Foot In diabetes UK

Rachel Mathison.

After graduating from Salford School of Podiatry in 1994, I worked in the NHS, developing a strong clinical interest in diabetes management.and tissue viability.
In 1999, I moved from Rochdale Primary Healthcare Trust where I gained valuable experience working in the community and also in a research role for the published ‘North West Diabetes Foot Care Study’, to work within secondary care for Stockport NHS Trust as a Clinical Specialist in ‘high-risk’ patient management.
In 2001 I was promoted to Deputy Head of the Department, maintaining a strong clinical focus in managing patients with Diabetes across primary and secondary care.
2005 opened a new door for me whereby I took up a position with a National role to work in the Medical Education Team for a commercial company within the remit of the ‘Diabetic Foot’.
From an early stage in my career I developed a true passion in the foot in diabetes and it remains an integral and important facet that I am able to maintain my clinical skills and practice from an honorary contract at Stepping Hill Hospital in Stockport working in the Diabetic Foot clinic one day per fortnight.

Describe your typical work day (50 – 100 words)

A typical working day…. This is difficult as with each working day comes a different location, different people and different tasks….!
My current role working across the UK and Ireland is to create a platform to generate evidence and deliver education to all health professionals involved in managing patients with diabetes, in particular with relation to ‘the foot in diabetes’.
I strive to build relationships and raise the profile of Podiatry within the tissue viability arena, aim for skill mix and whole systems thinking.

I look forward to the breakdown of traditional boundaries and the benefits of advanced changing workforce practice.

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

During my training I became fascinated by the underlying pathology of Diabetes and completely hooked into patient management of the subsequent complications.
I was motivated and enthusiastic to work as part of the multidisciplinary team and also in some respects ‘in the right place at the right time’ when an opportunity arose within the workplace for a maternity cover within this indication.

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

Within the broad scope of Podiatry, I feel ‘Diabetes management’ is one of the most challenging yet rewarding attributes of the profession.
To be part of a team involved in ‘improving patient’s lives’ and ‘making a difference’ is a golden nugget.
I have been inspired immensely by many fellow colleagues working within this indication but one in particular is, Louise Stuart who was my lecturer during my training who from day one displayed an infectious enthusiasm and immense subject knowledge, of which I contracted and can honestly say have never looked back.

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

Best moments:

From a clinical perspective, embarking on a patient journey, being part of ‘making a difference’, with particular reference to patient empowerment and wound management.

One particular case which will always stay in my mind is the day a patient walked into clinic following twelve months wheel chair bound due to exigent bi-lateral neuro-ischaemic foot ulcerations which unfortunately resulted in one below knee amputation, however to see the patient mobile again and his independence restored….a moment when your hairs stand on end and a tear forms in the corner of your eye…that’s what it’s all about.

From an educational perspective, creating and promoting a learning environment across all disciplines involved in managing the foot in diabetes to enable acquisition of new skills and knowledge thus encourage professional development to flourish.

Worst moments:

The obvious one undoubtedly focuses around patients ‘loosing limbs’ and its associated mortality and morbidity.
Frustrations also arise with lack of professional recognition in the scope of podiatry practice, which can lead to delayed referrals, access and poor communication.
Mutual respect and trust in each others skills and knowledge should be actively encouraged within the multidisciplinary team approach.

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

(A venti latte and a double choc chip muffin from Starbucks…Only joking!!!!)
‘A problem shared is a problem halved….’ Peer to peer support is invaluable.
To talk and identify current blocks and barriers is the best way forward.
Tackle problems sooner rather than later and in bite size chunks as opposed to all in one go!
FDUK web forum is a great tool to share your frustrations and challenging issues but also let’s not forget to highlight your success stories.
Motivational support and praise are key in creating a healthy work environment.

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

In a clinical capacity I am currently involved in reviewing and updating the NWDFG, and within my Medical Education role am involved in implementing an audit scheme for improving access to dressings for community based Podiatrists as opposed to a prescription request.

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

I feel the most challenging issues at present are: