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Numbers being booked increasing. Better in some areas than others. Clinic areas that started later are slower becoming embedded

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Learning and discussion

Mentorship

Mutual respect & co-operation

Shared decision making

Opposite to silo working

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One stop shop

Action-focused

Wound patients have access to ADP as well as MSK

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Staff training taken place to support practice

Who fits the device is currently a clinical decision based upon patient/device complexity and capacity in the sessions

Advice leaflet in place and supplied with device

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Need BCP

Ruth delivering session at Stafford

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Using NDFA with manual data review (excludes individuals without diabetes and time consuming, doesn't capture deterioration or problems)

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Joint ADP: MSK acknowledges as beneficial but not always possible

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Wound forms capture healing, wound specific, offloading change can be added to the wound form. Potential for an improvement on purely NDFA. Encourage use and explore what Rio reporting is possible

Caveat: Captures patient activation not just insole effectiveness, lots of factors influencing healing

How do we measure patient satisfaction? Microsoft form?

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Agreed direct feedback to Rob with NHS number plus return orthotic if appropriate -

Potential to inform future decision making and prescriptions

Identified transitioning from offloading to shoes presents challenges - footwear selection, realistic orthosis volume

Challenge corrective vs accommodative orthoses

Bringing incorrect shoes for fitting

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Agreed importance of ADP and MSK representation to ensure aim of the session is met

Issues with cover/planning of annual leave

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Co-ordination of joint clinics to ensure delivery

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Co-ordination of joint clinics to ensure delivery

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Clarify expectation for staff to prioritise sessions as solo sessions not fulfilling purpose of the session

Potential to change day of session to maximise sessions available (Wed Codsall)

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Caseload review/identify individuals who will benefit

Manage service user expectation

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Influencing who fits devices

Some areas greater demand

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When working need to ensure duties are evenly shared by both clinicians. If Pod dressing then other should be sorting apt/ uploading photographs. Person dressing can have to redress twice if casting as marking wound lesion site and then has own wound charts to complete and notes (no assistant) and has to deal with all normal issues infection/ swab/ SAU admission? Duties need to be shared equally and co-ordinate well.

Equally if whilst bio-mech side being done then other clinician can be doing things to assist other clinician as well - getting footwear/ insoles. However work load is more on wound often then biomechanics and can find myself behind if duties not shared well between who working with.

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I do not feel that the clinics are frequent enough in BLT area, could do with 2 a month at least, I feel this delays treatment and agree regarding annual leave, if this falls on the monthly joint clinic it's then another 4 weeks until an insole/orthotic/device can be prescribed.

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Insole review - Must be remembered that just because a patient has insoles, it doesn't mean offloading has been successful. Please highlight if need is still considered necessary - ie callus levels etc.

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Insole review - Must be remembered that just because a patient has insoles, it doesn't mean offloading has been successful. Please highlight if need is still considered necessary - ie callus levels etc.

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Clinics seem to run effectively and efficiently with regards to sharing wound management aspects whilst in Viv's clinic as there isn't a podiatry assistant to help