With last month’s NAIDOC week now behind us, it’s timely to look at the Healthy Deadly Feet Project (HDF Project). While this pilot project is specific to NSW, there are strategies in here which podiatrists nationwide may like to reflect on. You can look up the project in full here, and below are some key points about the program, which can be sourced in more detail here.
What are the goals behind the HDF Project?
The HDF Project aims to:
#1 Increase the Aboriginal and Torres Strait Islander workforce in foot care and podiatry in NSW Health, and;
#2 Improve diabetes-related foot disease outcomes for Aboriginal and Torres Strait Islander people in NSW.
What is the program?
The project team will work with podiatrists, Aboriginal Health Workers and practitioners, as well as Aboriginal/non-Aboriginal allied health assistants from participating local health districts and special health networks in NSW.
In line with improving access to High Risk Foot Services in NSW this project aims to increase the Aboriginal workforce in foot care and podiatry and improve diabetes related foot disease outcomes for Aboriginal people in NSW.
There are five pillars behind the program which you can read about on page seven here. The HDF team will support Aboriginal people in their communities across three domains of care:
- Cultural care navigator
- Health promotion and education
- Screening and early intervention.
You can read more about these details on page 14 here.
Why has this program come about?
Diabetes and diabetes related foot disease are disproportionately prevalent in the Aboriginal population. In NSW, Aboriginal people experience almost a four-fold amputation rate due to diabetes-related foot disease when compared to non-Aboriginal people. A literature review* in 2016 recommended an increase in the NSW Aboriginal workforce in foot care and podiatry to provide culturally safe and community focused care for Aboriginal people with diabetes related foot disease.
How did it start?
The NSW Ministry of Health, along with partners, developed the HDF Project. To make it happen, partners are working with four districts and one network in the HDF pilot project.
How will we know if this pilot program is successful?
The increase in the Aboriginal workforce in foot care services (and the establishment of High Risk Foot Services across NSW) should improve access for First Nations people to access culturally safe foot care services, as well as increase screening and early intervention.
This should lead to the following benefits:
- An improvement in patient reported experience and outcomes
- A reduction in diabetes related foot disease and complications such as amputations
- An overall improvement in the health and quality of life for Aboriginal people.
- There will also be a reduction in the variation between Aboriginal and non-Aboriginal people in prevalence, access to care and outcomes for diabetes related foot disease.
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The state of podiatry in the UK
The National Disability Insurance Agency (NDIA) is now releasing infographic-style monthly summary reports, so everyone can see how the National Disability Insurance Scheme (NDIS) is tracking compared to the same month in the past year. Read on to see how you can access this data, as well as how you can tap into a broader range of NDIS insights.
The NDIS are now sharing a monthly one-page visual snapshot, which provides year-on-year comparisons for the following statistics:
- How many participants are in the Scheme
- The average annualised level of payment per participant
- Overall amounts of NDIS payments to participants. For example the April 2022 report shows that the ‘year to date paid support to participants’ is up 20% from last year.
Other data sources
Beyond these monthly summary reports, the NDIS holds a vast amount of valuable data for health providers. This link will take you to the main data dashboard, and from there you can search through the following data sources:
- See how many providers are active each month; broken down into whether this is the provider’s first time or they are a returning provider.
- Scroll through category support payments, including related age bands of participants and their prevalence each month.
- Review a wide range of participant-led goals and outcome reports.
- Use the interactive data table to look at participant, provider, market and utilisation data.
- Access market dashboards that capture data such as:
- Participants per provider
- Provider concentration
- Provider growth and shrinkage
- Choice and control.
Given vast amounts of data can become a little abstract; here are some other ways to bring its relevance back to your role.
- See what the NDIS demand is like in the area you work in. Head to the NDIS demand map. This map also includes likely 2023 forecasts for your area (note that it is in BETA mode right now).
- Learn more information about any NDIS data sets that you have questions about, by contacting firstname.lastname@example.org
- Access information for providers on disability related health supports, which includes a section on podiatry, wound and pressure care supports (see pages 5 and 6).
- Explore why such data may be relevant for future planning by watching this explainer video. On this page you can download state-based presentations that show the growth curve of providers in your state over a period of years, as well as market data on what types of assistance is being required by Scheme participants. This information is a little out of date, last published in October 2019, but the insights are still useful.
