Access to a podiatrist
In a large public survey 85% of people stated they would like direct access to a podiatrist without going through the GP. FCPs in primary care would benefit not only the public, but the PCNs, the financial impact on primary and secondary care, and the workload and pressures on our current GPs. More FCPs would increase capacity for lower limb assessment and diagnosis with a focus on prevention which would improve population health management. We would also see early detection of problems, and therefore a more effective use of the resources and an overall better outcome for the patient.
Lower limb presentations are multifaceted. For example, calf swelling could be due to a number of different system presentations, such as vascular, neurological, musculoskeletal, trauma, or infectious, and a delay in correct diagnosis or treatment could not only lead to excess costs within primary or secondary care and impact on patient quality of life. At worse it could also lead to potential loss of part or all of the limb or life. It is vital for the lower limb health of the population that a podiatrist is positioned in primary care to provide the level of assessment and treatment required to prevent the escalation of these problems.
Audit of FCP podiatrists
An audit was carried out by the Royal College of Podiatry (2023) and provided a position statement including demographics, skill set and activity of current primary care podiatrists. The findings suggest each FCP can save 80 GPs or other primary care staff appointments per week. It is estimated that 76% of FCP podiatrist caseload was managed independently by the podiatrist, 5% required GP input, 4% PCN team input, and 15% resulted in onward referral to community and secondary care services, demonstrating the potential value and saving of both time and cost within primary care.