Foot In diabetes UK

Julia Shaw

Podiatry Manager and lead clinician in diabetes in the Regional Endocrinology and Diabetes Centre in the Royal Hospitals in Belfast

I lead a small team of Podiatrists who manage diabetic foot pathologies in both Diabetes and Vascular Surgery. I qualified from the Glasgow School of Chiropody in 1980 and worked for two years as a Senior 11 Podiatrist in primary care in the Belfast area.
I was appointed as a Senior 1 Podiatrist in the Royal Hospitals in 1982 working in the Diabetes clinics and was appointed to my present post in 1996. I graduated from the University of Salford in 1997 with a BSc in Podiatric Medicine.

Over the past 20 years I have seen huge changes in the role of the Podiatrist in diabetic foot management and have led the development of the multidisciplinary foot team within the hospital.
During the past ten years I have developed a keen interest in audit and research associated with the diabetic foot and have participated in several clinical trials. I've presented on various aspects of diabetic foot disease at a local, national and international level and had several publications in peer reviewed journals. I'm a member of a regional Wound Healing Research Group in Northern Ireland and the chairperson of the Regional Society of Chiropodists and Podiatrists Managers Forum. I am one of two facilitators of the Regional Diabetes Special Interest Group in NI. Currently I am a part-time D Phil student at the University of Ulster, Belfast investigating the effects of a novel drug-containing dressing on healing in diabetic foot ulcers.

Describe your typical work day

My working day is very varied. I work exclusively in secondary care and manage a clinical case load of both in and out-patients with the other Podiatrists. Typically post and emails are done at 8.30, morning clinics begin at 9am to approximately 12.30. At present there are busy research clinics running on a Tuesday and Friday mornings and a multidisciplinary ward round and journal club on a Thursday morning. Afternoons tend to be more flexible with some clinics, management meetings, paperwork and management duties.

How did you first become interested in working with the foot in diabetes?

I first started to work in diabetes foot care in 1982. I felt that I wanted to work in secondary care and an opportunity came up in the diabetes setting. At that time there were no real models of care as we know them today, and so knowledge and aspirations were limited. I have always felt that I am working “where I should be” however hard it may be.

Why does this speciality appeal to you as a career choice, and who, if anyone influenced / motivated / guided you in this area of work?

I was influenced by the development of the concept of the MD team by Mike Edmonds and Ali Foster in Kings College Hospital in London and by Andrew Boulton’s team in Manchester in the early years. Consultant staff within the centre have been incredibly supportive over the years and have supported the development of the Podiatry service. I have also been encouraged to develop research and audit on diabetic foot management within the centre.

What have been your best and worst moments working in this area and why?

Best moments are:

Worst moments:

Do you have any coping strategies you can share with us that get you through the worst bits?

Accept that you can’t do it all! But that hopefully the team does make a difference in some patients’ lives. There is enormous support from all members of the MD diabetes team and consultant staff. Use it. Drink red wine (modest amounts only!) at the weekend!

Do you have any new related projects in development at the moment?

Currently I am a part-time D Phil student at the University of Ulster, Belfast investigating the effects of a novel drug-containing dressing on healing in diabetic foot ulcers.

What do you feel are currently the most challenging issues for people working with foot in diabetes

Within NI there is currently a major reorganisation of the health care delivery system which will have a huge impact on NHS staff and patient care. Coupled with AFC we live in unsettling times. The issues for us as a region are: