Assess the feet of individuals with diabetes and provide advice on maintaining healthy feet and managing foot problems

This standard concerns assessing the condition of the feet of an individual with diabetes to determine risk status, and taking the appropriate action, which may include a referral for treatment, providing advice, or negotiating a care plan. The individual may be accompanied by a carer, who should be included in the discussions if the individual chooses to involve them.

The activities described in this standard may follow a referral from a preliminary examination or may be a first examination of the feet. The use of a hand-held Doppler to assess blood flow is not included in this standard.

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1. access and accurately interpret all relevant work instructions and information
2. work safely at all times and in accordance with all relevant legislation, guidelines, policies, procedures and protocols
3. deal promptly and effectively with any problems within your control and report those which cannot be solved
4. identify and minimise hazards and risk in the workplace
5. communicate with the individual and key people at a pace, in a manner and at a level appropriate to the individual's understanding, preferences and needs
6. respect the individual's rights and wishes relating to their privacy, beliefs, and dignity
7. communicate with individuals and carers throughout the discussion and examination in a manner which is appropriate to them and which encourages an open exchange of views and information
8. gain valid, informed consent from the individual in accordance with specific procedures
9. ensure that the individual understands:
   1. the potential effects of diabetes on vascular and neurological problems in the feet and lower legs
   2. problems or risks revealed by the examination, including any areas of uncertainty which may require further tests
   3. how they can manage their diabetes to maintain the health of their feet
10. gather information, through discussion with the individual and carer on:
    1. relevant medical history
    2. any subjective symptoms of problems in the feet and lower legs
11. examine and assess the individual for:
    1. the skin condition of the feet and lower legs
    2. sensory neuropathy using appropriate tools
    3. any current infection and ulceration
    4. any foot deformities
    5. vascular status for the presence of peripheral arterial disease by palpating pedal pulses
    6. joint mobility and identify any biomechanical problems
12. examine the individual's footwear and assess its suitability for foot type and risk status
13. identify the factors that are likely to affect the individual's ability to care for their feet, and make an overall assessment of their ability to self-care
14. arrange for further examination or treatment, with appropriate speed, where this is indicated by your risk assessment
15. negotiate and agree one or more actions that the individual and carer will undertake to address problems or risks
16. offer written information on footcare in a suitable form for the individual and carer to reinforce their understanding
17. agree when the individual will next come for examination, leaving an interval appropriate to the risks you have identified
18. complete and store all relevant documentation in accordance with organisational requirements

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1. the current legislation, guidelines, policies, procedures and protocols which are relevant to your work practice and to which you must adhere
2. the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
3. how to access and interpret all relevant work instructions and information
4. specific procedures for reporting issues which are beyond your competence, responsibilities and accountability
5. the duty to report any acts or omissions that could be unsafe/detrimental to you or others
6. the hazards and risks which may arise during the execution of your work role and how you can minimise these
7. how to adapt communication styles in ways which are appropriate to the needs of the individual  
8. the correct use of any equipment and PPE to protect the health and safety of you and others
9. evidence-based practice and its role in improving care
10. the principles, practice and procedures associated with informed consent
11. the needs of individuals and carers including issues relating to dignity, confidentiality, and privacy
12. organisational management structures, roles, and responsibilities
13. the procedures and methods relating to the coordination of inter-disciplinary and multi-disciplinary teams within and across services
14. diabetes monitoring, management and education
15. prevention and management of foot problems for people with Type 2 Diabetes
16. causes, signs and symptoms of diabetes
17. normal and abnormal blood glucose and HbA1c values
18. typical progressive patterns of diabetes
19. the importance and effects of individual education and self-management
20. the psychological impact of diabetes, at diagnosis and in the long term
21. the social, cultural and economic background of the individual/carer group
22. the effects of:
    1. smoking, alcohol and illicit drugs
    2. intercurrent illness
    3. nutrition and physical exercise
23. how to manage hypoglycemia
24. the medications used to manage diabetes
25. the long-term complications of diabetes and when they are likely to occur
26. how to examine feet and assess risk status
27. how to monitor:
    1. cardiovascular risk
    2. renal disease
    3. diabetic retinopathy
    4. glucose levels, HbA1c, blood pressure
28. the law and good practice guidelines on consent
29. referral pathways
30. quality assurance systems
31. the process of notification for legal and insurance purposes
32. sources of practitioner and individual information on diabetes
33. contact details of local and national support groups
34. how individuals can access local facilities for exercise and physical activity, education and community activities
35. how to complete and safely store all relevant documentation in accordance with organisational requirements

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2

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2026

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Current

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Original

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Skills for Health

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HA4

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Health and Social Care, Health and Social Services Officers, Health Associate Professionals, Health Professionals, Health, Public Services and Care, Healthcare and Related Personal Services

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2259

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Diabetes; feet; foot; assess; problems; manage

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