Podiatry & Diabetic Foot Care
An HCPC-registered Podiatrist-led clinic at KONCEPT® Kingston upon Thames, delivering NICE NG19-aligned diabetic foot screening, routine podiatry, nail surgery and biomechanical assessment, in close collaboration with the Consultant Vascular & Endovascular Surgeon team. Practice is in line with the Health and Care Professions Council standards of proficiency for podiatrists and the Royal College of Podiatry standards.
Note on relationship to the consultant diabetic foot page. This page is the podiatrist-led clinic: routine and preventive diabetic foot care, annual screening, nail surgery, callus and corn debridement, biomechanical assessment and footwear / orthotic review. The consultant-led complications service (active ulcer, suspected critical limb-threatening ischaemia, suspected Charcot foot, suspected osteomyelitis) is the separate diabetic foot clinic headed by Mr Magdy Moawad as Diabetic Foot Lead. Patients move between the two as the clinical picture dictates.
Annual
risk-stratified diabetic foot examination recommended for every adult with diabetes, in line with the UK national pathway
NICE NG19 (Diabetic foot problems: prevention and management)
4 risk levels
low, moderate, high, active diabetic foot problem, the NICE stratification that determines the frequency and intensity of follow-up
NICE NG19 risk stratification
IWGDF 2023
the current International Working Group on the Diabetic Foot guideline framework used internationally and referenced alongside NICE
IWGDF Guidelines on the Prevention and Management of Diabetes-Related Foot Disease 2023
The HCPC-registered Podiatrist at KONCEPT® works within an explicit scope of practice agreed with the supervising Consultant Vascular & Endovascular Surgeon, in line with:
Where the clinical picture is outside the agreed podiatry scope (active limb-threatening ischaemia, suspected critical limb-threatening ischaemia, suspected Charcot foot, suspected osteomyelitis, fast-spreading infection, systemic sepsis or active diabetic foot ulcer with deep tissue involvement), the patient is escalated, the same day where urgent, to the consultant-led diabetic foot clinic on site or to NHS 111 / A&E where it is an emergency.
NICE NG19 requires that adults with diabetes have a structured foot examination at least annually. The result of the examination places the patient in one of four risk categories, which determine the frequency and intensity of follow-up. This is the framework used at every diabetic foot appointment at our clinic.
| Risk | Definition (per NICE NG19) | Recommended follow-up |
|---|---|---|
| Low risk | No risk factors except callus alone | Annual foot examination, patient education, footwear advice |
| Moderate risk | Deformity, or neuropathy, or non-critical limb ischaemia | 3 to 6 monthly examination by a foot protection service |
| High risk | Previous ulceration, or previous amputation, or renal replacement therapy, or neuropathy and non-critical limb ischaemia together, or neuropathy in combination with callus or deformity, or non-critical limb ischaemia in combination with callus or deformity | 1 to 2 monthly examination by a foot protection service. Closer if there are concerns |
| Active diabetic foot problem | Ulceration, spreading infection, critical limb ischaemia, gangrene, suspicion of an acute Charcot arthropathy, or an unexplained hot, red, swollen foot with or without pain | Urgent same-day escalation to the multidisciplinary diabetic foot service (consultant-led clinic) |
In line with NICE NG19, IWGDF 2023 and the Royal College of Podiatry standards, the examination includes:
In addition to NICE NG19-aligned diabetic foot screening, the HCPC podiatrist provides the following services to all patients (with and without diabetes), within the agreed scope of practice.
Sharp debridement of hyperkeratotic skin (callus) and corns, under local anaesthetic where indicated, with attention to the underlying biomechanical cause. Diabetic feet are managed with extra care, in line with NICE NG19 and the IWGDF 2023 protective-sensation guidance.
Gait analysis and lower-limb biomechanical assessment to identify the contribution of foot posture, leg-length difference, joint range and muscle balance to symptoms such as plantar heel pain, metatarsalgia, Achilles tendinopathy or recurrent ulceration. Outcomes include footwear advice, off-the-shelf insoles, custom orthotic referral and onward physiotherapy referral where indicated.
Footwear review with the patient’s regular and exercise shoes. Off-the-shelf insoles where appropriate. Referral to an orthotist for custom orthoses where the biomechanical assessment supports it. Diabetic footwear advice in line with NICE NG19, including the role of pressure-redistribution insoles for high-risk feet.
Structured education on foot self-care for patients with diabetes, peripheral arterial disease and lymphoedema, in line with Diabetes UK and NICE NG19. Written materials and a plan tailored to the patient’s risk category.
