Making the Move: From the NHS to Private Practice

By Shila Ansari

I recently moved from a podiatry department in the National Health Service (NHS) to Dulwich Podiatry.  My eight years working in the NHS provided me with the opportunity to develop my core podiatry skills, especially in managing the high risk foot, ulceration and wound care. Unfortunately, I felt could not develop my scope of practice further nor update my current knowledge of new techniques and recent advanced technology due to the limitations of the services we could provide to our NHS clients.

Eligibility criteria within podiatry in the NHS limits the service to high-risk patients who suffer from long term illnesses such as diabetes, Rheumatoid Arthritis, and patients on certain medication such as anticoagulant therapy.  The NHS department in which I was working only provides limited core podiatry treatments such as nail care, removal of corns, calluses, nail surgery with phenolisation, wound care and some limited musculoskeletal podiatry.  Treatments for conditions such as fungal infection in toenails, verrucae, and treatment of ingrowing toenails under local anaesthetic without full surgery is not available under the NHS as they are considered cosmetic treatments.

Private podiatry is available to every individual who requires treatment or foot health advice regardless of their concern, age or medical conditions.  A wide range of treatment and new technologies are available in the private sector, providing a greater choice for the clients, taking into consideration their personal circumstances (lifestyle, psychological or financial).  We directly involve you in the decision making, to create your own care plan.  Longer appointment times and the abillity to follow up with our clients, helps us to improve the quality of care we can provide in private practice.

The first thing I noticed as soon as I joined Dulwich Podiatry was that working together as a team, regardless of our job and responsibility, created a welcoming, friendly environment in which everybody is respectful, supportive and looking after one another.  In private practice, having one person as a lead with strong management and leadership skills is the key to an effective, well run, patient focused and team orientated successful practice.

As HCPC-registered podiatrists we must always keep up to date with our skills and training.  Whilst in the NHS, my experience was that I was only provided with core skills training. In private practice we have been given the opportunity to have regular training to keep up with our continued professional development (CPD).  In Dulwich Podiatry, our Clinical Director, Debbie, offers us training in the most recent available treatments and techniques, tickets and accommodation to annual podiatry conferences, monthly clinical team meetings with presentations and reviewing core podiatry topics, case studies, workshops and peer reviews.  We have regular one to ones to discuss any issues that we may have and all employees have access to a workplace health and wellbeing scheme.

One of the greatest advantages of working in the NHS was to have access to the patients’ medical/hospital record, medications, all their previous test results, examinations and reports such as blood tests, X-rays, MRIs and consultations. It creates a great opportunity to work within a multidisciplinary team (with other health care professionals) for further planning and decision making to provide every individual patient with the best available short term or long-term treatment and care plan.  It also enables you to have faster or direct referral pathways to other departments.

At Dulwich Podiatry our aim is to put private practice at the forefront of patient care by creating a close relationship between our practice and our patients, local GPs and other health care providers.  We can refer directly for X-rays and MRIs and are working hard to bring all together to create a faster route and a direct line of referral to other specialists, to advance the quality of our care for benefit to the patients.

The NHS is free at the point of contact, is available to all UK residents and provides a variety of healthcare services to improve the population’s wellbeing.  Unfortunately, an increase in demand has created a critical situation, where the waiting lists to receive initial assessments and appointments as well as surgical treatments has increased greatly.  Unlike the NHS, in private practice booking an appointment is much easier, with direct access without the need for a referral from your GP.  At Dulwich Podiatry, we provide convenient flexible appointment times such as Saturdays, early mornings or evenings, which suit most patients, like school children or people working weekdays.

Even though I will always treasure my experience within NHS podiatry and appreciate all the guidance from my colleagues and co-workers, I am eager to learn more and to face the new challenges that my new role in private practice will bring.  I believe these will enable me to provide excellent care and to improve the quality of care for my patients at Dulwich Podiatry.