GPs views (taken from survey)
In 1987 we introduced podiatric surgery to the Northampton area and this became very popular during a period before GP Fundholding was brought in by the Thatcher Goverment. Podiatric Surgery took off after this and resulted in the King’s Fund undertaking a report.
The King’s Fund produced a booklet on ‘The cost Effectiveness of Podiatric Surgery Services’ in 1997 using the results of a number of surveys. One survey within the publication used our own study from 1993.
Tollafield, D R. Podiatric Surgical Audit. Impact on Foot Health – results of a five year study. Journal of British Podiatric Medicine 48:89-95 1993
‘Very satisfied with the service’
‘Superb service, much quicker recovery than after orthopaedic surgery’
‘Extremely good, patients full of praise’
‘Satisfactory and pleased with the speed of operation’
‘Probably more attention than is possible in the orthopaedic department’
‘I shall continue to refer’
Desire to run a marathon but could not as too much foot pain
“…I have progressed through my foot operation. You have all been patient with my many concerns and there is now light at the end of the tunnel. I can walk, hop and skip, so watch the London Marathon this year! Very best wishes”
A.D female patient 73 years of age
As a keen golfer I have recently struggled with foot pain caused by an arthritic hallux valgus. I was referred to Mr Tollafield who decided, after X-rays, that I needed a replacement joint. My recovery has been rapid and, following expert Physio advice, walking after two weeks and now after almost five weeks have been signed off from Mr Tollafield. I am now pain free and ready to hit the golf course next month. The whole experience under Mr Tollafield’s guidance at Spire Hospital was a pleasant one and I whole heartedly recommend the procedure to anyone with a similar problem. Many Thanks, Betty Allington February 2015
“I have suffered from a bunion for approximately 15 years. More recently I have asked various medical people, including an orthopaedic surgeon for advice. Nothing constructive was offered so I limped on, walking on the outside of my affected leg and suffering pain in the knee on that side as well. As a walker, enjoying 1 to 2 hours walk daily, I became worried as to what I was going to do. In the past 5 years I have had 2 hip replacements and I want to preserve them for as long as possible. You suddenly realise how important your feet are! Then a friend recommended Mr Tollafield.
The whole passage from initial assessment through to surgery and the after care was well organised. The consultations were unhurried and there was plenty of time to ask questions. There were comprehensive fact sheets about what operations were available, with all the pros and cons . All went smoothly on the day of operation, and exactly as explained on the fact sheet .I was a bit taken aback that I needed a replacement joint but the joint was worn out so there was no option.
I was most impressed with the physio who I saw 3 times post operatively, before discharging me. 8 weeks later and I had my first 2 hour walk . My knee no longer hurts and I am trying to do what the physios have taught me. Wouldn’t it be fantastic if we all had such a wonderful experience of the N H S ? But well done Mr T for heading such a great team. You have always been very approachable, kind and thoughtful with a good sense of humour ( all important for us patients and ex nurses !!!!!). I am quite happy for my telephone number to be forwarded to anyone contemplating the same journey!” Best Wishes
Jo Latimer December 2013 (Op 31st Oct)
“Removal of bunion and joint replacement – two procedures over the last six months as a day patient by Mr David R Tollafield. Both operations were carried out under local anaesthetic with a relaxant drug. Both procedures took approximately one hour, during which time I was totally unaware of what was taking place and felt no pain. …people had warned me that such procedures were very painful and the recovery would be lengthy. This certainly was not my experience. After three weeks, I was seen by a physiotherapist who gave me further exercises for another three weeks. The treatment I received from Mr Tollafield and his team at the Spire Hospital was first class and I would not hesitate in recommending Mr Tollafield to anyone who who is considering surgery on their feet.”
James White, 71 years, retired Chartered Accountant. December 2013
Mr White is willing to speak to anyone about his experience and can be contacted on 0121 308 0430.
“What having this operation means to me? No longer enduring pain in my hip because I can walk correctly. I am able to wear shoes without having to take one off as soon as the opportunity arises. To relieve the pain in my toe. I am able to go on long walks again, 8 to 10 miles, without having to stop every 20 minutes and also to relieve the pain. I am no longer woken up at night if my husband accidentally touches my toe and sends a sharp pain from my toe up my leg. I no longer have to visit my chiropodist every month. I no longer cry with the pain. I have my life back.
Carol Roberts November 2013
“I had surgery performed for a bunion removed. I would just like to say thank you very much. My foot looks so much better, I have no pain and bunion has gone. It takes a long time to get better, but it was all worth it. Also, I can still wear ‘high heel shoes’. Thank you”
S.A.N female patient 53 years of age
“…I’m so pleased with the progress I’m making since having two foot operation in the last 12 months…at least the appearance of them has greatly improved and I’m not so self conscious when wearing open sandals anymore…you’ve always been very reassuring, patiently explaining all the procedures and possibilities to me…managing to make me feel completely at ease…!”
SB Female 2007
“Just wanted to say thanks for my new feet!! I’ll look forward to showing them off in the summer. Thank you”
AL Female 2007
Foot & Heel Pain
Heel pain; Kim writes about problems with allergies, but we had a solution.
“I wanted to write and thank you for recommending Tuli’s Heavy Duty Gel Heel Cups, which I am using to help alleviate the pain caused by a calcaneal heel spur.The classic heel cups, I originally tried, unfortunately aggravated my latex allergy but I have had no such problems with the gel heel cups. I find them light-weight, yet supportive and they are flexible to fit all my shoes. The heel cups cushion my heel and help relieve the pain when walking and standing.I would have no hesitation in recommending this product to others. Once again, many thanks.
