Gade Surgery: Gade House, tel 01923 775291, Witton House, tel 01923 283900

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Service Criteria

Patients should be assessed according to their individual needs, and treatment provided from a range of specialists as appropriate. These patients will have a wound, structural, or skin/nail condition that requires specialist care in the presence of the following high-risk conditions:

  • Diabetes (Stage 2 and above as per West Herts guidelines)
  • Rheumatoid Arthritis plus associated conditions
  • Peripheral Vascular Disease
  • Peripheral Neuropathy
  • Severe structural anomaly of the whole foot, congenital or acquired, requiring specialist treatment and management
  • Ingrowing toenail or nail pathology requiring surgery under local anaesthetic
  • Other - if you believe your patient to be high risk please state your reason on the new referral form for consideration.
  • Musculo-skeletal foot or leg problem.
  • The patient takes Steroids
  • The patient takes Anticoagulants (not aspirin)
  • The patient takes Immunosuppressants

Musculo-Skeletal Podiatry - Adult and Child

These patients will have the same high-risk medical conditions as above, together with a musculoskeletal problem. Note that requests for surgical footwear and splints should go to Surgical Appliance Department.


This should be undertaken with treatment plans which wherever possible result in curative outcomes or, where appropriate, arrest or reduce deterioration in the patient's local or systemic condition.

Patients (or carers with consent) should be involved with their own care whenever possible. The service cannot support treatment where the patient is able to safely assist in their own treatment, but does not wish to. Treatment will not include:

  • Social care (of patients not in the priority groups)
  • Benign soft tissue lesions such as verrucae
  • Asymptomatic congenital problems with no proven treatment, ie curly toes in children

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