Mr Jason Nandlal MSc FCPodS
 CONSULTANT PODIATRIC SURGEON

 

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Pod Surg      JN                   

 Foot Surgery

Biomechanics

Podiatry

Patients with Health Insurance

Prior to initial consultation, a GP referral letter is required for any consultations and or surgery that are to be covered by Health Insurers.

Self funding patients may self refer without a GP letter.

                                  

 

The three C´s of good practice  in podiatric surgery

 Choice             Clarification       Confirmation

A three stage process is outlined to ensure adherence to sound and safe practice from initial patient contact to treatment.

CHOICE
Stage One

Patients are referred into the healthcare market more often by a doctor in general practice. The modern nature of the health  service may mean that referral may be to a podiatric surgeon.

Providing information to support patient choice
Podiatric surgeons . online websites and social networking facilities should provide a clear statement that podiatric surgeons are not registered medical practitioners i.e medical doctors. This statement and associated supporting information is considered mandatory by the Society of Chiropodists and Podiatrists  
(SCP).
An explanation of the training,qualifications, country of qualification and scope of practice of the podiatric surgeon should also be provided along with a link to the SCP and HCPC website. www.feetforlife.org  and   www.hpc-uk.org


Patients should be provided with this information, preferably in written form, prior to their initial consultation or, at the latest, during the initial consultation.

CLARIFICATION
Stage Two
At the initial consultation all podiatric surgery clinicians should introduce themselves and clarify with the patient that they have received and understood the information described in stage one. This should be documented in the notes by the clinician. If this is not the case, then such information should be provided and explained verbally.

Podiatric surgeons work in different centres and documentation such as consent forms, radiology requests and sickness absence certificates may vary. Clinicians must annotate the page with the appropriate title, clearly placing a line through any medical title i.e. doctor, so as to make clear the designation of the person treating the foot.

CONFIRMATION
Stage Three
When a plan of surgical treatment is agreed, the podiatric surgeon will move to consent. At this point the podiatric surgeon should re-check that the aforementioned information has been exchanged and stage 1  choice and stage 2
clarification are fulfilled at the last point of contact prior to surgery.

Podiatric surgeons should use the section on the consent form where reference is made to leaflets/ information provided to ensurethe patient agrees that they have received information (given in stage 1) about the podiatric
surgeon´s designation.


Principles of Good Practice
All podiatric surgeons should work within their
knowledge, professional competence, physical abilities and the Society of Chiropodists and Podiatrist's Code of Conduct. Misleading claims should not be made. Trust arises from the public and colleagues when they believe that podiatric surgeons act honestly and fairly at all times. Podiatric surgeons must be able to demonstrate that they have accurately informed the patient regarding their status and qualifications and provided the relevant written information.

If the patient should decline a podiatric surgery
service, the podiatric surgeon must explain that the patient is entitled to another professional opinion (podiatric or medical).

To download a PDF copy of this document    click here

 

What is a Podiatrist / Podiatric Surgeon

Podiatric surgery is a specialist field of practice within the podiatry profession.
Podiatric Surgeons are podiatrists who have had extensive postgraduate training in the surgical management of foot and ankle problems.

Despite practising surgery, your consultant will advise you about the non-surgical treatments available for your foot problem. This will help you make an informed choice regarding your treatment and agree a care plan together.


...an Expert in their Field

Podiatric Surgeons have a formal education in foot health and medical sciences and are trained to recognise the signs and symptoms of general medical conditions within the lower limb e.g. diabetes. Your consultant will be able to
treat the foot and ankle symptoms of these conditions, but will liaise with your GP for a formal medical opinion or assistance if required.

Podiatric Surgeons are independent clinicians in the field of foot surgery and not medical doctors. They are to feet very much like dentists are to teeth.

Where do Podiatric Surgeons Work?

Consultant Podiatric Surgeons work in the NHS and private sector and are recognised by private health insurance providers.

Podiatric Surgeons are valued members of the healthcare team and receive referrals from a range of health professionals seeking their expert opinion, e.g. GPs, other consultants, podiatrists, practice nurses and physiotherapists.

