North East and North Cumbria Integrated Care Board (ICB) which plans and pays for NHS podiatry services in South Tyneside and Sunderland, is proposing to change the current system of various service providers to just one.
The number of clinic locations is set to be reduced from the current 30 to at least 18, to be decided by the chosen provider. There will also be a move towards supported self-care for those who are able and a single point of contact for referrals to be need assessed against one clear, standardised set of criteria.
ICB has highlighted a number of challenges it faces including a national shortage of podiatrists, increased demand and cost, more patients with complex needs and unequal services in the two areas which have necessitated change.
It says the proposals for changes will not lead to a reduction in appointment numbers, with self-care freeing up clinics for those with the most need. But ICB acknowledged that it could mean some regular patients may see a change in staff.
ICB commissioned Healthwatch to attend NHS podiatry clinics to speak with patients and gather their views on the proposed changes and to give them an opportunity to have their say around any concerns or potential service improvement.
A survey was jointly developed to obtain views on the proposed move to one provider, a reduction in clinic locations, the focus on self-care and being able to self-refer.
We attended eight clinics at Cleadon Park Primary Care Centre and The Westoe Practice between September 11 and 26 to speak to patients, assisted service users who phoned in for help to complete the survey and promoted the online survey via the Healthwatch website and social media channels.
The overriding themes from the 89 participants included wanting continuity of care with the same podiatrist, concerns about a move to self-care leading to increased problems and of accessibility to a reduced number of clinic venues.
In our report to ICB, Healthwatch South Tyneside has recommended clear communication on:
- explaining how a move to one provider will work
- stressing that those who could not self-care due to age or disability would not be expected to do so
- confirming that an initial assessment would always be carried out by a podiatrist prior to tutorials in self-care (for those patients able to manage this)
- highlighting the range of appropriate foot care products and aids that would be provided for self-care
- the new venues for consultations and treatment and public transport links to them.
John Lowther, Chair of Healthwatch South Tyneside, said: “Many of the patients we spoke to, or who completed the survey online, were concerned about lack of continuity of service – both in terms of the podiatrist providing the care, the location of the clinic and a move towards self-care.
“Our report to ICB is therefore calling for clear communication to patients on the changes, once agreed, and a focus on accessibility to clinics for service users without access to private transport.
“We are pleased that ICB has confirmed it is currently reviewing the patient feedback before making a final decision on the changes to podiatry services in the borough, and would like to thank all staff and patients who assisted us with the survey.”
The full report can be downloaded here.
