Podiatry Service – West Essex

Summary

West Essex Podiatry Service includes:

• Community Podiatry
• Musculoskeletal (MSK) Podiatry
• Diabetes Multidisciplinary Foot Team (MDFT) at Princess Alexandra Hospital, Harlow

Service Information

Community Podiatry

Specialises in the assessment and treatment of people who are at moderate to high risk of developing foot complications. This includes the assessment of the vascular and neurological status of the lower limb, assessment and treatment of foot and nail pathologies and foot ulcerations.

The Community Podiatry Service is commissioned to see patients with a registered GP within West Essex. community podiatry clinics run at Dunmow; Saffron Walden; Bishop Stortford; Harlow; Epping; Waltham Abbey and Loughton.

We also provide a limited domiciliary service for patients that are:

• Bed or chair bound 24/7
• Require hoisting in order to be moved to travel
• Deemed too clinically ill to be expected to travel

The service provides nail surgery under local anaesthesia to all individuals who are registered at a GP practice within West Essex or East and North Herts. 

The Musculoskeletal (MSK) Podiatry Service

The patient has to be registered with a GP within the West Essex or East and North Herts. The service is commissioned to see children and adults with MSK related foot or ankle pain.

The team treat the following;

Joint pain

Non-surgical treatment of hallux valgus, hallux limitus and general osteoarthritic conditions.

Metatarsalgia

Non-surgical treatment of Morton’s neuroma, capsulitis including functional foot orthotics and injection therapy.

Mid/rearfoot problems

Degenerative arthritis, mechanical foot and ankle pain, heel pain/plantar fasciitis, tendinopathy.

Flat feet

Symptomatic flat feet, adults and children including tibialis posterior tendonitis/dysfunction, tarsal tunnel syndrome.

Injection therapy

Steroid injections for treatment of plantar fascia, neuroma, bursitis, synovitis, capsulitis and joint pain – are performed on suitable patients in house or referrals made via ICE for US guided injection therapy.

Extra-corporeal shockwave therapy

For treatment of chronic plantar fasciopathy and Achilles tendinopathy (Available at Herts and Essex Hospital).

Key points

• We work within the 8 week standard, from referral to treatment.
• MSK clinics are held at the following sites:  Herts & Essex Hospital in Bishops Stortford, St Margaret’s Hospital in Epping and Addison House Health Centre in Harlow.
• To offer treatment with functional foot orthotics, patients will require supportive, accommodative footwear with a functional fastening i.e. a running trainer. Slip on or open shoes will not support this line of treatment.
• The advanced practice MSK podiatrists have full access to pathology and diagnostic imaging and make onward referrals to secondary care services where appropriate.
• MSK Podiatry is integral to the foot and ankle care pathway and should be considered the first point of referral for most MSK foot and ankle pathology (see pathway).

The MSK Podiatry service do not provide footwear or make modifications to footwear – these patients will need to be referred to the patient appliances service.

Who is not suitable for MSK podiatry treatment

• Chair, bedbound or housebound patients
• Children who are not yet walking
• Asymptomatic flat feet
• Patients who are not wearing closed supportive footwear on a regular basis

Diabetes Multidisciplinary Foot Team (MDFT)

To provide a seamless pathway for patients with diabetic foot disease to assess within 24 hours of hospital admittance as per NICE Guidance NG19 (2019). To ensure that the patients are triaged to the appropriate treatment in a timely manner to prevent limb and life threatening infection and lower limb amputation. To provide expert Multidisciplinary outpatient clinics for those with diabetic foot ulcerations.

• To work with inpatients and the wider community
• Part of a plan to reduce amputation rates across West Essex and encourage rapid referrals for active foot disease

Referral Information

Referral is made via a referral form. A different referral form is required for a healthcare professional and patient, please see below for all referral information.

Healthcare professionals

Please use the podiatry referral form to access the Community and Musculoskeletal Podiatry Services and the MDT referral form to access the Diabetes Multidisciplinary Foot Team (MDFT) at Princess Alexandra Hospital.

Patients

Patients are only able to self-refer for Community Podiatry and Nail Surgery. We do not accept patient self-referral forms for MSK Podiatry or the Diabetes Multidisciplinary Foot Team (MDFT), a referral to these services must be made by a healthcare professional.

Community Podiatry patient self-referral

To be eligible for treatment with the community Podiatry service you must have one or more of the following:

• Foot wound or ulcer (please note we do not treat ankle ulcers)
• A Moderate or High risk diabetic foot risk status
• Lower limb/foot circulatory disorder
• Currently taking immunosuppressant medication
• Loss of sensation in your feet due to diabetes or a neurological problem
• Rheumatoid arthritis or any other inflammatory arthritis/connective tissue disorder

Please note that the Podiatry service is not commissioned to offer foot care based on age, cut non-pathological toenails, treat verrucae or issue/repair surgical footwear. If you feel you have a medical condition with a foot pathology that qualifies you for assessment, please complete this form.

Nail Surgery patient self-referral

To be eligible for nail surgery with the Podiatry service you must have one or more of the following:

Moderate-Severe Symptoms include:

• Increased pain and inflammation of the toe
• Discharge
• Bleeding
• Recurrent Infection
• Severe and disabling pain
• Substantial erythema (redness)  and inflammation
• Infection
• Misshapen or curved nail causing pain

If you feel you have an ingrowing toenail and one or more of the statements above is true, you could qualify for assessment, please complete this form.