Foot In diabetes UK

Lee Hawksworth

Clinical lead Podiatrist, Tameside & Glossop PCT.
PCT Commissioning Lead in the areas of Diabetes, Coronary Heart Disease and Renal.

I have been working within Diabetes and High Risk care for the last 6 years within the north west of England. I have been predominately community-based, with roles within both Diabetes and Vascular multidisciplinary out patient’s clinics

In the last 3-4 years our local specialist podiatry team had become integrated with the community Diabetes Specialist Nursing team, leaving us part of a developing, challenging and ultimatley rewarding 10-person MulitDiscplinary team.

In the last year I have taken up a Commissioning post. The shift from clinician to commissioner has been a massive challenge, with a huge learning curve, having to appreciate bioth the role of the clinician and the strategic drivers / repsonsbilties of Commisiosner and PCTs

Describe your typical work day

The sort of day I have is based on which job I am doing that day, without fail it starts with checking e-mails and a very strong coffee

If it’s a Podiatry day, clinic sessions vary from Vascular Screening, Consultanty-led Out patient clinics, GP sessions or wound assessment / review in patients homes. The Clinical leadership component of my podiatry work will be varied, from meeting others Pods to liaising with Medic and Nursing colleagues. There is also the work around service design / redesign.

My Commissioning days are largely taken up within service planning and meeting stakeholders. In English that means getting out there meeting anyone and everyone with a part to play in making services happen. That goes form stragtegic to service dleiovery and includes the Directors, Clinical leads, Specialist Clinicians and patients. I can’t get very far with just a Commissioning perspective, so engaging providers is an essential!

A part of everyday life, in both roles, is dealing with your planned work, whilst also solving the daily issues and challenges that land on your desk.

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

In the distant past I was passionate about biomechanics. My very first NHS podiatry post was in a Trust with a developing, modern approach to podiatry role in diabetes. After spending a couple a months seeing the motivation and drive the service lead had and job satisfaction gained from this work I was a converted!

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

My motivation, and the thing that brings me to work everyday, is the opportunity to work in, and be part of, a team of skilled, passionate clinicians and managers. That is the common theme in both the Diabetes and Commissioning Teams; people who want to modernise, develop and improve the services we offer to patients.

Working with the whole spectrum of patients and professionals, at many different levels, in many different environments provides constant challenge.

As green newly qualified Pod, I was (and still am) greatly influenced (some would say indoctrinated!) by the trusts diabetes lead podiatrist. I think motivation rubs off on and influences those around you, and that’s certainly what happened with me.

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

Worst moments, as I am sure many of us will say, is the poor outcomes that are pretty much inevitable in the are we work within. That’s from limb loss, right the way through to a patient you have know and worked with over a number of years, dieing.

To try and be positive though, and without sounding too pompous, at its best the work we do can improve quality if life for both patients and families during really difficult times.

Outside of clinical work, I get most enjoyment from the service-redesign element of both my roles. Taking a project or service and developing it into something that delivers for both clinicians and patients is satisfying

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

Coping strategies? I am really hoping that someone will share some strategies with me, because mine aren’t very successful.

For me, I am lucky to work closely with colleagues with very similar working roles. So our problems tend to be very similar, so advice is readily available as is someone to scream at / with!

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

In my Commissioning role I am involved in the development Diabetes-related services:

Back in podiatry I am involved in the continuing development and delivery of our Lower Limb Vascular Triage, our foot screening programme and meeting the challenges Choose and Book, Practice based are presenting to High Risk foot services in general

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

The brave new world that is embodied by the NHS modernisation programmes: The choice agenda, Practice based commissioning, Payment By Results, the list goes on!

The development of diabetes foot related services in this new environment is a huge challenge for us as clinicians and for bodies such as FDUK.