The Medway CCG is looking to appoint a provider that can deliver a high quality, and equitable community and/or community hospital in-reach Podiatry services driven by clinical excellence and responsive to the needs of the Medway population. The service will be delivered as part of multi-disciplinary team to including referral triage, clinical care, staff and patient training, research and health promotion for medical problems affecting the foot and lower limb. The key service aims and objectives include: To provide a community-based specialist foot care service which includes the triage of referrals to identify risk. To diagnose, treat, and where applicable prevent and provide rehabilitation of lower limb disorders for adults in line with the agreed access criteria (appendix one), To provide timely proactive assessment and appropriate intervention, Adherence to relevant formularies e.g. Medway Joint Formulary and Wound Care Formulary. To provide care that is in line with most up to date national standards and guidelines, that is evidence based and cost effective, To provide a comprehensive range of podiatric treatments in line with the access criteria To provide appropriate and up-to-date advice and information on all relevant aspects of effective foot care to patients on the caseload, carers and professionals To provide access to high quality, safe care that gives timely advice, early interventions, assessment, diagnosis and treatment for patients according to their individual need Patients and their carers/relatives better supported to self-manage their condition in their own homes through a responsive service that provides easy access to appropriate clinicians and advice To ensure inter connectedness with other disease areas in particular diabetes and cardiac services To provide a proactive discharge process ensuring appropriate patients are discharged from the service with appropriate information and support packages. To provide a shared care approach ensuring communication and collaboration with relevant clinicians involved in the patients care Improved transfers of care through better integration with other healthcare services/professionals to ensure patients experience a seamless service. To ensure the service is responsive and flexible enough to respond to changing need and demand To gain insight in to patient service satisfaction levels. To provide services to excluded communities (e.g. travellers not registered with a GP) referred on from acute services, voluntary services etc. To provide a comprehensive assessment and evidence based care plan for all patients engaged in the service driving a one stop service to the majority of patients allowing the minority with most clinical need to be followed up. To raise awareness of skills and knowledge through education among local health care and social care staff, To ensure patients are appropriately informed about high risk behaviours and work to support behavioural change To ensure timely access to treatment to prevent deterioration in foot health and to prevent unnecessary admissions into secondary care To ensure effective demand management, including gate keeping, the management of waiting lists and waiting times, via an appropriate clinic booking system and the implementation of efficiency measures in all clinics To implement a strategy for identifying and reducing DNA rates in all clinics, including appropriate solutions to minimise and prevent missed appointments and to reduce wasted staff time To ensure multi-disciplinary collaborative working with other specialist services across primary, secondary and social care To provide operational workforce resilience e.g. sickness, AL, resignations, retirement etc. To provide student podiatrist training support To deliver ongoing patient / carer education on foot health and healthy footwear To manage the budget and delivery links across the treatment pathway into the voluntary sector through an agreement and partnership with Age UK who deliver low level foot care in the community. The service will offer a comprehensive range of specialist and clinical interventions ranging from health education and promotion and effective screening, triage, assessment, diagnosis and treatment of foot problems. This includes core podiatry, specialist care, podiatric biomechanics of the lower limb and the assessment and treatment of different lesions of the foot. The provider will use a range of treatments, including- surgery, sharp debridement, pharmacology, wound management, rehabilitation and therapies in conjunction with footwear advice and the provision of orthoses where appropriate.