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<p>Diabetes is one of the most common causes of amputations in the United Kingdom
and there are a variety of mechanisms in place to support the care of people with
diabetes to minimise the risk of amputations. NHS England published Action for Diabetes,
which sets out that in many cases amputation as a result of diabetes is avoidable.</p><p>
</p><p> </p><p> </p><p>NHS England has also piloted a diabetes service specification
in a small number of clinical commissioning groups (CCGs). Feedback has been very
positive and they have now published the service specification on the NHS Commissioning
Assembly website so that it is available nationally for CCGs to use.</p><p> </p><p>
</p><p> </p><p>In addition, the National Diabetes Foot Care Audit was launched this
year. The audit aims to establish the extent to which national guidelines on the management
of diabetic foot disease are being met, and will provide local teams with the evidence
needed to tackle any identified differences in practice which will lead in turn to
an overall improvement in management and outcomes for patients.</p><p> </p><p> </p><p>
</p><p>Finally, NHS Improving Quality is supporting a project to reduce the high mortality
associated with diabetic foot disease. People with diabetic foot disease are at particularly
high risk of premature death, much of which is due to cardiovascular disease, with
5 year mortality for those with Type 1 or Type 2 diabetes and diabetic foot disease
around 50%. The project will pilot an approach in several multidisciplinary foot clinics
across the country over the next 18 months to introduce an additional clinical pathway
which includes a cardiological test and subsequent actions to address risk.</p><p>
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