Manifesto 2021 - The College of Podiatry 2021 Scottish Parliamentary Election Manifesto

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Manifesto
2021

The College of Podiatry 2021 Scottish
Parliamentary Election Manifesto
For further information:
The College of Podiatry, Quartz House, 207 Providence Sq, Mill Street, London SE1 2EW
Email: Ross.Barrow@cop.org.uk

www.cop.org.uk

The College of Podiatry 2021
Scottish Parliamentary Election
Manifesto
The College of Podiatry is the professional body and trade union for registered Podiatrists. There
are approximately 1000 HCPC registered Podiatrists working throughout Scotland in the NHS,
independent practice and within higher education institutions. As degree educated clinicians, and
experts of the foot and lower limb, Podiatrists provide a vital role across health and social care by
preventing and diagnosing illness and disease, providing limb saving treatment for people with
diabetic and vascular disease and supporting the population to remain healthy, mobile and active.

Commitment 1: Improve Patient Care

Commit to ensuring that everyone living in Scotland, who needs Podiatry assessment, and/or
treatment has timely access to NHS Podiatry Services that are sufficiently resourced to ensure
that prevention is at the centre of care.

The demand for Podiatry services amongst the Scottish population is increasing as the number of
people developing foot and lower limb complications linked to long term conditions and co-
morbidities rises. At the same time, the numbers of Podiatrists working in the NHS is decreasing.
This is leading to increased waiting times to access NHS Podiatry services, especially for people with
non-acute injuries, meaning opportunities to provide early intervention to keep local populations
healthy, mobile and active are being missed.

It is vital that Podiatry services are sufficiently resourced, so they fully meet the foot and lower limb
health needs of their local populations. Podiatrists should be placed within appropriate clinical areas
and integrated into multidisciplinary pathways within the Health and Social Care system so that

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patients can see Podiatrists, in the right place at the right time. In practice, this means that patients
should have timely access to Podiatry in primary and community care, who have the requisite skills
and knowledge to work as first point of contact practitioners. Similarly, patients in residential care
should be able to access local NHS Podiatry services quickly and easily. Podiatrists can provide
educational programmes to support staff working in social care to know when their patients need
access to NHS Podiatry, and we would like to see this strategically implemented across Scotland.
Through this, patients will be able to access Podiatry services more quickly which will enable
Podiatrists to focus their clinical expertise on early intervention and preventative measures, which
will help to keep the population mobile and active, reducing the numbers of people developing
acute foot and lower limb pathologies.

Commitment 2: Increase the Scottish NHS Podiatry Workforce

Commit to reversing the decline in Podiatrists working in Scotland’s NHS by implementing a
strategic, nationally funded programme to increase the numbers of people training and
working as NHS Podiatrists.

The number of Podiatrists working in Scotland’s NHS is decreasing, which is reflected in an
increasing number of vacancy rates for Podiatrists across Scotland’s NHS Boards. As demand for
Podiatry services increases and the NHS Podiatry workforce decreases, waiting times increase,
opportunities to provide early interventions are missed and ultimately patient safety is
compromised.

Demographic data shows that more people are living with complex conditions such as diabetes,
rheumatoid arthritis and peripheral arterial disease, which can lead to foot and lower limb
problems. The reduction in the number of Podiatrists working in Scotland’s NHS is therefore a major
public health concern.

In order to reverse this decline, it is vital that Government introduces long term solutions to
incentivise increased numbers of potential Podiatrists to train and work in the NHS. One way of

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doing this would be to introduce a nationally funded programme with the aim of increasing the
Podiatry workforce across Scotland. This programme should have a twin approach, focussing on
both recruitment and retention of Podiatrists.

It is crucial that Scottish Government supports additional and alternative training routes for Podiatry
including apprenticeships. Currently there are two routes to Podiatry qualification in Scotland
through the undergraduate programmes at Glasgow Caledonian University and Queen Margaret
University. A Podiatry apprenticeship programme should be established as an additional training
route in order to attract, for example, mature students who can earn while they learn, and who may
live in areas which are a considerable distance from existing Podiatry schools in the central belt,
which is an additional barrier to accessing Podiatry training.