- If you have any questions relating to this article, or about the NDIS more broadly, reach out to our advocacy team at email@example.com
Why I recommend volunteering
Q: How can podiatrists best support a patient with lymphoedema?
A: Podiatrists can make a big difference in so many ways, particularly by looking at how to reduce the load on the lymphatic system. For example, bandaging and garments are absolutely essential. They’re one of the three things that are very critical in terms of lymphoedema management, being: compression, massage and skincare.
Q: Can you discuss some more about each of these three interventions?
A: In the intensive phase, massage will be quite frequent and combined with compression bandaging and compression garments or sometimes wraps (these can be adjusted by the patient). However, as we get into the management phase when we’ve got the swelling down, we’ve then got some degree of control. This is where the patient or their partner can help to take over.
At this stage, the lymphatic drainage massage can be less frequent and it can be done by a well trained patient themselves or a well trained partner, combined with other patient-led activities like breathing (yoga or tai chi based for example) as well as making sure they are not constipated or bloated and so forth.
Patient-led activities are really important. Perhaps there is a bit of tension building in a limb and some associated swelling which has been picked up by doing a pitting test in one of the lymphatic territories. So the patient might think, ‘Well, there’s a bit more fluid here, let’s get in and do something’. By telling the patient about the pitting test described earlier, it can help them to help themselves in between podiatry visits.
When it comes to the actual massage, lymphatic drainage massage generally should be light and very gentle. The reason is that if we go back to the lymphatic system, it’s a low pressure, low volume, low flow system. This is really important to remember. Intra-lymphatic pressures rarely go above 10 or 15 millimetres of mercury, unless there’s a big blockage when the system’s pumping hard. Remember also that the volume of lymph fluids draining from each leg is only about 400 millilitres a day. This is 20 millilitres per hour! Not much you say – but it’s crucial that it gets removed, otherwise the leg and foot continues to swell.
So, ideally the patient does their own massage when it looks like it’s needed in the maintenance phase. Yet this should be done under the guidance of a therapist (who they don’t have to see too much but certainly some therapeutic advice is important). For example, podiatrists should be aware of signs that the lymphoedema is not being resolved or getting worse, and they should help to educate the patient to be alert to these signs too.
A: Compression gets a bad reputation sometimes because the patient hasn’t been prescribed (or hasn’t selected) the right compression or the right compression gradient.
There are two things with lymphoedema we’ve got to remember. Let’s imagine we have a swollen foot, a swollen ankle or such. If there’s fluid down there, it’s got to find its way up past the knee, past the groin, through the abdominal area, through the thoracic area, to a junction at the left subclavian jugular right up in the left shoulder. I keep on saying this I know, but never let it out of your mind! That is why holistic whole body care is important.
So if we put compression on – down distally in the foot or the ankle – and there’s a lot of fluid already in the system proximally, then that fluid is going to have a tough time getting out of that leg. No matter how much compression we put on there, it’s going to be a problem. This is related to what you may remember as Pascal’s Law – fluids move down a pressure gradient. The greater the gradient, the better the flow is likely to be!
The take away point is this: before you even use compression, you’ve got to clear out the area proximally. I use the analogy that if you want to get a good result from compression, you need to, ‘Empty the buckets’. You can’t put water in a bucket full of water. And with a lymphoedema patient, you’ve got to actually do that sort of thing proximally, such as looking at all the possible external compression around the groin that could be caused by the elasticity of underwear and so forth, because that may compromise the optimum outcome from a compression garment. Otherwise, despite good intentions, unwanted outcomes can take place, like the swelling can arguably be trapped to some extent through the use of compression garment.
Speaking of unwanted outcomes, we also tend to see some examples where the compression garment is inappropriately selected. Say there’s a higher pressure proximally than there is distally. This means that the fluids get forced down distally. So you might see a patient with a compression garment over the knee and the leg, and there’s nothing compressing it over the toes or the foot. And of course, if the pressure gradient is not right, if there’s too much pressure proximally, then the pressure goes back down a failed lymphatic system into the foot and exacerbates it.
A: The other big role for podiatrists is to look at the skin. Perhaps the podiatrist can see plantar fibromas and so forth, or warts and other skin issues around the nail beds and such. It is helpful if a podiatrist can remember that the lymphatic system effectively works not too dissimilar to a sewage system; it’s part of our defence system. So if there is a nail bed infection for example, it is likely to be exacerbated if lymphatic drainage is poor which is why it is so important to recognise these potential underlying causes, because if that’s not recognised and dealt with, then things get worse!
