Foot Health Service - Newham

Based on guidelines from Newham CCG we have set out access criteria:

High Risk Patients are patients with conditions that put them at risk of ulceration or amputation, such as: diabetes and rheumatoid arthritis. Patients on anticoagulation therapy and those who are immunocompromised and COPD patients will be a priority for ongoing care, if needed due to the risk stats.

Low Risk Patients are those with no medical conditions or have conditions that are not limb threatening. Patients who are accepted to the service may be discharged to self care following initial assessment or provided with a short course of treatment, depending on their condition. These patients do not qualify for nail cutting service.

Home Visits - We carry out domiciliary visits for patients who are bedbound or who are receiving end of life care, in their own homes or in residential care. Hospital transport if available for those who require additional assistance in travelling to the clinic, the service can be arranged by calling Patient Transport on 0330 041 6767.

We accept referrals from health professionals for patients registered with a Newham GP. Please complete the appropriate referral form. Patients with diabetes should be referred using the Diabetes Service Referral Form.

If you require urgent advice regarding a patient, please call 0208 496 9007 and speak to the Duty Podiatrist.

*Please note: referrals for low risk nail cutting and verruca treatment will not be accepted. Please refer to access criteria for more information.

A foot ulcer is an open wound on the foot. People with diabetes, poor circulation or autoimmune conditions are more likely to develop foot ulcers. It can be a challenge to treat ulcers in people with these conditions, as even a small foot ulcer can become infected or get bigger if it is not treated quickly. If you have an ulcer on your foot, please contact Foot Health on 0208 496 9007 or your GP.

Diabetes is a condition where the body is unable to control blood sugar levels effectively. People with diabetes have a much greater risk of developing problems with their feet due to the damage that can be caused to the sensation in the feet and circulation.

A foot attack is an injury to the foot (or feet) of someone with diabetes who has reduced feeling or reduced blood circulation to their feet.

What are the danger signs?

Any redness, heat or swelling, a break in the skin, any discharge/fluid (or oozing) onto your socks or stockings or if you feel unwell (fever, shivering, nausea).

A foot attack is a medical emergency that needs urgent attention – contact your GP or the Foot Health Service immediately.

Useful information:

Diabetes UK – 10 tips to prevent foot problems

Diabetes UK

Diabetes.co.uk

We provide routine treatment for corns, callus and nail deformities where it is assessed that there is a medical need. Many common foot conditions can be treated with self-care without having to see a podiatrist. Please see our advice leaflets for common foot conditions.

If you have a condition which puts your feet ‘at risk’, such as diabetes, rheumatoid arthritis, peripheral vascular disease, COPD or if you are on blood thinning medication, then please seek advice from a health professional before you self care.

We provide a nail cutting service for patients with limb threatening conditions i.e. High risk diabetic patients, patients with rheumatoid arthritis or patients who are immunocompromised. Patients with COPD and patients on anti-coagulant medication are also given priority for this service. We do not offer basic nail cutting without medical need. For further advice on how to cut your nails, please see our advice leaflet.

An ingrowing toenail develops when the side of the nail grows into the surrounding skin. The big toe is often affected, either on one or both sides. The nail pierces the skin, which becomes red, swollen and tender. It can also become infected.

If you think you have an ingrowing toenail, it is important not to try to manage it yourself but to contact the Foot Health Service or your GP.

Permanent removal of part or the whole toenail may be necessary in order to treat the ingrowing toenail. The podiatrist will discuss the appropriate course of treatment with you following assessment.

Corns and calluses are hardened layers of skin that form on the sole or the top of the foot. They can cause discomfort if left untreated. Please refer to your patient leaflet for further information and advice. Simple changes to footwear can prevent the development of corns and calluses.

The medical name for athlete’s foot is tinea pedis and it is a common fungal infection of the foot. Typically, an itchy red rash develops in the spaces between your toes, but it can also affect the soles of the feet. The affected skin may also be scaly, flaky and dry.

