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Diabetes-related amputations have a dramatic effect on quality of life and life expectancy and are also a huge financial burden to the National Health Service (NHS). The city of Portsmouth had the second-highest amputation rate in the country from 2007–2010, according to data published in early 2011, leading to a restructuring of the foot care pathway in the area. Over a three year period, the rate of major amputations in people with diabetes in Portsmouth has fallen from 2.3/1,000 to 1.4/1,000, compared with the national average of 1.1/1,000. Repeat hospital admissions for diabetic foot disease are comparable to the national average for the first time. We continue to identify areas of improvement needed for our patients with diabetes and hope to continue to improve foot outcomes for our patients.

Improving a diabetes foot service to prevent amputations: the Portsmouth experience