Foot Pulse checks in patients with diabetes identifies new AF cases in Durham and Darlington

Patients with diabetes undergo an annual review. This includes a foot check where pulses are assessed. Therefore any patient with an irregular pulse can be detected as part of the review process.

Durham and Darlington Podiatry Services (covering North Durham CCG, Darlington CCG and Durham Dales Easington and Sedgefield CCG areas) were interested to run a pilot project examining how many patients with previously unknown AF could be detected in the diabetes foot check. Any patients detected with an irregular pulse were referred back to their GP for a 12-lead ECG to confirm or rule-out AF

Impact

  • Extrapolating figures from 3 months to 12 month indicates that 40 new patients with AF could be identified annually across North Durham, Darlington and DDES CCGs. This would prevent 2 strokes per year – a cost-saving of £46,630 (1).
  • Extrapolation shows that for every 500 patients with diabetes having their feet checked, one new case of AF could be identified.
  • In 2013, the National Diabetes Information Service (NDIS), YHPHO estimated 231,777 people in the North East, North Cumbria, Hambleton and Richmondshire area with diabetes (2). Therefore 463 patients could be found with AF, preventing 23 strokes and saving £539,742 or in excess of £0.5M.
  • Podiatry staff are already taking pulses and this would appear to be well placed opportunity to ensure patients with irregular pulses are being identified.
Ref: (1) National Audit Office. Progress in improving stroke care, Report on the findings from our modelling of stroke care provision (February 2010). NAO Report (HC 291 2009-2010). (2) NDIS, YHPHO. Levels of diabetes in the North East, North Cumbria, Hambleton and Richmondshire area. 2013 [Accessed www.yhpho.org.uk/resource/view.aspx?RID=189815]

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