Commitment 3: Invest in early intervention for prevention of illness and disease

Commit to providing ring fenced Scottish Government funding available for NHS Boards and
Integrated Joint Boards to invest in preventative Podiatry services in primary and community
care.

The amount of money which NHS Boards are spending on Podiatry services is reducing every year as
budgets get tighter. Many NHS Podiatry services are asked to make annual savings of around 2.5%,
which amounts to six figure sums in some board areas. Some Podiatry services are having to cut the
numbers of Podiatrists which they are employing, in order to prevent overspend. This is an
additional factor leading to a reduction in the numbers of NHS Podiatrists across Scotland.

In this constrained financial environment, Podiatry departments do not have any resources available
to invest in new, innovative pathways within primary and community care. This is frustrating,
because when these pathways are established, there is the potential for these to reduce the overall
cost of health and social care services, whilst at the same time, improving patient care.

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For example, the NICE Proven Quality and Productivity case study ‘Community triage for lower limb
vascular concerns: Reducing the burden on hospitals’ is a prime example of a primary care service
model which can improve patient outcomes and reduce demand in both primary and secondary
care. It describes a podiatry led model of care where hospital referrals for lower limb vascular
conditions are reduced by providing podiatry-led vascular assessments in the community. 1 This has
model has been fully evaluated by NICE and has shown to evidence quality and produce significant
cost savings to the system. Where evidence such as this exists, money should be made available to
allow such initiatives to get off the ground.

Commitment 4: Introduce bursaries for Podiatry students in Scotland

Commit to introducing a bursary for all Podiatry students in Scotland (as is the case in
England, Wales and Northern Ireland).

In Scotland, the number of people studying Podiatry is too small to compensate for the number of
people who are leaving the profession, either to retire or pursue alternative career options. It is
essential that Scottish Government introduces practical support to grow the Podiatry workforce in
Scotland. Podiatry is facing a workforce crisis. This will negatively affect patient care and cost the
health and social care system more in the longer term as people develop preventable foot and
lower limb complications which are not only expensive and complicated to treat, but can have a
devastating impact on people’s quality of life.

The English, Welsh and Northern Irish Governments all have bursaries in place to support people to
study Podiatry. Scottish Government should introduce bursaries for Podiatry undergraduate
programmes, as they do for Nursing and Midwifery students (up to £10,000 per annum) to attract
more people, including mature students who already have undergraduate degrees, into the
profession. This will ensure that the Podiatry workforce is futureproofed.

1   Community triage for lower limb vascular concerns, Salford Royal Foundation Trust (October 2016)

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Commitment 5: Right to Rehabilitation

Commit to ensuring everyone living in Scotland has the right to access rehabilitation services
whenever this is needed.

The College of Podiatry enthusiastically supports the multidisciplinary call for a ‘right to rehab’. As a
result of COVID-19, there is an urgent and increased need for this as the requirement for
rehabilitation services amongst the Scottish population rises, in particular: 2
     •    Those recovering from COVID-19.
     •    Those whose health and function are at risk due to pauses in planned care.
     •    Those who have avoided accessing health services during the pandemic and are therefore at
          increased risk of ill-health due to delays in diagnosis and subsequent treatment.
     •    Those for whom the lockdown has caused physical and mental challenges.

Podiatry services, which were already in high demand pre-COVID, will be required by even more
people following the pandemic. Podiatrists have a huge amount to offer patients in all of the above
categories, in particular, by supporting recovery and keeping people healthy, mobile and active.
Similarly, Podiatry musculoskeletal services provide an essential function in keeping local
populations healthy, mobile and active whilst also reducing demand on orthopedic services.

We join with our Allied Health Professional colleagues in calling for a commitment to ensuring
everyone living in Scotland has the right to access rehabilitation services whenever and wherever
this is needed.

Contact

For further queries please contact Ross Barrow, Policy and Public Affairs Officer, The College of
Podiatry Ross.Barrow@cop.org.uk

2 https://www.england.nhs.uk/coronavirus/publication/allied-health-professionals-role-in-rehabilitation-during-and-after-covid-19/, Viewed on

16/06/2020

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