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A self-care management programme called Footstep provides evidence that patients can be successfully educated and enabled to attend to their own foot care. The criteria for appropriateness are based on the patient's clinical and medical need for nail care (see attached matrix chart) and the ability to pass three tests. 1) To read a passage of writing in size 12 font; 2) To open and close a pair of nail clippers three times; 3) To remove five stickers from the bottom of their foot - placed on the toes, heel and ball of the foot. Currently all patients referred into the service are being assessed against these criteria. If suitable, they are asked to attend a two-hour training session where a staff member will teach them how to cut their nails safely, eg, by putting their foot on to a chair rather than bending to the floor. The success of this new initiative will result in releasing capacity that can be used to provide an extra session for annual diabetic screening.

Yorkshire Podiatry Managers' Assessment Matrix (Peter Daniels)

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