A review has been published by NHS Resolution in the hope it will decrease Clinical Negligence claims relating to patients who have had serious lower leg complications as a result of diabetes. The review appears to have been triggered due to a growth in the volume and value of claims involving patients with diabetes related lower limb complications since 2013/14.
Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high. High blood sugar levels can cause nerve damage which can affect the feeling in feet and damage the circulation, making it slower for sores and cuts to heal. 7957 major diabetic lower limb amputations were reported in England between 2017 – 2020.
The review analysed 92 claims of negligence, highlighting shortcomings in diabetes foot care in England. It revealed recurrent themes of unacceptable delays in diagnosis and referral to specialist care. It was reported that up to 85% of amputations were avoidable. Appropriate recognition of pathology followed by the provision of timely care was key to improve patient outcomes.
The review made 7 key recommendations, including raising awareness, education and training, referral and treatment pathways with the focus on timing. Additionally, it was considered that the way in which footcare services were commissioned should also be reviewed to ensure consistency in care nationally.
Amputation is life changing, and not just the obvious immediate practical and psychological effects of the loss of a limb. In the long term there can be significant effects on quality of life and health and wellbeing associated with the loss of or impairment of mobility. There will also often be a financial impact – loss of earnings or even of employment, the need for care and assistance or adaptations to the home or equipment needs. Unfortunately, Local Authority or welfare benefits is wholly inadequate.
If the amputation could have been avoided with better medical care then a claim for damages can be brought. Whilst this cannot possibly compensate for the true loss it will at the very least ensure that there are sufficient funds to pay for the care and adaptions needed to try and restore quality of life. Claims for medical negligence are often depicted in the media negatively. We quite rightly champion our NHS and the hardworking and dedicated healthcare workers. But we also should not ignore the needs and suffering of patients when things go wrong. This review by NHS Resolution demonstrates the positive effect that claims for clinical negligence can have in highlighting trends of poor care in specific areas. It has initiated this review and instigated change for the better in medical care which is welcomed.
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