Hyperbaric oxygen therapy for diabetic lower limb ulceration (diabetic foot ulcer) (all ages)

NHS England | April 2019 | Hyperbaric oxygen therapy for diabetic lower limb ulceration (diabetic foot ulcer) (all ages)

NHS England will not routinely commission hyperbaric oxygen therapy for diabetic lower limb ulceration in accordance with the criteria outlined in this document.

In creating this policy NHS England has reviewed this clinical condition and the options for its treatment. It has considered the place of this treatment in current clinical practice, whether scientific research has shown the treatment to be of benefit to patients, (including how any benefit is balanced against possible risks) and whether its use represents the best use of NHS resources.

Full details from NHS England

CCG Diabetes Assessment 2017/18

NHS England | January 2019 | CCG Diabetes Assessment 2017/18

This document contains the independent panel commentary, methodology of the ratings for 2017/18 and the CCG individual assessment ratings for 2017/18.

The measures are drawn from the 2016/17 and 2017/18 National Diabetes Audits which include data from 95 and 98 per cent of GP practices respectively. This means all areas have robust measurements of their diabetes performance.

The data show that overall the proportion of people reaching treatment targets is stable but there is much underlying variation. The panel has continued to use the same measurements and targets for HbA1c, blood pressure and cholesterol to ensure consistency between years.

The panel has chosen to use the benchmarks from 2016/17 as this better illustrates year-on-year progression in improvement. The improvements this year mean that there are therefore more areas with the higher ratings than if 2017/18 benchmarks had been used. The regional distribution has evolved over the last year so that there are no CCGs rated as inadequate in London now, while there is a concentration in the North (Source: NHS England).

CCG Diabetes Assessment 2017/18

Improving Diabetic Foot Care: A Guide for Commissioners

The College of Podiatry in collaboration with Health Education England and Insight Health Economics have produced a toolkit for commissioners in England to enable Diabetic Foot Care services to provided more effectively.


The College are calling on healthcare commissioners to prioritise diabetic foot care and end avoidable amputations that can have a devastating impact on the lives of patients and their families and cost the NHS millions.

Complications from diabetic foot disease are costing the NHS in England more than a billion pounds a year. Today, and every day, 23 people with diabetes in England will have a toe, foot or leg amputated. A third of these are major amputations, meaning that the patient loses their whole foot above the ankle or even more of their leg. Many of these amputations are preceded by diabetes related foot ulcers, caused by a combination of impaired circulation and nerve damage – common problems experienced by people with diabetes.

Experts believe that by improving the way diabetic foot health is commissioned and delivered, around half of these life-shattering surgeries could be avoided.

Full detail: Improving Diabetic Foot Care: A Guide for Commissioners