how other areas across Scotland were progressing with developing simple foot care services. The information I received was very positive and in areas where independent sector groups had received training and delivering a simple foot and nail care service, there has been a high satisfaction rate, costs are significantly reduced, and are approximate to personal care charges, hair cutting, finger nail care, etc. In addition people were experiencing less of a waiting list for nail cutting.

Free Personal and Nursing care is available without charge for everyone in Scotland over the age of 65. If a person is assessed by their local authority as needing essential foot care it comes under the umbrella of Personal Care.

Diabetes UK have produced a guide to follow towards healthy feet for diabetics and this can be downloaded or obtained by visiting:


The Age Scotland Silver Line is a free phone from a landline and can also give you advice on who can help on this issue. Call NHS Inform on 0800224488 for information on foot care and podiatry services in your area.

The Scottish Government has produced a foot-care guidance. Booklets or DVDs, both for people wishing to carry out their own foot care and for those who want to assist someone else can be obtained by visiting www.lookafteryourfeet.info

I hope I have been able to provide reassurance that a good deal of work is being undertaken by NHS Dumfries & Galloway to help people who may find simple foot and nail care a problem and some of the contact details outlined above may find of benefit.

with best wishes


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