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A WAR pensioner denied NHS chiropody treatment is outraged after being told he should "get a neighbour" to cut his toenails.
Quote:
"He suggested my daughter do it but she lives miles away. Then he said can't you get a neighbour to do it?'.
"I wouldn't lower myself to do that, I fought for my country. It made me feel so low. It's degrading; you would never ask a neighbour to do that."
.....
Quote:
"We are also taking every necessary step to ensure the advice given by all our podiatrists in future takes full account of the individual circumstances of our clients."
Didn't someone do a study on education of patients for self treatment including advice on using a nail file? (It was either an NHS dept in Sheffield or London, I think) Perhaps this may have been a more appropriate suggestion for the people concerned. Having said that, it could be that such things were omitted from the press report to sensationalise the story.
Last edited by bob : 10th November 2004 at 09:29 AM.
I think the study was carried out in Sheffield. I did read that part which was published in Pod Now, and was unimpressed.
I believe the study was biased (ie, driven by what the researcher hoped to find, which fitted in nicely with NHS policy in that District).
If a patient has arthritis in spine and hands, and spouse has arthritis too, how can they cope with just a nailfile anyway?
And why, if there are private practices around, are we not simply looking at devolving NHS work into PP's ?
Having said that, it could be that such things were omitted from the press report to sensationalise the story
Nothing like the truth toget in the way of a good story :)
Quote:
FOOTSTEP: a randomized controlled trial investigating the clinical and cost effectiveness of a patient self-management program for basic foot care in the elderly
Robin Waxman, Helen Woodburn, Melanie Powell, Jim Woodburn, Susan Blackburn and Philip Helliwell,
Journal of Clinical Epidemiology
Volume 56, Issue 11 , November 2003, Pages 1092-1099
Background and Objectives
Podiatry (chiropody) services are one of the most frequently requested services in primary care. The elderly are given priority access to podiatry services in the UK blocking access for other priority groups. To evaluate the clinical and cost-effectiveness of a self-management program as a means of managing nonurgent demands for podiatry services by the elderly without compromising foot-related disability.
Method
Randomized clinical trial with blinded 6-month follow-up and economic evaluation. People aged 60+ seeking self-initiated or primary referred podiatric consultation were screened. Five hundred ninety-nine were excluded on the basis of health status, and 259 refused to participate or did not attend initially. Seventy-eight were randomized to receive a self-management program, and 75 usual care. The main outcome measure was foot disability, as measured by the Manchester Foot Disability Questionnaire.
Results
At 6 months, self-management program participants had lower foot disability scores than the usual care group (difference between scores -1, 95% C.I. -2, 0), and returned for fewer treatments within the 6-month study period (39 vs. 92 treatments). The cost per patient for the self-management program (£10.92) was found to be the same as for usual care (£10.71), but this included the cost of nail care packs.
Conclusion
In this group a self-care program for routine foot care did not compromise therapeutic outcomes, and may be more cost effective in the long term. Further work is required to extend self-management programs to other target groups, such as people with diabetes at low risk for foot problems.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
In response to your lead article this week, The NHS puts its' Foot in it, I would be interested to discover if any of your other readers had similar experiences to that of Mr Parker (News Shopper, November 10).
Although Bromley PCT has arranged for Mr Parker to receive chiropody treatment, I suspect there are many other people in a similar predicament to him, and the PCT is not keen to advertise this fact.
I recently heard an interview on the BBC's Radio Four Today programme, where Stephen Ladyman, a Government Health Minister with special responsibility for chiropody/podiatry, defended the Government's position on NHS chiropody provision.
The article was highlighting the fact 986,000 patients in the UK had been discharged from chiropody services in the past year. Allowing for cured patients and deaths, this still left a very high number who, like Mr Parker, are being denied chiropody services.
Mr Ladyman's response was the responsibility for the provision of NHS chiropody services was devolved to local PCTs.
Each PCT, therefore, has its own policy on accessibility to services, hence the term postcode provision of services differing from district to district.
The question one needs to ask of the PCT is, do we in Bromley borough get the level of chiropody service based on the needs of the patients or do we get what it is deemed the PCT can afford?
Hi All,
Just been told last week that nurses in my local hospital, (A very large new one!), are receiving training if they show willing in nail cutting. After all that is what they used to do before 1960 didn't they!
It takes three weeks for a chiropodist to attend to patient's in this hospital's Wards, (I believe they will not attend before three weeks are up even regarding diabetes, but I have taken that one with a pinch of salt?).
There has also been a whisper that Age Concern are also considering doing this but I have not been able to confirm this yet?
Normal podiatry services appear to have reached four month visits in this hospital's Outpatients Dept. which is far to long for most of mine to wait. Long may it continue, but it's not so good for the patients?
Who is responsible for cutting the toe nails of those that cannot plus those that are at risk.
My parents are lucky. They have me. Dad is 84 mum is 74, both with dodgy toe nails but thankfully otherwise OK. Not high risk...although dad did serve with the 84th Armoured Division. He kept the division on the road and repaired my very 1st car.
So what is the cost of all the flowers, chocolates, drawer liners, pot pourri, socks, novelty presents at Christmas and birthdays?
SOCAP invented gift vouchers all those years ago.
Re-invent and market them at your practice. Flowers 2times annually = what £80?? Need I say more.
I thought my Gran was totally bonkers when she asked me for tin foil and batteries as a Christmas present a long time ago when I was 16. She had a Chiropodist. They shared a nail cut and a gin and tonic monthly on a Friday evening. I haven't a clue what he charged but it was pence or pennies.
Many years later, bless you Doris, at long last I understand your motivation.
Whatever generation we belong to; whatever our age and whatever our health we and our families have to take responsibility for welfare. Never have we been richer. Gran had her priorities right-we had to buy her batteries and tin foil. Her hard earned brass was going on her 15 minute nail cut and foot massage. She supplied the gin and tonic. Her Chiropodist knew to fit her in last for a good gossip and a homeward glow. Gran was high risk. Full to the gills with steroids and it wasn't her toe-nails or gin that saw her to the world beyond.
There are ways and means to look after toe-nails. It is up to us to invent those ways and means. Market them professionally, safely and bring those family members that care on side with us.
Re: NHS tells veteran 'get a neighbour to cut your toenails'
I have tried vouchers, I have even given then as 'raffle prizes' to encourage the use of them, but to no avail. The only people who buy them are family, but usually most of them live miles away - and 'voucher presents' are not a last minute buy, if you have to post a cheque to the podiatrist and wait for the return post. ???
NHS tells veteran 'get a neighbour to cut your toenails'
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