Kim 14th August 2014
“…thank you for all your patience and understanding, I know that I was not the easiest of patients to treat…”
PB female patient 23 years of age
“…I had pain and unable to walk for 6 years, but know I am walking as good as a 40 year old…thanks to your clinic. Will you please convey my sincere thanks to Mr Tollafield and his team…for the work they are doing.”
EJ Male patient 71 years of age
“…very satisfied with the whole treatment and do not regret for one minute having the operation on both feet. It is so different walking now, after many years of discomfort and pain when putting shoes on. PS I also liked not having to wait for a long appointment.”
AS Female (age unknown)
“It was the best job I had done for a few weeks of discomfort, I am now completely free from pain in my feet and can wear shoes with comfort thank goodness”
MM female (age unknown)
“Didn’t realise it was 7 years since the operation. There is hardly a weekend passed that I don’t have a country walk in one of the many beauty spots which is therapy for my back pain. Many thanks for keeping me mobile!”
Stubborn ingrowing toes nails
“I had a minor operation (Winograd) for an ingrowing toe nail. The operation may have been minor but the care I received was far from minor. The team involved in the operation were exceptionally professional. I was well briefed and well informed. They were efficient, reassuring and caring. I felt that Mr Tollafield and his team made the effort to see me not just as a patient but also as a customer and as such needed to be respected, informed and put at ease.”
P.G Male patient 64 years of age
“ Thanks you so much for all your help over the past years. I know it seems a regular occurrence with me having these operations but from day one you have reassured me and made me feel at ease…knowing my luck I will be coming to see you when I’m 30! Thanks again for your help. I’m sure I will be normal one day!”
K H Female 20 years of age
“…I feel I must write to express my sincere gratitude for the excellent outcome of the operation which you performed on my left foot in November 2003. My foot has been completely transformed pain-free and flexible and walking is now so much more comfortable.
As you know, I first came to you 12 years ago when both of my feet were badly deformed with bunions and hammertoes. Walking had become extremely difficult and very painful, and my mobility was therefore very limited. Your corrective surgery transformed my life, and I have never forgotten that. Therefore, when my recent problems arose, you were the only person I was confident would solve them – and I was right!
I cannot thank you enough for the second transformation you have wrought for me. Let us hope there won’t be a third episode, but if there is, I shall know where to come!” Eileen Hodgson 23rd January 2014
Repetitive chiropody can cost more money over time. Evidence shows that surgery can be actually cost effective and save money
“…for years I was going to the chiropodist each month, and was told I had a very bad toe. I did not need to be told I know the pain I was in…It was my lucky day when the article regarding your clinic was in the local paper…”
ER Female patient 54 years of age
“…I can’t speak high enough of them, no pain, didn’t know they had done it, and I’ve never had any trouble since…”
VEM female (age unknown)
“…was able to wear my own sandals after 2 weeks…”
“…I can tell you she was pleased with the results of both foot operations; very satisfied with all aspects of treatment and hold the operating team in high regard…”
“…I had every confidence in the people performing the surgery because their knowledge of feet, so I wouldn’t call them ‘non medical’. I am very pleased I had surgery. If I had any criticisms I would liked the operations explained better…”
Thanks you Mrs X your point is well made. Since 2010 significant changes have been made in consultation processes, consent and in 2013 the professional body of Podiatric Surgeons has added two very significant policy changes to improve clarity. This is supported by more information to broaden clinical education for all, bringing the patient closer to playing a part in making decisions about their care
“…having had five operations before on my foot, I can honestly say this is the only time I have been comfortable in walking and have no discomfort. I wish this operation could have solved my problem years ago. I would have faith in you and your team any time…”
VT Female patient (age unknown)
Evidence for age and gender
Figure 1: The distribution of age is shown for a sample of 800 patients taken from 2010 to 2013.
Female patients (red) account for 80% of the cases referred to this service ranging usually between 40 years of age to 70 years (52%). The range for the largest group being aged 60-64 (12% – females) 55-59 (3%- males -blue). This suggests that retirement age from 55-70 captures most interest as this group notices greatest impact on mobility and comfort. This group also has a greater ability to take action for their foot health.
Golden Heart Awards
During 2012 Walsall Hospital introduced wider awareness of services provided. Patients provided nominations for my service and my own work.
“You have been nominated by a patient for the excellent care she received. Your advice, manner and efficiency was much appreciated, and you are a credit to the profession. With many thanks.”
Richard Kirby, Chief Executive, Walsall Healthcare
“You have been nominated by a patient the excellent care he received. His treatment was first class and has greatly improved his quality of life for which he is very grateful.”
Richard Kirby, Chief Executive, Walsall Healthcare
Dear Mrs Kerrigan
“…I was referred by my GP … to see Mr David Tollafield…From the moment I arrived (everyone) looked after me very well and my operation went smoothly…After discharge my outpatient appointments were carried out with kindness…I would like to pass on my thanks to all the people who looked after me especially Mr Tollafield for his skill and courtesy to me.”
Surgery at West Midlands Hospital patient JW Female 2009
Not always successful
Foot surgery is not always successful for many reasons. We would want all patients to be aware of this. Sometimes revision work can help as two cases below illustrate. I will always try to provide a risk assessment to advise the likelihood of good versus poor outcome. We now use tools like PASCOM-10, a database to help co-ordinate such predictions.
“…for 18 months or so I had no problems. Now unfortunately (the) problem has recurred so I am in discomfort most of the time. Some days are better than others. CRG (further operation performed and totally cured one year after)”
“…the corn has reappeared and I feel that more surgery on my foot would not do any good I am afraid.
JB Female (age unknown)