Nail Surgery

Nail surgery: removal of the nail or a section of the nail under local anaesthetic. The nail root can be treated so the removed nail does not regrow. There are 2 types of nail problems that can benefit from this procedure

Nail is painful because it is growing abnormally ie thickened/curved/fungal/. The skin is not broken and there is no infection of the surrounding skin and soft tissues

The nail has broken the skin causing a wound, there is inflammation/weeping/swelling/infection of the skin and soft tissues surrounding the nail.

A
B
C
D

Referral criteria for nail surgery

Anyone over the age of 8 whose medical status does not put them at increased risk of poor healing and/or post operative infection.

Is the patient diabetic? *

Yes

What is the most recent HBA1c? *

Is there any additional information so we can process your referral effectively? *

General Podiatry

Treating painful corns, calluses and abnormal nails by helping patients maintain their own foot health through advice, education and support in order to help sustain mobility and independence and reduce pain.

Conditions that are not eligible for general foot care are

Verrucae
Fungal nail or skin infections
Dermatological conditions e.g. psoriasis, eczema
Hard skin that is not painful
Inability to self care
Ingrowing nails that could need nail surgery

If you are wanting to refer to nail surgery, biomechanics, wound care or diabetic screening please to go back to the referral home page.

Please note you may be asked to provide a photo of your condition prior to an appointment in order to allow us to place you in the appropriate clinic.

Medical Eligibility for General Foot Care and Conditions Treated

High Podiatric Need

Painful corns/callus that cannot be filed and need scalpel debridement.

Painful nails that are thickened/distorted and cannot be cut/filed at home

Low Podiatric Need

Painful callus/corns that can be filed.

Painful nails that can be cut/ filed at home (long neglected nails are not included as a painful nail condition)

No Podiatric Need

Non painful corns/callus

Non painful nails

Inability to self care

Medical conditions putting the foot at high risk

Chronic kidney disease (stage 4+) with associated podiatry need

Currently immunosuppressed with associated podiatry need

Diabetic foot screening – Increased risk and high risk

Foreign body in the foot

Peripheral arterial disease with associated podiatry need

Previous foot ulcer

Sensory diabetic neuropathy

Pt will be assessed, and problem treated.
Eligible for ongoing foot protection appointments if needed

Pt will be assessed and treated.
Will be offered help and advice to self-manage, if assessed as unable to self-manage routine care appointment could be offered

Pt will be assessed and treated if required
Will be offered help and advice to self-manage, if assessed as unable to self-manage routine care appointment could be offered

Foot not at high risk

Pt will be assessed and treated.
Will be offered help and advice to self-manage, if the podiatric problem is assessed as unable to self-manage routine care appointment could be offered

Pt will be assessed and treated if required.
Will be offered help and advice to self-manage and discharged

Ineligible for podiatry

Have you had any treatment by Locala Podiatry in the last 12 months? *

Yes

Please state your current foot problem (if not completed this referral will be rejected) *

Impact on day-to-day activity *

Biomechanics

The biomechanics service accepts referrals for musculoskeletal (muscle, tendons and joints) pain and disfunction.

Treatment could involve gait assessment, functional orthotics(insoles), exercises and lifestyle advice.

Referrals for footwear, steroid injections or surgery will be rejected
If you are wanting to refer to nail surgery, general foot care, wound care or diabetic screening please to go back to the referral home page

Other please give details *

Is the patient under 18 years old? *

Yes

Suspected Ganglion cyst, lipomas and fibromas please refer to MSK service, if this is a self-referral please see your GP to assess and refer to this service.

Any other relevant information *

Wound Care

If located on Ankle or Leg - wounds are only accepted following a Community Nurse assesment

Please give more detail on wound location *

Please attach photo of wound * Upload file

Current treatment inc. dressing regime *

Is the patient diabetic? *

Yes

If yes, when was last HBA1c? *

Is the patient on antibiotics? *

Yes

Has the patient been referred to any of the following TVN, CNN, vascular, Diabetes foot clinic, dermatology, orthopaedics – please specify *

Diabetes Foot Assesment

Locala Podiatry undertake Diabetes foot screening for those patients who have increased risk and high risk of diabetes foot ulceration following assessment in primary care. (This referral is only for pulses and sensation screening )

Has the patient had a face to face assessment in primary care where pulses were palpated and sensation checked with a monofilament? (If Yes, continue with referral, if No, this referral will be rejected) *

Yes

What date was the most recent face to face diabetic foot check that initiated this referral? *

Were pulses palpable? *

Yes

Was the monofilament response normal? *

Yes

If Pulses palpable and Monofilament response is normal, Do not refer for foot screening, annual screening for low risk diabetics should be undertaken by the GP . If Monofilament Response is anormal continue with referral

If pulses not palpable you can continue to refer if Monofilament reposnse is normal or abnormal

Any low risk referrals will be rejected. If the patient has other reasons to access podiatry services please use the relevant referral form

Outcome - 2 Sensation present using monofilament *

Last HBA1c *

Is the patient under the care of vascular service? *

Any additonal information to support the referral *