For anyone living with diabetes, foot problems can quickly become serious ” and in the worst cases, life-changing. One of the most effective ways to manage and treat diabetic foot ulcers is through a multidisciplinary team (MDT) approach.
NICE Guidance is clear that urgent referral (within 24 hours) to a multidisciplinary foot care service is required if a person with diabetes has:
- A foot ulcer that shows signs of infection or is clinically severe;
- Unexplained red, hot, swollen foot;
- Critical limb ischaemia.
NICE emphasises early referral and assessment because diabetic foot ulcers can deteriorate very quickly, and timely, coordinated MDT care significantly reduces risk of amputation and complications.
But what does that is an MDT, and why is it so important?
What is a multidisciplinary team?
An MDT brings together a range of healthcare professionals who each contribute their specialist expertise to your care. In the context of diabetic foot disease, an MDT might include:
- Diabetes consultants / endocrinologists.
- Vascular surgeons.
- Podiatrists and specialist diabetic foot nurses.
- Orthotists / footwear specialists.
- Tissue viability nurses.
- Microbiologists (for infection control).
- Sometimes, dietitians and physiotherapists These professionals do not just work in isolation ” they share information, discuss each case, and agree on the best, tailored plan for each patient.
Why does a multidisciplinary team make such a difference?
Diabetic foot ulcers can deteriorate quickly, sometimes within days. Rapid access to an MDT helps to:
- Identify and treat infection early.
- Assess blood flow and decide if vascular surgery is needed.
- Plan surgical debridement or other interventions promptly.
- Provide specialist dressings and pressure off-loading devices.
- Give consistent advice about diabetes control, diet, and self-care.
Evidence shows that coordinated MDT care significantly reduces the risk of amputations and hospital admissions and leads to better overall outcomes and quality of life.
What does NICE guidance say?
As well as setting the standard for when an urgent referral is needed (see above) the UK clinical guidance (the NICE NG19 and the NHS Diabetic Foot Care Pathway) recommends that there should be clear communication between community services and hospital-based specialist teams.
Sadly, in reality, not everyone has timely access to this level of care, and delays can have devastating consequences.
Our client Kevin experienced a delay in diagnosis of his Charcot Foot condition which resulted in a below knee amputation, changing his life forever.
What can you do?
If you or someone you care for develops a foot ulcer:
- Seek medical attention immediately ” do not wait and see if it gets better on its own.
- Ask if there is an MDT or specialist diabetic foot clinic locally, and insist on a referral if it’s not offered.
- Make sure you keep up with regular foot checks as part of your diabetes reviews.
Diabetic foot ulcers a medical emergency
A diabetic foot ulcer is not just a wound ” it is a medical emergency that deserves a fast, joined-up response. The MDT model exists because complex problems need coordinated solutions. And when it’s done right, it can make all the difference.
If you, or someone you know, has experienced a delay in a referral to a diabetic foot clinic or MDT, and suffered an injury as a result, you can contact us by email at [email protected].
