Sharon Wiener-Ogilvie, Podiatry Service Lead at NHS Borders speaks of the important role podiatrist have in people's health and wellbeing

This opinion piece is published to mark AHP Day 2021.

Podiatry is often a poorly understood discipline with the contribution of podiatrists to the improvement of quality of life and the prevention of foot disease and related hospitalisation in Scotland, often going unnoticed. Podiatrists are foot-care specialists. We help people with a range of issues including mobility, foot pain management, and infections and ulcers in the lower limbs and feet. In particular, podiatrists are pivotal to the prevention of foot disease and lower limb amputation in people who suffer from diabetes or peripheral vascular disease. As podiatrists, we often have an ongoing relationship with the people we care for. We assess people for the risk of foot pathologies but also work together with them, their families, and carers to develop a preventative plan to avert deterioration in foot pathology.

During the pandemic, I have seen podiatry staff working tirelessly to support those most at risk of foot pathologies, to ensure that people continue to live independently at home and, to prevent hospital admission in such a challenging time for the NHS. Junior staff, supported by more senior staff, have adapted their roles and have taken on additional responsibilities whenever necessary, often managing complex foot ulceration. We worked closely with other primary and social care colleagues often working in a very different way. For example, podiatrists worked together as part of district nursing teams across the community to enable people to say at home, utilising a range of skills including prescribing and wound management skills to support people. Like many other NHS staff, podiatrists worked flexibly, being deployed to work in vaccination and testing centres, and supporting PPE distribution.

Since the gradual reduction in restrictions, we have been seeing an increase in the number of people who due to reduction in activity during lockdown, have reduced functional capacity, strength and balance, consequently having significant deterioration in foot health. More than ever, podiatrists are required to support unmet needs in the community however as a profession we are facing significant workforce challenges: depletion in our workforce due to persistent lack of investment in podiatric services by health boards and difficulties in recruiting staff, means that we are required to work differently. Podiatry services need to be visionary and work more closely with the varying strands of the health and social care system, including strategic planners who plan the provision of community-based services. We have to work with and train community staff and social care staff on basic foot care and preventative footcare measures. Only through co-operation and collaboration, we will be able to ensure that unmet need in the community is addressed and that rehabilitation and enablement post- COVID is supported.

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