Who are we?
The podiatry team is made up of Podiatrists, Podiatry Assistants and Admin staff who are responsible for delivering podiatry services across Lothian. All our Podiatrists are registered by the Health and Care Professions council (HCPC).
We aim to help you to:
- Relieve pain
- Maximise function and mobility
- Prevent or minimise deformity
- Reduce the risk of ulceration and amputation.
- Prevent future foot problems through health education
- Self care where appropriate
What do we do?
Podiatrists assess, diagnose and treat people with foot, ankle and lower limb problems to alleviate pain, maximise function and promote self management, to improve the overall quality of life and independence of our patients. We also aim to reduce complications associated with conditions affecting the feet.
We assess and treat a range of foot, ankle and lower limb musculoskeletal conditions that cause pain, which include injuries caused by sport or other activities, bone and joint disorders. These include arthritis and soft tissue problems, for example, muscle strain. The treatment program may include an exercise regime, orthotic devices, footwear advice and steroid injection therapy.
We provide podiatric management of foot problems for people who have complex conditions that put the foot at risk of ulceration and amputation. Some of these conditions include diabetes, vascular, rheumatology, neurological and renal disease.
We provide wound management for non-healing foot wounds as part of the multi-disciplinary team.
We provide assessment and treatment of painful nail conditions, for example, an in-growing toe nail. Treatment may include conservative treatment, self care advice, administration of local anaesthesia and nail surgery.
We can aid the prevention of falls through podiatry care, which may include an exercise regime for foot and ankle weakness or reduced range of motion, footwear advice, orthotic devices and management of associated foot pain.
For more information on the support that can be provided by the NHS Lothian Podiatry Service please access this letter to care home managers.
How do I make a referral?
Please access the Podiatry Referral Pathway page
What do we not do?
NHS Lothian Podiatry Service does not offer:
- A simple nail cutting service.
- Fungal nail treatment (including taking clippings)
- Skin care (including corns and callous) in the absence of medical need.
The Scottish Government’s Personal Footcare Guidance (2013) endorsed the removal of personal footcare from NHS Podiatry provision. The NHS Podiatry service now focuses on core podiatry provision and specialist Podiatry services. Please see the NHS Scotland Personal Footcare Guidance for more information.
Personal footcare is deemed as part of a personal hygiene routine for feet and covers a set of tasks that an individual, whatever their age, would normally do for themselves if they are able to.
Personal foot care is described as follows:
Toenail care
- Clipping and/or filing toenails safely
Skin care
- Daily smoothing and moisturising dry and rough skin
- Keeping feet clean, dry, comfortable and warm at all times
- Daily checks for cracks and breaks in the skin
- Daily looking for signs of infection or other obvious early problems and seeking professional advice
Footwear
- Checking footwear for comfort
- Making sure footwear is a good fit
- Footwear is in a good state of repair
- Making sure footwear is safe to wear
Looking after your resident’s feet
Looking after your resident’s feet (foot care) and treating common foot problems – such as corns, callus is vitally important to aid mobility. Wearing footwear that’s safe, appropriate and in good repair can also keep your feet healthy as well as prevent falls.
What can I do?
- Check feet morning and night.
- Ensure the resident has appropriate footwear. Where possible shoes should be worn during the day and leave slippers until night time.
Foot care
Good foot care is easy to do and it can include:
- Keeping feet clean and dry – especially between the toes.
- Checking them regularly for cuts or sores, redness, swelling or bruising. Get to know your resident’s feet well and know what’s normal.
- File nails weekly (when dry) to the pulp of the toe. File nails in length and thickness. If cutting nails cut after a bath when softer. Do not share any equipment between residents.
- Applying moisturiser to prevent the skin from cracking and improve its texture. Apply daily but not between the toes.
- Filing dry or hard skin using a foot file and apply moisturiser.
Resources:
- NHS Lothian Podiatry Basic Footcare Nail Filing (video)
- NHS Lothian Podiatry Basic Footcare Skincare (video)
Footwear
Pay attention to your resident’s footwear as this can also affect their walking and balance.
A good shoe should support and protect the foot and allow natural movement during walking. Poorly fitting shoes can cause foot problems – such as corns, calluses, bunions and ingrown toenails.
When replacing shoes, look for:
- an upper made of leather or breathable natural or synthetic materials with seam-free linings.
- a deep roomy toe-box at the front of the shoe to prevent pressure on the toes and joints on the side of the foot
- a cushioned and flexible light rubber sole with a good grip
- laces or Velcro strap fastenings that hold the shoe comfortably and securely on the foot. Avoid slip on shoes and always tie laces.
You can use this monthly Footwear Checklist developed by NHS Lothian Podiatry to assess individual residents.
Foot Problems
If you experience any problems with your resident’s feet – such as cuts or sores or fluid/blood leaking from any area – cover the affected area with a dry sterile dressing and contact the Podiatry Department.
Other Useful Resources
NHS Inform Looking After Your Feet – a range of resource made available to the general public
Diabetes UK – useful diabetes information and advice leaflets from the Foot Action Group for people with a low to high risk of developing foot ulcers.
Foot Risk Awareness and Management Education (FRAME) Project – A range of resources to support foot care for people with diabetes. It includes training materials and competencies.
Further information
For information on the podiatry referral process and training materials please see the following webpages.
Podiatry: Referral Pathway
Podiatry: Training Material
