Podiatry

Only healthcare professionals can refer patients to the service. 

This is available to those who fall into the following groups:

•    People who have a medical condition such as diabetes, ischemia, or cancer. 

Those who fall into this group have a higher foot risk. This is because their feet are more vulnerable to complications such as infections and ulcers and will require Podiatry treatment.

•    People who we can see for short period for a package of care.

These patients are people who have:

- Infected in-growing toenails
- Foot pain from Musculoskeletal problems such as plantar fasciitis/heel pain
- Musculoskeletal foot problems in children
- Palliative patients requiring specialist foot care.

•    People needing home visits.

We make home visits for people with conditions that prevent them from leaving the house. This includes:

- People who are completely bedbound/on oxygen
- People who need hoisting 
- People who are critically unwell and unable to travel
- Palliative care patients.

Diabetic foot service
The majority of patients in the service have a condition that puts them at high risk of foot complications. Diabetes is one of those conditions as it can make a patient more susceptible to ulcerations/wounds. To prevent amputations and reduce hospital admissions, the podiatry team offer carries out diabetic foot screening, regular treatment with a Diabetic Specialist Podiatrist, and education to avoid foot complications.

Nail surgery
This is for patients with problematic ingrowing toenails or those with a long-standing history of infected ingrown nails. This can affect adults and children alike. It can be caused by sport, ill-fitting footwear or cutting the nails inappropriately. 

Musculoskeletal podiatry (Biomechanics) 
This service is provided for adult and paediatric patients with foot/leg/hip/back pain or foot deformities. Biomechanical assessments assess your gait and body alignment, and treat musculoskeletal imbalance to enhance mobility, reduce pain, and limit future complications. The treatment regime will involve exercises to stretch and strengthen tight muscle groups. Insoles or orthotics will also be given if required.

Routine foot care
This is for patients defined as moderate or high risk, who present corns/callus and nail care, to maintain mobility, improve their quality of life and promote independence, and avoid foot complications. 

Our nail cutting service supports patients with significant medical podiatric needs that put their feet at risk of problems. We ensure they’re assessed and treated within an appropriate timeframe.

We identify who can take responsibility for their own nail care, with guidance, and who can’t manage safely without our help. This means that we don’t offer toenail cutting services to most people.

Toenail cutting - asessment

We do not offer simple nail care cutting service. To be eligible for assessment by the toenail cutting service, you must be suffering from significant medical conditions and mobility issues to access podiatry care. Self-care, family care, carers or non-NHS providers are otherwise recommended to provide simple toenail cutting. Significant medical conditions include:

• Diabetes
• Poor circulation (peripheral vascular disease)
• A history of ulceration, amputation, or infection
• Reduced sensation in the feet (neuropathy)
• Rheumatoid disease
• Cancer
• Renal problems
• Neurological/Immunological conditions.

Toenail cutting - who isn't eligible

The community podiatry service can’t see you for nail cutting if you are/have:

• Low-risk diabetes presentation (absence of diabetes risk complications or requiring diabetes screening), have a low-risk foot (that is, no risk factors present, such as loss of sensation or signs of peripheral vascular disease)
• Partially sighted with low podiatric and low medical needs.
• Unable to bend to touch your toes, with low podiatric and medical needs
• Fungal infections of skin and nails 
• Hard or thickened nails.

We also can’t provide nail cutting if you:

• Are able to look after your own feet, for example, toe nail cutting and skin care - unless clinically appropriate for high risk patients
• Have someone, such as a family member or carer, who can provide this care. This could also include paying private podiatrist to provide treatment.

Private podiatry

If you don’t qualify for this service from Ealing Community Partners we can help you find other professionals who can provide the support you need.

You can find a private podiatrist near you on The College of Podiatry website 

Podiatrists can also be called chiropodists. They have the same qualifications and do the same thing.

We provide care, treatment, and education for a wide range of conditions, but don’t offer:

• General nail care
• Treatment for verrucas
• Treatment for fungal nails
• Treatment for minimal or non-painful callus/corns
• Have non-symptomatic musculoskeletal issues
• Diabetic low-risk foot checks
• Non-symptomatic musculoskeletal issues.

Once you've been referred to us, we’ll assess you. This gives us the information we need to plan your care. 
If your referral meets the required criteria, then you’ll be sent an appointment for an assessment. 

At the assessment appointment, you’ll be seen by a member of our highly experienced team of podiatrists, who will ask about the foot problem. We’ll ask you about your medical history, the medication you’re taking, and carry out a foot examination to assess your sensation and circulation to assess what treatment you need.

Your care plan will be based on the outcome of your assessment. This allows the service to offer specialised care that is personal to each person’s needs. If at the assessment your foot risk is deemed to be low foot risk, we will provide a plan for your care and treatment or offer advice on self-care, and will be discharged from the service.

For further care for low-risk issues, it is recommended to see a podiatrist in a non-NHS setting. Local providers can be found at the Royal College of Podiatry website here.
 

You can be referred to the service by:

• GPs
• District nurses
• Social workers
• Allied health professionals
• Health visitors.

Referrals should be sent with a photograph, to: ealingcommunity.referrals@nhs.net 

We assess all patients who are referred to us before offering treatment.

Podiatry is not generally an urgent service. However, wherever possible, we aim to prioritise referrals marked urgent and where there’s an underlying medical condition that puts someone at high risk.

If you are already registered with our service, please contact us if you:

• have an urgent/emergency foot problem
• have a high foot risk
• need to cancel or rearrange an appointment.

If it's been six months or more since you have been seen by the podiatry service, you'll need to contact your GP for a referral.

If you require out-of-hours treatment, please contact your GP/call NHS 111, or attend Accident & Emergency services.