Agenda item

The attached report, to be introduced by the Head of Strategic Commissioning, provides an update on work undertaken to ensure sufficiency of foot care provision in Haringey.

Charlotte Pomery, Assistant Director, Commissioning, provided an update on Haringey foot care services. It was noted that during 2015/16, the Panel’s work programme had focused on ensuring there was sufficient foot care provision in Haringey. It was noted the take up of foot care services by older people was an important measure in preventing falls and treating acute conditions such as poor circulation as a result of diabetes. 

During the discussion a variety of issues, highlighted in the report, were considered, including: 

-       Recent changes that had been made to foot care provision in Haringey, including the development of community-based preventative services following the closure of the Haven Day Centre, and progress that had been made to ensure continuity of service.

-       The locations, outlined in 6.4 of the report, where each year over 650 older adults received community-based services. In addition, it was noted that the Foot Care + service had started to visit new locations, previously visited by staff from the Haven Day Centre. In response to questions, Ms Pomery agreed to send Panel Members further information to explain why Larkspur Close had not been used by the Foot Care + service.   

-       The steps that had been taken to tackle performance issues with the Whittington Health Podiatry and Foot Health Service.  The Panel was informed that Haringey and Islington CCGs managed the performance of the service via regular contract performance monitoring meetings. The Panel was informed that both CCGs had identified the need to improve performance and that the service would be developing an action plan to deliver improvements to ensure the service met expected targets. 

-       The performance of the Podiatry and Foot Health Service at July 2016, outlined in section 7.2 of the report, was noted. Concerns were raised in relation to the number of patients waiting more than six weeks for their first appointment. However, it was suggested that additional monitoring was required in relation to the maintenance of the service (e.g. the time you wait for an appointment once you are in the system). The Panel asked Ms Pomery to circulate further information on the performance matrix that was used for the service.

-       The work, outlined in section 8 of the report, that was taking place to raise awareness of foot care services across the borough. It was noted  this was being done via a variety of channels, including: the nurse and health care assistant forum; the locality teams; the Haringey Advice Partnership; Patient Advice and Liaison Services; the Integrated Access Team; Haricare; and NHS Choices.

-       The information provided by Haricare. The Panel noted the correct information was not always available at the right time to enable citizens, service users and carers to help themselves effectively and to be aware of their own health so they could take steps to manage emerging or existing conditions.

-       Concerns in relation to the number of older people who may have problems carrying out basic foot care, such as nail cutting, by themselves. Consideration was given to the estimated need and unmet need in the borough and the possible cost of unmet need. It was suggested that better data collection was required in order to understand these issues/costs. 

-       Opportunities to expand the availability of foot care services in Haringey to ensure gaps in service provision were addressed.

The Panel was informed that the Council and Haringey CCG were exploring options with the Whittington Health Podiatry Service and the Bridge Renewal Trust to take advantage of the fact Bridge Renewal Trust Foot Care staff had been trained to deliver nail cutting services to people with diabetes. It was noted that one option, being explored to ensure gaps in provision were addressed, would be to agree an approach where patients referred to the Whittington Service, but who did not meet the service criteria, were signposted to alternative community based options. The panel also suggested more could be done via GP surgeries to help promote/signpost residents to services across the borough.    

AGREED:

(a)  That the update, on foot care services across Haringey, be noted.

(b)  That a further update be prioritised for inclusion in the Panel’s work programme for 2017/18, focusing on work undertaken to ensure sufficiency of foot care provision in the borough.