Community health services: foot clinic consultation

Healthwatch Tower Hamlets undertook research on changes to the foot clinic service at Mile End Hospital following the introduction of new eligibility criteria that restricted treatment to patients with higher clinical needs. They spoke to 66 people through a consultation survey and analysed a further 22 comments from focus groups, interviews, social media and other feedback sources.

The consultation found strong opposition to the changes, with 85% of respondents opposing or strongly opposing them. While patients generally praised the quality of care and staff at the foot clinic, many felt the changes would remove an essential preventative service, particularly for older people, disabled people and those on low incomes. Respondents were concerned that people who could no longer access routine foot care might develop more serious health problems in the future. 

Many participants said private podiatry services were not a realistic alternative because of cost. Nearly half of respondents said paying privately would be difficult and over a quarter said it would be impossible. Many people who relied on the clinic for toenail cutting or other routine care reported that they would become ineligible under the new criteria despite having conditions that affected their mobility, independence or quality of life. Concerns were also raised about a lack of consultation before the changes were introduced and about administrative difficulties in accessing the service. 

Healthwatch Tower Hamlets concluded that the impact of the changes should be monitored carefully and recommended further consultation with patients. They also recommended improving information about alternative services, providing training and support for carers, exploring the development of a low-cost community foot care service, and assessing whether reduced access to preventative foot care leads to increased demand for more intensive NHS services in the future.