Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what action they have (1) considered, and (2) taken, to reduce the number of preventable amputations occurring within the National Health Service.

Diabetes is one of the most common causes of amputations in the United Kingdom and there are a variety of mechanisms in place to support the care of people with diabetes to minimise the risk of amputations. NHS England published Action for Diabetes, which sets out that in many cases amputation as a result of diabetes is avoidable.

NHS England has also piloted a diabetes service specification in a small number of clinical commissioning groups (CCGs). Feedback has been very positive and they have now published the service specification on the NHS Commissioning Assembly website so that it is available nationally for CCGs to use.

In addition, the National Diabetes Foot Care Audit was launched this year. The audit aims to establish the extent to which national guidelines on the management of diabetic foot disease are being met, and will provide local teams with the evidence needed to tackle any identified differences in practice which will lead in turn to an overall improvement in management and outcomes for patients.

Finally, NHS Improving Quality is supporting a project to reduce the high mortality associated with diabetic foot disease. People with diabetic foot disease are at particularly high risk of premature death, much of which is due to cardiovascular disease, with 5 year mortality for those with Type 1 or Type 2 diabetes and diabetic foot disease around 50%. The project will pilot an approach in several multidisciplinary foot clinics across the country over the next 18 months to introduce an additional clinical pathway which includes a cardiological test and subsequent actions to address risk.