SCGH High Risk Foot Service (HRFS) achieves accreditation as a Centre of Excellence

The SCGH High Risk Foot Service (HRFS) is a multidisciplinary service which meets the needs of patients with complex diabetes related foot complications. It brings together the specialties of Vascular, Infectious Diseases, Endocrinology, Podiatry and Nursing (including Silver Chain Liaison Nurse) and provides care to patients with limb threatening diabetic foot ulcers and infections, and other complex foot disorders such as Charcot neuroarthropathy.

Established in May 2019, the service offers an outpatient multidisciplinary clinic (the MDFU) located in the SCGH Podiatry department, and an inpatient diabetic foot unit (SCGH), and has links to the amputee rehabilitation service (OPH) and Hospital in the Home (Homelink) Service which provides care to patients in their own homes.

After three years of operation, the SCGH High Risk Foot Service now helps around 60 outpatients each month and performs 400 diabetes related vascular interventional procedures each year, including limb salvage to prevent amputation, which is increasing significantly year on year. All the patients the Service supports have high-risk foot complications, primarily diabetes related, resulting in complex foot ulceration and other limb threatening foot problems.

Dr Mendel Baba, Head of Podiatry at SCGOPHCG, said, “Across the High-Risk Foot Service, a team of 15 or more staff work every day to give patients the best outcomes, reducing their risk of amputation and infection, helping them to keep their limbs and independence, celebrating every success.”

This year sees a new milestone for the Service, which has recently been accredited as a Centre of Excellence by the National Association of Diabetes Centres (NADC). The NADC Interdisciplinary Diabetes HRFS accreditation, the only national accreditation of its kind, aims to improve quality and safety within Interdisciplinary Diabetes HRFS. The accreditation model is focused on a three-pronged approach, combining governance, clinical, and quality criteria. The objective of the NADC accreditation is to assist Diabetes HRFS to achieve quality patient care through improved interdisciplinary team-based care, improved governance and centre structure, as well as providing opportunities for clinician education and research.

Dr Baba said, “After a rigorous process, we were thrilled to be notified that our service has met the standard to be accredited as a Centre of Excellence.

“We are only the second high-risk foot service in WA to be accredited at this level, and one of only 8 nationally, and it is a significant achievement. This has been a massive team effort and it is a cause for celebration for us all; it is a win for the Service and a win for our patients”.

Alongside patient-facing services, the group is delivering a significant international research program. The research program is led by Professor Shirley Jansen, Director Heart and Vascular Research Institute (HVRI) based in the Harry Perkins Institute of Medical Research QEII campus.

Professor Jansen, who is also Head of Vascular Surgery and Professor of Vascular Surgery at Curtin Medical School, also oversees the supervision of higher research degrees, with 5 PhDs and 2 Masters students currently completing projects with the research group. The HVRI has run over 150 industry sponsored trials including pharma, device and first-in man research. Professor Jansen and colleagues, such as Professor Grant Morahan, world leading geneticist and diabetes expert, were part of a large collaborative national group of experts to recently be awarded funding to become a virtual research centre for diabetes, under the Targeted Translation Research Accelerator (TTRA) initiative. This initiative will build a multi-sector collaboration across all Australian States and Territories, under the Australian Centre for Accelerating Diabetes Innovations (ACADI) Research Centre.  In addition to helping people with diabetes, this will build strong national and international collaborative research opportunities.

Dr Baba is leading a newly introduced Diabetes Research stream, which incorporates all the current diabetes related projects and initiatives the HRFS are involved with locally, state-wide, nationally and internationally. The Diabetes Research stream sits as a research sub-unit under the auspices of the HVRI, and is particularly focused on diabetic foot disease. The research will impact patients by ensuring that their care is evidence based and constantly improving in line with new research, enhancing the potential to save limbs.

Dr Mendel Baba, Head of Podiatry at SCGOPHCG

Outpatient multidisciplinary foot ulcer clinic (MDFUC)

Prof Shirley Jansen