Peer review and follow-up to enhance diabetic foot services throughout the patient journey.

Multidisciplinary peer reviews were performed to audit the efficacy of diabetic foot care services in the South West region of England. The resulting peer review recommendations were implemented in practice and have led to a reduction in the incidence of major amputation associated with diabetic foot ulceration. Inequalities and gaps identified in diabetic foot ulcer treatment have led to the reconfiguration of some services and the consideration of future changes to others. Service improvements require cogent commissioning, responsive, locally-sensitive provision of care and adequate funding from clinical commissioning groups. The provision of integrated care by a strong multidisciplinary foot team will result in prompt recognition and treatment of diabetic foot disease and enhance outcomes. [ABSTRACT FROM AUTHOR]