Biomechanics is the science of the movement of a living body. It involves consideration of the forces acting upon the body and how they can affect muscles, tendons and bones. Podiatrists use biomechanics in their assessment (which may include gait analysis) to determine how the forces acting on a patient’s feet and legs may be contributing to the pain that they are having. Biomechanics are a key consideration in the musculoskeletal (MSK) podiatry clinic, where patients may be seen for sports injuries, neurological conditions, long term conditions such as diabetes and rheumatoid arthritis, or problems related to growth in children and teenagers. The podiatrist may prescribe orthoses (insoles) as well as recommending strengthening or stretching exercises to manage a patient's pain.

Plantar Fasciopathy (Heel pain) Plantar - Fasciopathy is sometimes called plantar fasciitis. It causes pain in the soft tissues in the heel and the sole of the foot, particularly first thing in the morning or after standing or walking for long periods.

You can get more advice on this condition from our leaflet.

Bunions – Bunions are a common foot problem. They appear as a lump to the side or top of the big toe joint and can also cause the big toe to press against the toe next to it. Bunions can be painful and it can be difficult to find shoes which fit properly.

Achilles Tendinopathy - Achilles’s tendinopathy is a condition that causes pain, and sometimes swelling and stiffness of the Achilles tendon. The Achilles tendon joins your heel bone to your calf muscles. Tendinopathy is thought to be caused by repeated trauma to the Achilles tendon and is often managed with specific exercises.

Patients registered with a Newham GP are able to access the service using our self-referral form (option to download form), completed forms can be posted, emailed to us or handed in at the reception desk at Appleby Road.

Your GP, District Nurse, Physiotherapist and all other health professionals can also refer you to the service. The form will be triaged by one of our Podiatrists; if you meet the access criteria for our service, we will be sent a letter asking if you want to be placed on the waiting list. If your referral is rejected, you will receive a letter in the post informing you of this. Please note that we do not accept referrals for basic nail care without medical need.

If your GP is located outside of Newham, your referral will not be accepted.

Via email on epct.spa@nhs.net

The Foot Health Service has specialist clinics including musculoskeletal, nail surgery and diabetic foot ulcers and run a daily triage assessment clinic.  We are involved in multi-disciplinary clinics and ward rounds with vascular and diabetes consultants which take place at Newham University Hospital.  

Our services are provided in the following centres:

Shrewsbury Road Health Centre, Shrewsbury Road, Forest Gate, E7 8QP Tel: 0208 586 5100  

Appleby Health Centre, 63 Appleby Road, Canning Town, London E16 1LQ Tel: 0207 445 7000 

The podiatry team is formed of podiatrists and trained foot care assistants working together to provide advice and clinical expertise for patients experiencing foot problems.

MSK/Biomechanics  

Biomechanics is the science of the movement of a living body. It involves consideration of the forces acting upon the body and how they can affect muscles, tendons and bones. Podiatrists use biomechanics in their assessment (which may include gait analysis) to determine how the forces acting on a patient’s feet and legs may be contributing to the pain that they are having. Biomechanics are a key consideration in the musculoskeletal (MSK) podiatry clinic, where patients may be seen for sports injuries, neurological conditions, long term conditions such as diabetes and rheumatoid arthritis, or problems related to growth in children and teenagers. The podiatrist may prescribe orthoses (insoles) as well as recommending strengthening or stretching exercises to manage a patient's pain. 

Useful websites

• The Society of Podiatrists and Chiropodists
• Diabetes UK
• Arthritis Research UK
• Arthritis Care
• National Arthritis Rheumatoid Society
• Diabetes UK 

The service objectives are to: 

• Improve the clinical outcomes of residents of Newham with lower limb and foot health needs enabling them a better quality of life. 
• Provide a foot health service working alongside other health and social care services that improve the quality of care for Newham residents with foot health needs - aligned to best practice and national guidelines. 
• Provide clinical interventions that reduce the debilitating effects of long-term conditions and other illnesses on foot health, thereby promoting greater independence and mobility.

To work with us, please visit our job vacancies page.