Information
In NHS Lothian patients with foot and ankle conditions are treated by several services who work together to ensure that they provide the right service for the right person at the right time in the right place.
The NHS Lothian Integrated Orthopaedic Foot and ankle Service includes Advanced Physiotherapy Practitioners clinics, Advanced Podiatry clinics, Orthopaedics and Radiology.
Many patients with foot and ankle pathology can be treated non-operatively and in most cases should be given a trial of non-operative management in the first instance. This may be with specific exercises, insoles, splints or injections depending on the condition and patient. If we are provided with an appropriate referral letter then we can more easily triage the patient to the correct treatment.
We would request that the following information is included on any referral letter. If this basic information is not received then we may return the referral.
- Brief History of problem & clinical findings
- Treatment received so far – e.g. have they seen physio or podiatry in the community.
- Has any imaging been performed?
- How is the condition affecting the patient (i.e. off work/sport/etc)
M.A. & J. McK. 24-09-24
Who can refer:
GPs
Who to refer:
Urgent/Emergency referrals:
Most urgent/Same day referrals will be dealt with by the trauma service (i.e. Oncall team), the diabetic service, the vascular service or the sarcoma service. Most other foot and ankle referrals are generally non-urgent. However, we will consider giving a referral priority if the condition is significantly affecting a patient’s quality of life to the extent that they are unable to work or mobilise safely. There is also the opportunity to prioritise Athletic patients who are unable to take part in their sporting activities as per the Edinburgh Orthopaedic Sports Medicine Guidelines.
To be able to prioritise any of these patients we must receive a detailed description of why the patient should be prioritised.
Routine:
Most elective conditions will have a trial of conservative measures such as Podiatry, Physiotherapy and Orthotics before surgery would be considered. For most cases surgery is to improve patient’s quality of life and is not essential. Therefore, patients who are not willing to consider surgery would not benefit from a referral to see a surgeon.
The following is a list of common foot and ankle conditions. The link will take you to a page with some information and referral guidelines.
Who not to refer:
- Fractures (Refer on the same day to orthopaedics via switchboard)
- Recent Fracture fixation with problems (Refer to Fracture clinic via SCIgateway)
- Tumours (please see – Sarcoma – RefHelp (nhslothian.scot))
- Peripheral arterial disease (Please see – Vascular Surgery – RefHelp (nhslothian.scot))
- Diabetic foot problems (please see – Management of the Diabetic Foot – RefHelp (nhslothian.scot))
How to refer:
SCI gateway > Lauriston Buildings > Orthopaedics – Foot & Ankle
We would request that the following information is included on any referral letter. If this basic information is not received then we may return the referral.
How is the condition affecting the patient (i.e. off work/sport/etc)
Brief History of problem & clinical findings
Treatment received so far – e.g. have they seen physio or podiatry in the community.
Has any imaging been performed?
