Save a Life, Stop a Stroke
During a three-month pilot project, podiatrists (also known as chiropodists) performed foot pulse-checks on patients with diabetes, aiming to increase diagnosis of Atrial Fibrillation (AF), identifying a number of patients with previously undiagnosed AF.
The work was conducted by County Durham and Darlington NHS Foundation Trust and has been part of a wider AF Programme run by the Academic Health Science Network for the North East and North Cumbria (AHSN NENC) in conjunction with the Northern England Clinical Networks. The programme aims to reduce the number of strokes and deaths in the region by identifying and treating AF as early as possible.
During the initiative, 45 podiatrists from across North Durham, Darlington and Durham Dales Easington and Sedgefield CCGs were trained to spot heart irregularities when taking pulse readings of diabetic patients’ feet during their annual foot screening appointments. This means more podiatrists from the region are now upskilled in this potentially life-saving check. Over the course of the three-month pilot 5,000 diabetic patients had their feet pulse-tested across the North East. The project uncovered that for every 500 patients who had their feet checked, one new case of AF could be identified.
The podiatrists have been very receptive to the programme and recognise it as their clinical responsibility to help detect AF. The pilot has been an excellent opportunity to raise awareness of the condition amongst patients and healthcare professionals alike, and training continues to be successfully adopted throughout County Durham and Darlington and, more widely across the North East and North Cumbria, through the Northern Diabetes Footcare Network.
To translate this work into other areas, podiatrists and foot technicians need to feel for pulse regularity and follow an agreed pathway allowing patients to be referred to their GP for further investigations, usually a 12-lead ECG. Heart problems are two to three times more common in people with diabetes; so any simple process that can identify a potential problem quickly can save lives. Extrapolation of data shows that in the North East and North Cumbria area, a potential 463 patients could be identified with AF, therefore preventing 23 strokes and save in excess of £0.5M.
Kate Mackay, AF Programme Lead, AHSN NENC
Linda Hicks, Advanced Podiatrist, Podiatry Department, County Durham and Darlington NHS Foundation Trust
Dr Rahul Nayar, Chair of the Northern Diabetes Footcare Network, Diabetes Clinical Lead for Northern England Clinical Networks, NHSE & Consultant Diabetologist at City Hospitals, Sunderland