Priority 18 from the Foot Health PSP

UNCERTAINTY: What are the most common factors that PREVENT people from accessing National Health Service/Public foot health services? (JLA PSP Priority 18)
Overall ranking	18
JLA question ID	0092/18
Explanatory note	For many people being able to access Foot Health Services is difficult. Understanding why this is and what factors are most likely to contribute to preventing or reducing access is key to building more accessible foot health services in the future. There is very little current research to show what the underpinning barriers to access are.
Evidence	Diabetologia. 2011 May;54(5):1190-9. doi: 10..1007/s00125-010-2030-3. Epub 2011Jan 20. Risk stratification systems for diabetic foot ulcers: a systematic review. Monteiro-Soares M(1), Boyko EJ, Ribeiro J, Ribeiro I, Dinis-Ribeiro M. Core variables of the various systems are comparable but the number of variables in each model and risk groups varies greatly. Overall quality of evidence for these systems is low as little validation of predictive ability has been done.
Health Research Classification System category	Generic health relevance

Extra information provided by this PSP
Original uncertainty examples	I dont know where I would go for treatment or how to access it - if I didn't come here (university clinic) ~ I think my feet would need to be very bad to get into NHS podiatry and I would have to go though my GP is that right? ~ How do I access a chiropodist without paying when there is diabetes in my family already who had foot problems but lived in a different part of the UK(I'm 50, not diabetic) ~ Why do we not get referred for feet problems?"
Submitted by	Healthcare Professional x 20, Patient x 21, Other x 1

Extra information provided by this PSP

Original uncertainty examples

I dont know where I would go for treatment or how to access it - if I didn't come here (university clinic) ~ I think my feet would need to be very bad to get into NHS podiatry and I would have to go though my GP is that right? ~ How do I access a chiropodist without paying when there is diabetes in my family already who had foot problems but lived in a different part of the UK(I'm 50, not diabetic) ~ Why do we not get referred for feet problems?"

Submitted by

Healthcare Professional x 20, Patient x 21, Other x 1

PSP information
PSP unique ID	0092
PSP name	Foot Health
Total number of uncertainties identified by this PSP.	30 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	26 September 2019