Diabetes Foot Clinic
Diabetes Foot Clinic
This is a dedicated specialist multidisciplinary foot clinic for patients with acute diabetic foot complications.
The main team includes both medical and surgical consultants, specialist podiatrists, a clinic assistant, limited orthotic practitioner and an orthotist. However, there are also microbiology and radiology specialists readily available if needed. Care is undertaken in both outpatient and inpatient settings.
The foot clinic can be found in the Elsie Bertram Diabetes Centre. This is a multidisciplinary centre with a variety of professions involved in diabetes care, covering central Norfolk, and the surrounding areas.
Who We Are
The Elsie Bertram Diabetic Foot Clinic in East block level 3 is open Monday to Friday and runs by appointment but if you are an existing patient you can arrange for a follow-up or an emergency appointment in clinic by telephoning on 01603 288522.
Existing patients can also contact us by email at ebdcfootclinic@nnuh.nhs.uk if you would like advice about your foot. If you can email us a photograph of your foot, then that will help us give you the best advice. Please include your name, date of birth, address, and hospital/NHS number in any email you send us so that we can correctly identify you, and a telephone number we can contact you on if we need to speak to you urgently.
The Foot Clinic does not offer a drop in service, please always ring to arrange an appointment. If we are unable to answer your call immediately, please leave a message and we will get back to you as soon as possible. If you are worried about your foot outside of normal working hours, we recommend you seek advice from the out-of-hours services.
Whilst the foot clinic is usually run by the podiatrists, the other members of the team are always available. We run specialist foot clinics every week. These are Medical Foot Clinic run by Professor K Dhatariya, Consultant Diabetologist. Vascular Foot Clinic with Mr D Morrow or Mr P Bennett Consultant Vascular Surgeons. Mr D Loveday, Consultant Orthopaedic Surgeon holds an Orthopaedic Foot Clinic once a fortnight. Professor K Dhatariya also attends the Vascular and Orthopaedic foot clinics.
New patient referrals are accepted from all healthcare professionals, however the clinic does not accept self-referrals. A new patient appointment will take approximately one hour; during this time you will be asked about your general health, diabetes control, current medication and history of foot problem. In order to help us complete our assessment we ask that you provide an up-to-date list of medication (ideally by bringing your most recent repeat prescription). We will assess the blood supply and nerves in your feet. Subsequent appointments will take 30-45mins.
The Norfolk and Norwich University Hospitals Foundation Trust is a teaching hospital, this means that there may be student doctors, nurses or podiatrists in clinic, and we will discuss your foot problems with them, if you would rather not have a student present please let the podiatrist know.
We aim to be an academic unit, and as such, patients attending the foot clinic may be asked to participate in clinical studies being undertaken in the department if they are deemed appropriate. Patients are under no obligation to take part and will be made aware that if they decline participation their ongoing care within the foot clinic will not be affected.
How Diabetes Can Affect Your Feet
Diabetes can lead to foot complications as a result of nerve damage, which can lead to loss of sensation in your feet and damage to the blood vessels that supply your feet. Diabetes can also increase your risk of developing an infection in your skin or bones. These three factors make your foot more susceptible to injury and can lead to other complications including:
- Ulceration
- Gangrene
- Charcot foot
- Bone infection
- Amputation
Who Should Be Referred
Referrals are accepted from all healthcare professionals for the acute foot conditions mentioned earlier. If you are concerned, you have an acute foot problem please contact your regular healthcare professional.
What We Do
The treatment we provide is based on national and international guidance:
- National Institute for Health and Care Excellence (NICE) Diabetic Foot problems: prevention and management (2015, last updated 2023)
- International Working Group of the Diabetic Foot (2020)
We provide a wide variety of specialist investigations and treatments including debridement, offloading, and emergency admission and pressure analysis.
Debridement
One of the main skills a podiatrist has is debriding hard skin (callus) and removal of unhealthy infected tissue using a scalpel, this is done under clinical conditions and is generally painless. If you attend the foot clinic with an ulcer or gangrene, your verbal permission will be sought to debride the affected site. Another form of debridement used in the foot clinic is Larvae therapy; this is used when there is too much unhealthy tissue to remove with a scalpel. You will have to attend the clinic once or twice a week to have fresh larvae applied. Callus and unhealthy tissue are removed to promote healing, reduce pressure and risk of infection.
