"Feedback about podiatry from dialysis patients"

About: Specialist services / Podiatry

(as a staff member),

As part of an ingenuity project looking at service improvement and innovation, we wanted to look at ways of improving access for harder to reach patients. One patient group that sometimes struggles to access services is patients on dialysis. We proposed a new podiatry service for these patients, to be delivered on the dialysis units. In order to determine whether this would be of benefit, we completed a questionnaire with over 100 patients at 3 different dialysis units in Nottinghamshire. All patients gave their comments verbally, which have been transcribed below in their own words.

Kings Mill Hospital Dialysis Unit.

'I went to my doctor and they referred me to the podiatry at Mansfield Community Hospital. It's very difficult to get there. Either my brother has to take me, and he's not always available because he works, or I have to get hospital transport, and sometimes it takes 3 hours. With being here at Kings Mill 3 days a week it seems madness I can't have them done whilst I'm here. I think it would be brilliant if you started coming to dialysis to do them. It would be one less thing for me to worry about. '

'I was going to ask if you could do finger nails too, as I live on my own'

'I have a lady come and see me at home. She's not a qualified chiropodist but she trims my nails. I'm diabetic and my husband lost half his foot, so I know how important it is. I think it would be great to have someone here to do them. '

'I go to the big health hub at South Normanton. It's lovely when you get there. The only problem is I can't get out on my own, I have to get my daughter to help and she's got little children. Sometime's it's hard to get an appointment because I can only go on a Tuesday or Thursday when I'm not on dialysis. It limits the appointments I can get and I have to wait a bit longer. I would definitely use a podiatrist on dialysis - really good idea. '

'If you'd asked me yesterday, I'd have said I'd had no trouble with my feet. But I was at Meadowhall and someone stood on my toe with their heel. I didn't know anything was wrong at first but then I saw the blood on my shoe. I'm diabetic and my feet are numb. I have checks with the practice nurse but it would be nice to know there's help if I have a problem, here on dialysis'

'I go to the clinic at Alfreton. My partner has to take time off work to take me. They're very good when I get there, but in the past they've been quite stretched with patients and it's been a bit too long in between. It has improved recently, though. '

'I wasn't able to get to the clinic so I got a private podiatrist. '

'Difficult to get an appointment at the clinic. I did not receive an appointment in the post, need to improve the appointment system. '

'I got to Mansfield Community Hospital. I'm very happy with the service. I don't have any problems getting there, my husband takes me in the car. We ring up when we want them doing and they give us an appointment within 2 weeks. '

Ling’s Bar Hospital Dialysis Unit

'I have been trying to get my feet done for ages. I went to the doctor and asked, but they wouldn't do it. I went to a private chiropodist, but they wouldn't touch it, said they didn't do corns. So I went back to the doctor and got in with a lady at East Leake. I've got to go to Keyworth now for it, as they aren't open on Tuesdays or Thursdays and they are the only days I can go. I think it would be easier to have them done on dialysis. '

'It would be great to get them done whilst I'm here. I asked at the doctors but they said it was a long waiting list, so my carer does it. '

'It would be very good if I could have it done here. It's not very easy to get an appointment when I go to the clinic. '

'I go to Strelley to have my feet done. The podiatrist is good and it's a free service which I need but one of my free mornings is taken up, as I'm on dialysis every Monday, Wednesday and Friday. '

'My feet are in a terrible state. '

'I did go to podiatry once but I never went back. I just do them myself now. I've got a lot of worries about my feet. I'd definitely want to see the podiatrist if they were on the unit. '

City Hospital Dialysis Unit

'It's very difficult to get an appointment - they used to send me a reminder but now they don't. '

'It costs me £10 to get to the clinic and back to have my feet done, because I can't walk. '

'By the time I got my feet appointment, my feet were too bad so I gave up and I had to ask my husband to do it. '

'They see me every 8 weeks or sometimes it's 10 weeks, but it's supposed to be 6. They are snowed under, but it's too long. I end up with ingrowing toenails. '

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Response from Duncan Heaney, Head of Service - Podiatry, Health Partnerships - Nottinghamshire Healthcare

Thank you for posting the patient comments in relation to the podiatry service visting the dialysis units. There was the realisation by staff that patients attending the dialysis units often found it difficult to access the podiatry service. The new initiative has been driven by the clinical staff within the podiatry team to meet this need, and initial feedback has been very encouraging.

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Response from Lisa Metcalf, Specialist Podiatrist, Podiatry, County Health Partnerships We have made a change

picture of Lisa Metcalf

A big thank you to all the dialysis patients who took the time to talk to us. As a result of this feedback, we are going to start a three month trial providing podiatry treatment on the dialysis units starting in October. We will attend every 3 weeks or so and provide treatment to all patients that wish to use this service. We will undertake a review after this period to establish whether we are meeting patient's needs. I look forward to talking to you all again in the new year!

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Updates, changes and questions related to this story