Podiatric surgery services are based in acute hospital and community trusts, as well as in
independent hospitals across the UK.


Quality Assurance

Podiatric surgery is a proven and effective part of foot health care, with thousands of foot
operations undertaken in the UK by Podiatric Surgeons every year.

Information is collected for audit purposes in order to review performance, show evidence of
practice and assess patient outcomes and experiences. Ask your consultant about the
national audit database PASCOM-10.

 

The Following is information from  The College of Podiatry.

 podiatrist will have studied for three years to obtain a degree in Podiatry or Podiatric Medicine. Podiatrists are independent clinicians, qualified to diagnose and treat foot problems. Many podiatrists specialise in specific areas of work such as diabetes, rheumatology, sports injuries etc. With the exception of nail surgery, podiatrists use non-surgical (all non-invasive) methods of treatment and this remains the mainstay of treatment for most foot problems. Until recently, podiatrists in the United Kingdom were known as chiropodists.

 Podiatric Surgeon is a podiatrist who has undertaken extensive post graduate training in foot surgery. They are therefore non-medically qualified specialists in the treatment of all foot problems utilising conservative (non-surgical) and surgical treatment methods.

 Training in Podiatric Surgery

A podiatrist is specifically trained to assess, diagnose and manage foot complaints. Whilst a podiatrist is not medically trained and therefore not a doctor, extensive postgraduate training enables podiatrists to perform foot surgery. Podiatric Surgeons are highly specialised only operating on the foot rather like a dental surgeon who will only treat your mouth. Podiatric surgery is a proven and effective aspect of foot health care with thousands of foot operations performed each year. The training involves:

 

  • 3 or 4 year full time degree, BSc Hons in Podiatric Medicine, (Not General Medicine)
  • 2 years general Podiatric Practice
  • 2-3 year  MSc in Theory of Podiatric Surgery and Assesment of professional skills
  • 3 year Consultant supervised  surgical training programme  
  • Final Fellowship examination
  • 3 year specialist training (Clinical Fellow in Podiatric Surgery)
  • Accreditation with the Faculty of Podiatric Surgery. CCPST(Certificate of Completion of Specialist training)
  • Consultant Podiatric Surgeon. Appointments made by employing NHS trust panel interview
  • MINIMUM OF 12 YEARS TRAINING

 

All Podiatric Surgeons are required to be registered with the Health Professions Council with the award of Fellowship and training provided by the Faculty of Surgery of The College of Podiatrists. 

Where necessary, general anaesthetic or sedation is available and the risks associated with these techniques are now extremely small.

 

From The College of Podiatry Website  http://www.scpod.org/podiatric-surgery/

Are Podiatric Surgeons the same as Orthopaedic Surgeons?

No, podiatric surgeons have trained exclusively in the surgical and non-surgical treatment of the foot. Orthopaedic surgeons complete a medicine degree before going on to further training in the management of bone and joint conditions which affect the whole body. Podiatric surgery training begins with the non-surgical management of foot problems and then after completing a 3 year BSc Hons degree and at least two post registration years in clinical practice and two Year MSc in Theory of Podiatric Surgery, surgical training can commence. While podiatric surgeons do not treat problems outside the foot and ankle, they do as part of their undergraduate and post graduate  training learn to recognise and understand diseases or complaints that do not originate in the foot but may give rise to symptoms in the foot. Podiatric surgeons are part of the health care team and will always refer on to medically trained physicians or surgeons when a problem is outside their scope of practice.

The advantage of such a focussed training and scope of practice is that a podiatric surgeon will gain intensive experience in managing foot problems. Some podiatric surgeons employed full time in the NHS will perform up to 1000 foot operations a year. Clearly this will allow them to develop highly skilled and meticulous surgical technique as well as great experience in handling complications which unfortunately are an inevitable part of any surgical specialty.

 

In Summary Podiatric Surgeons are not doctors but are trained specifically to undertake surgery on the  the foot  and this is their only area of practice, in the same way dental surgeons treat conditions in the mouth

 


 

© 2004-15 Jason Nandlal