Decision Report 201508812

Summary

Mr C complained about the care his late wife (Mrs A), who suffered from diabetes, received from the board. In particular he complained that when a home visit was made by a district nurse, his wife's podiatry appointment was not brought forward by the board.

During our investigation we took independent advice from a consultant podiatrist. The adviser considered that when Mrs A's diabetic foot ulcer was noted during the home visit, an urgent referral should have been made to the board's multi-disciplinary diabetic foot care service which would have given her access to vascular assessment and a vascular consultant.

The adviser, when commenting on the care given during the home visit, also referred to the podiatry care Mr C's wife received when she was admitted to Western Isles Hospital. In particular, the adviser commented that there was no record of a vascular assessment having being carried out and that this represented a failure in assessment by podiatry.

Recommendations

We recommended that the board:

• ensure podiatrists and district nursing teams have the competencies required to provide assessment for patients with diabetes and acute foot conditions;
• ensure all health care professionals are aware of the available guidance for diabetic foot conditions;
• ensure the pathways and signposting for urgent referrals are in place and implemented;
• consider the adviser's comments on referral to an acute multi-disciplinary diabetic foot care team and report back on action taken;
• ensure clinical data is available across the organisations; and
• issue Mr C with an apology for the failings identified in this investigation.