New analysis by Diabetes UK suggests that there are now 20 diabetes-related amputations in England every day. This is the equivalent of 7,370 per year and is based on information from Public Health England.
Many of these amputations, however, are avoidable if good care and support is provided. The vast majority of amputations for diabetes-related complications may ultimately be avoidable, that could mean perhaps 5,000 or more amputations need not have happened, which is an astonishing statistic. Having diabetes does not lead inevitably to an amputation or serious complications. Good quality care, however, should be provided to all.
Foot care which is recognised as a high priority in diabetics is variable depending on geography. In addition, there has been a significant increase in people diagnosed with type 2 diabetes so that resources are stretched. Diabetics need foot care protection, advice, and reviews to ensure that problems are identified long before they become significant and ultimately catastrophic.
In addition, I have clients who received their diabetic foot care from private providers who undertake some work for the NHS. They may not have speedy referral systems or may have additional budget constraints due to contract terms. There may not be the continuity of care which is preferable, particularly where there is a wound or ulcer.
An amputation, from whatever cause, is devastating and completely changes the way people live their lives. The impact on family, friends, and finances can be significant and is often under-estimated.
The majority of amputations may not result from accidents and negligence but it’s possible that, as resources are more stretched and less available, minor problems may not be detected appropriately and speedily.
Clinical negligence claims involving amputations can be lengthy. Even where a trust may have admitted fault, quantifying the case can take a considerable time. There are, for example, a large number of prosthetic limbs bow available albeit not always on the NHS. For those who are very active or who love water sports, there are specific limbs which can be built with appropriate cosmetic finishes.
Regardless of how well an amputee adapts to their home environment (and I have clients who without prosthetic can go upstairs quicker than most people) ultimately a home which is adapted to their needs should be provided if not at the time of settlement, then for later in life.
Most people require some care and assistance as they age. In some cases amputees can require this earlier or in a different form. They may need wheelchairs and adapted equipment if not at the time, then into the future. All of these issues and many more need to be reviewed and subject to expert opinion.
Understandably many amputees have ongoing physical problems with their stump and pain control. They can continue to have symptoms of diabetic complications elsewhere. They can require psychological assistance, vascular and orthopaedic reviews. The consequences of an amputation on physical and mental health can be significant.
I recently settled a case of a man in his late fifties that underwent an amputation as a result of negligence. There was an admission of fault at an early stage in the case but there were still 10 different experts required to prepare reports and comment on what help he would need now and in the future. The defendants had much the same so it was a lengthy process collating all the information.
It is important to remember that people can suffer an accident or a medical condition which develops complications and devastating as it is there may be no one at fault. But there are others who do not receive the care they need and as a result of that failing develop problems. Compensation cannot make up for losing a limb but it can improve some aspects of life. For those people who have suffered poor care, there is the possibility of a claim and if successful funds which could improve the quality of life and perhaps provide security.