Co creating Healthy Footsteps - a supported self management programme for looking after your feet

Abstract

The aim of the project was to integrate though a partnership approach the podiatry service, the Education Programme for Patients (EPP) and service users to stop one to one appointments with podiatrists for a routine appointment. We developed a 2 hour group session to deliver a more prudent way of providing education and information to promote self-care when looking after our own feet. This reduced the need to provide appointments for routine referrals, and improve access for those needing the care of a podiatrist. The referrals to podiatry have changed with a significant rise in high risk, complex, co morbid patients who required rapid assessment and intensive ongoing treatment. In January 2017 the manager of the Pembrokeshire podiatry service, EPP and service users explored a different way of supporting people referred to podiatry for a routine referral. An educational programme was identified, revised with the support of patients and the podiatry service and a pilot to test the Healthy Footsteps programme was implemented.• Evaluation of each session was planned and comments were written down from the service users who attended the pilot programmes to gain feedback and make changes.• The evaluation data from the pilot programmes led to changes to the manual• Volunteers to become lay tutors were identified from the service users who attended the programme.• Healthy Footsteps Train the Trainer programme developed.From April 2017 to November 2017, 569 routine referrals were sent to EPP to invite on to Healthy Footsteps. 12 programmes completed.137 had completed a course in this time of which• 49 discharged at the end of the education session• 48 were given appointments• 40 put on hold (given advice to try and discharged if not heard from at 6 months)In 8 months delivering Healthy Footsteps s reduced waiting lists by 66% Breaches of waiting times reduced by 58%.The outcome of the new way of working has resulted in :• Access to the service is improved for patients• More appropriate referrals• Programmes are delivered closer to home.• Clinic slots freed up for patients with complex podiatry needs i.e. Diabetic/ Vascular• Increased knowledge of Foot Health with the potential to reduce future referrals• Promote self-management /empower patients and carers Total of 197 pre course empowerment scores and 94 post empowerment scores collated. A response rate of 48%. Comments made by service users include; “This course was very well presented and covered many problems that apply to me and my feet” “Attending Healthy Footsteps session proved very beneficial, my symptoms have been greatly alleviated by wearing proper footwear. ”From the positive feedback and empowerment scores the next stage was to consider roll out across the three counties. We now run regular Healthy Footstep programmes in all three counties in Hywel Dda. Patients have the opportunity to access any community venue within a 6 week time slot.Healthy Footsteps training launched across Wales and enabled a sustainable model across HDUHB and Wales.