The NHS provides comprehensive podiatry and diabetic foot services through community podiatry teams and acute diabetic foot multidisciplinary services. The NHS pathway remains the right route for many patients. KONCEPT® is designed to complement, not replace, that care.
| Step | Standard NHS approach | What KONCEPT® adds |
|---|---|---|
| Access to a podiatrist | Referral via GP or self-refer to NHS community podiatry where local services accept self-referral. Timing varies by region and local provision | Direct booking with an HCPC-registered podiatrist. Same-week appointments subject to availability |
| Diabetic foot screening | Annual diabetic foot check per NICE NG19, often as part of a diabetes annual review | NICE NG19 risk-stratified examination with same-visit ABPI, monofilament and vibration testing, written plan and patient education materials |
| Nail surgery | NHS provision varies by region, with waiting lists subject to local capacity | Planned partial nail avulsion with phenolisation under local anaesthetic at a scheduled appointment |
| Biomechanical assessment | Available within community podiatry or via MSK pathways depending on region | Same-visit biomechanical assessment with footwear and orthotic advice |
| Onward vascular input | Vascular outpatient referral, timing varies by region, specialty and clinical urgency | Same-site Consultant Vascular & Endovascular Surgeon escalation pathway and same-site advanced wound care clinic |
| Continuity with your NHS GP | NHS letter to your NHS GP after each visit, subject to local processes | Clinical summary letter to your NHS GP on request, with your consent, after each KONCEPT® visit |
NHS provision varies by region and clinical context, and the NHS pathway remains appropriate for many patients. KONCEPT® encourages continued NHS GP involvement and shares clinical summaries with your NHS GP on request.
These are the situations where the podiatry clinic is not the appropriate first stop and the safer route is elsewhere:
KONCEPT® serves patients across Kingston upon Thames, Surbiton, New Malden, Wimbledon, Richmond upon Thames, Putney, Teddington, Hampton, Esher, Cobham, Walton-on-Thames, Thames Ditton and Twickenham. The clinic sits opposite Kingston railway station (Waterloo 28 minutes direct), with parking nearby and easy access off the A3 from Wimbledon, Putney and central London.
A podiatrist is a Health and Care Professions Council (HCPC) registered allied health professional, trained in the assessment, diagnosis and management of the foot, ankle and related structures. In the UK, the title “podiatrist” is protected by law and HCPC registration is mandatory. The term “chiropodist” is the historical name for the same registered profession. “Foot health practitioner” is a separate, unregulated role and is not the same as a podiatrist.
This page is the podiatrist-led clinic for routine and preventive diabetic foot care, annual screening, nail surgery, callus care and biomechanics. The separate consultant diabetic foot clinic, headed by Mr Magdy Moawad as Diabetic Foot Lead, manages active diabetic foot problems and complications. Patients move between the two as the clinical picture dictates.
A structured foot examination with visual inspection, foot pulses, ABPI where indicated, 10g Semmes-Weinstein monofilament test for protective sensation, 128 Hz tuning-fork vibration test, footwear review, risk stratification in the four NICE NG19 categories, and a written plan including the follow-up interval.
Low risk (no risk factors except callus alone), moderate risk (deformity, or neuropathy, or non-critical limb ischaemia), high risk (previous ulceration, amputation, renal replacement therapy, or combinations of neuropathy, ischaemia, callus and deformity) and active diabetic foot problem (ulceration, infection, critical limb ischaemia, gangrene, suspected Charcot arthropathy or unexplained hot red swollen foot). The category determines the follow-up frequency.
A 10g Semmes-Weinstein monofilament is a calibrated nylon filament that buckles when 10 grams of force is applied to the skin. It is the UK national-pathway standard test for protective sensation in the diabetic foot. Loss of protective sensation increases the risk of unnoticed foot trauma and ulceration.
Yes. The podiatrist performs partial nail avulsion (PNA) with phenolisation for symptomatic ingrown toenails, under local anaesthetic, per the standard UK podiatric surgical technique. Indications, contraindications and consent are reviewed at a planning consultation before surgery is booked.
A structured assessment of foot posture, gait, leg-length difference, joint range and muscle balance, used to identify the mechanical contribution to symptoms such as plantar heel pain, metatarsalgia, Achilles tendinopathy or recurrent ulceration. Outcomes include footwear advice, off-the-shelf insoles, custom orthotic referral and onward physiotherapy referral where indicated.
No. Custom orthotic manufacture is not performed on site. Where the biomechanical assessment supports custom orthoses, the podiatrist refers the patient to an orthotist with a clear specification. Off-the-shelf insoles are advised on site where appropriate.
Acute Charcot arthropathy is a destructive bone and joint condition that can develop in a foot with neuropathy, often without pain. The classic presentation is an unexplained hot, red, swollen foot in a patient with diabetes, with or without pain. Per NICE NG19, suspected Charcot arthropathy is an urgent same-day escalation to a multidisciplinary diabetic foot service. We escalate it on the day, on site, to the consultant-led clinic.
No, you can book directly. Most insurers also allow direct booking. A small number still require a GP referral letter, we will confirm what your insurer needs when you enquire.
With your consent, yes. A clinical summary letter is shared with your NHS GP after each visit on request.
Routine podiatry services (nail surgery, callus and corn debridement, biomechanical assessment, footwear and orthotic advice) are available for patients without diabetes. Diabetic foot screening is specifically the NICE NG19 pathway for patients with diabetes.
Self-pay fees for the consultation, NICE NG19 diabetic foot examination, nail surgery and other services are published on the vascular surgery pricing page. A written quote is provided before any procedure is booked.
46–48 Wood Street, Kingston upon Thames, KT1 1UW. Opposite Kingston railway station (Waterloo direct, 28 minutes). Parking is available nearby. The clinic is on the ground floor and step-free.
NICE NG19-aligned screening with monofilament, vibration and ABPI on the same visit, with a written risk-stratified plan and same-site escalation pathway if needed.