NICE guidance (NG19)1 on diabetic foot care highlights the need for healthcare professionals to stratify the risk of each patient and ensure that the patient is aware of their risk level. The Flexitol Foot Screening Toolkit has been developed in conjunction with Donna Welch, NHS Advanced Podiatrist, Diabetes, to support this process.
Diabetic foot: What’s the risk?
The Flexitol Toolkit helps you to complete a comprehensive foot assessment by providing step-by-step checklists for:
- The questions to ask the patient
- The visual examination
- Classification of risk for your patient and your next action
- Your patient’s next actions.
From the results of checklists and the patient’s records, a score can be calculated, which can be totalled to objectively and accurately classify the patient’s risk and actions:
| Score | Risk Classification | Action |
| 30+ | Ulcerated Foot or Foot Emergency | Immediate referral to specialist diabetes multi-disciplinary team. |
| 10-30 | High-Risk Foot | Refer patient to specialist foot team for assessment and ongoing management. Review foot screen in 3-6 months. Supply emergency contact numbers. Supply advice leaflets on warning signs of infection and self care. |
| 5-10 | Moderate-Risk Foot | Refer patient to local podiatry team for ongoing management. Review foot screen in 6-12 months. Supply emergency contact numbers. Supply advice leaflets on warning signs of infection and self care. |
| 0-5 | Low-Risk Foot | Advise patient on self care, including checking feet daily, use of a urea-based emollient daily and review foot screen in 12 months. |
The Flexitol toolkit provides the methodology to deliver an effective, high-quality foot screening. The toolkit is not intended as a substitute for practical training but provides content to ensure all aspects of the assessment are covered and, more importantly, discussed with the patient.
References
1. NICE NG19. Diabetic foot problems: prevention and management. nice.org.uk/guidance/ng19 (accessed December 2023).
UK-FLEXRX-63ec | December 2023
