Improving Diabetic Foot Care Through a Multidisciplinary Clinic: Experience From Pilgrim Hospital, UK

Background Diabetic foot ulcers are a major cause of morbidity and mortality in people with diabetes. Although multidisciplinary team (MDT) models are increasingly recognised as best practice, they remain under-implemented across the United Kingdom. This study evaluated the clinical impact of introducing a diabetic foot MDT service at a district general hospital in the United Kingdom. Methodology This retrospective, cohort study compared clinical outcomes in two patient groups, namely, those managed before (Cycle 1; January to June 2016, n = 72 patients, 85 lesions) and after (Cycle 2; January to June 2019, n = 90 patients, 111 lesions) the implementation of the MDT. Primary outcomes included major amputation and mortality, while secondary outcomes included healing rate. Further data were collected on demographics, interventions, service outcomes, and Charcot foot. Results Following MDT implementation, major amputations decreased from 11% to 6% (p = 0.196), three-year mortality reduced from 39% to 29% (p = 0.180), and healing rate improved from 64% to 74% (p = 0.289), all clinically meaningful although not statistically significant. Ulcer healing time improved significantly from 300 to 244 days (p = 0.0375), and readmission rates due to recurrent or new lesions dropped from 47% to 22% (p = 0.0008). All post-MDT patients received vascular review, with an increase in revascularisation and orthopaedic surgeries. Charcot foot cases demonstrated stability post-treatment, with no reactivations over three years. Conclusions Implementation of a diabetic foot MDT significantly improved healing time and reduced readmissions, with clinically meaningful reductions in amputation and mortality. These findings support the adoption of integrated MDT models in district general hospitals to optimise diabetic foot outcomes in the United Kingdom.