Offloading
If you have an ulcer on the sole of your foot or a Charcot foot it is important to reduce the pressure. You may be offered one of a variety of sandals or boots to reduce the pressure on the affected foot. These off-loading devices include;
- Plaster Casts
- Off-the-shelf removable/non-removable walker
- Bespoke removable walker
- Temporary therapeutic walker
Plaster casts are non-removable and are made from polyester. They are the gold standard treatment for off-loading problem feet. Before you are offered a cast the podiatrist will advise you on the risks associated with the cast and how it will affect your mobility. If you are offered a plaster cast you will need to attend the weekly casting clinic for review.
Antibiotic Therapy
Diabetic foot ulceration is frequently complicated by infection. Infections can delay or prevent healing. When you attend the foot clinic your foot will be assessed for infection and swab, tissue or bone samples may be taken. If required we will arrange for you to receive antibiotics.
Emergency Admission
In some instances it may be necessary for people to be admitted to hospital, this occurs for two main reasons:
- Infection not responding to treatment
- Reduction in blood supply threatening the viability of the limb.
If this is the case you will be reviewed by either a consultant or registrar to arrange emergency admission from the foot clinic. After discharge from hospital you will be reviewed in the foot clinic as an outpatient.
Care of people admitted to hospital with a foot problem
Patients admitted to the NNUH with acute diabetic foot problems will be reviewed by the podiatrist and if needed on the multi-disciplinary foot clinic ward round.
Medical/Vascular/Orthopaedic Foot Clinic
If your foot condition is not getting better the podiatrist will arrange for you to be seen in either the Medical or Surgical foot clinics. These are consultant led clinics, where your diabetes and foot condition will be assessed further and a long term treatment plan agreed.
Hospital Shoes
When your foot condition has begun to improve you may well be offered hospital footwear. These shoes are designed to fit your foot shape and reduce the chances of future foot problems developing. If your foot shape has altered as a result of Charcot or amputation it is especially important that you have well-fitting footwear.
Discharge
Once your foot problem has healed you will no longer need to attend the Foot Clinic. However ongoing podiatry care will be essential to reduce the chances of future foot problems. You will be referred to your local community podiatry clinic.
Checking your feet every day will help reduce the risk of future foot problems. It will also mean that you spot any potential problems quickly and can get help before things get too serious.
If you notice any of the following you should contact the foot clinic or speak to another healthcare professional:
- A red, warm, or swollen foot which is new or different to how your foot normally looks
- A break in the skin/wound or any blood/bleeding, discharge (oozing) onto your socks, stockings, or shoes
- A sudden change in your foot shape
- If your foot looks different to how it looks normally
- Pain in your foot which is new or different for you
Future Foot Problems
If you have previously attended the foot clinic you can contact us directly if you are concerned about your foot/feet.
If you are able, please email a photograph of your foot as this will help the team decide whether we need to see you and how quickly we need to arrange an appointment for you.
Please include your name, date of birth, address, and hospital/NHS number in any email you send us so that we can correctly identify you, and a telephone number we can contact you on if we need to speak to you urgently.
- The email address to contact and send pictures is – ebdcfootclinic@nnuh.nhs.uk
If you are not able to email us, you can contact us by phone
- The phone number to call is – 01603 288522
The diabetic foot clinic is open Monday – Friday during normal working hours. If you are worried about your foot outside of normal working hours, we recommend you seek advice from the out-of-hours services.
Never ignore a foot problem or wait to see if it heals or goes away on its own.
Your referral will stay open for up to five years from when you were seen in clinic. After five years your referral will be automatically discharged.
If you develop another foot problem after five years you will need to be re-referred to the foot clinic by a health care professional (doctor, nurse, local podiatrist).
Podiatry Team
- Catherine Gooday, Principal Podiatrist
- Rachel Murchison, Podiatrist – Diabetes
- Heather Dinar, Podiatrist – Diabetes
- Rachael Saywood, Podiatrist – Diabetes
- Jessica Haw, Podiatrist – Diabetes
- Clare Edie, Podiatrist – Diabetes
- Rebecca Hiley, Podiatrist – Diabetes
Contacting Us
You may contact us either via the email address/contact telephone number below or by mail to:
Catherine Gooday
Principal Podiatrist
Diabetic Foot Clinic
Elsie Bertram Diabetes Centre
Level 3 East Wing
Norfolk and Norwich University Foundation Hospital
Colney Lane
Norwich
NR4 7UY
Main Telephone Number: 01603 288522
Phone lines are open Monday to Friday until 16.15
Email Address: podiatrysecs@nnuh.nhs.uk
Opening Times
| Monday | 08:00 – 17:00 |
| Tuesday | 08:00 – 17:00 |
| Wednesday | 08:00 – 17:00 |
| Thursday | 08:00 – 17:00 |
| Friday | 08:00 – 17:00 |
| Saturday | Closed |
| Sunday | Closed |
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