Conversely, podiatrists should not do or suggest massage or even compression if a patient has cellulitis. No manual lymphatic drainage should be given. If a podiatrist sees cellulitis in a patient with lymphoedema then they should be aware of what needs to be done in terms of referring that patient on to a qualified lymphoedema therapist or their GP. The Australasian Lymphology Association has a National Lymphoedema Practitioners Register (NLPR) which can help patients find a nearby trained therapist, but not all therapists are on this register.
Q: How else do you see the role of the podiatrist as being critical in lymphoedema management?
A: Podiatrists really do have a very important role for a number of reasons, in addition to the above points.
I’m not sure of the level of understanding that you as a podiatrist have in terms of the lymphatics of the lower leg, but there are two major drainage pathways which we refer to as lymphotomes or territories in the lower leg and through in the upper leg, and each of those has got different drainage pathways. It’s important to be aware how they drain differently. One pathway follows the back of the knee and the other pathway goes up through the groin. The pathway that goes into the back of the knee, into the popliteal nodal group, drains the plantar surface of the foot.
So, if you are wearing the wrong sort of orthotics which put the wrong pressure on the wrong part of the foot, the ability for those planar lymphatics to pick up lymph evenly from around the plantar surface of the foot and go to the nodal system might be compromised. Or if too much pressure is being caused by a particular shoe in an area where there’s a crucial lymphatic drainage pathway, that may influence the ability of that system to drain effectively. This in turn may exacerbate anything else the patient is doing in terms of managing their lymphoedema, which shows just how big the role of a podiatrist can be here.
Q: When it comes to red flags, are there any that podiatrists should be alert to?
A: If a podiatrist can recognise the following red flags and then refer the patient to a GP or a lymphologist, it would make a big difference.
For example, any cardiac failure, pulmonary issues and so forth will probably show up as a general edema, and through kidney and liver failure and the like. But one of the other important red flags is certainly cellulitis as I mentioned before! These all require referral onto clinicians.
If a podiatrist has a potential feeling that there’s something going on with the venous system, deep veins, thrombosis, and so forth, or where there may be some external compression on the lymphatics up in the more proximal areas, then this would be a red flag for a podiatrist to be alert to. Likewise, the beginnings of an infection or a problem in the skin, such as in the foot or the nail beds or somewhere like that, can become serious pretty quickly if those bugs get hold of the patient’s already compromised innate and acquired immune systems, which are normally delivered by lymphatics.
Q: When it comes to patient education, do you have a favourite analogy you like to use?
A: I think one of the most important elements is getting all people to think holistically about the lymphatic system. Remember that everything that leaks out of our vascular system from the capillary beds in the foot and so forth has to be picked up by the lymphatic system. Nowadays we are more aware that very little, if any of what leaks out of our blood vessels along the arterial side of the capillary beds goes back into the venous system, like we used to believe. It’s the lymphatics which are responsible for that!
So one has to think holistically and be alert to symptoms from the way they are breathing, through to the types of external pressure on their abdomen which could be caused by tight underwear or jeans.
Looking to get more involved?
The Australasian Lymphology Association (ALA) is the peak body for health practitioners who specialise in treating lymphoedema. The ALA oversees an accredited lymphoedema practitioner program for health professionals interested in specialising in lymphoedema treatment. Accredited lymphoedema practitioners are then eligible to be on the National Lymphoedema Practitioner Register. More information can be found on the ALA website.
Neil is a lymphologist and director of the Lymphoedema Clinical Research Unit at Flinders University, and he is a member of a number of Australian and international lymphoedema and lymphology groups and the Australasian College of Phlebology. He is editor of a range of International Lymphology journals and is patron of the Lymphoedema Association of Australia – a patient group. Neil invites you to submit any interesting case studies about lymphoedemas you come across to be considered for the lymphology journals. Neil is the editor of the ‘Journal of Lymphoedema (UK)’ and the Australasian Editor of ‘Lymphatic Research and Biology (USA)’
This article is the final installation in a four-part monthly series by Shelley Thomson, which focuses on the nuances that drive patient-centred care, why it matters more than ever, how to better understand these dynamics, and how to measure its effectiveness.
Over the previous articles in this series, we have explored how adopting a patient-centred care approach helps healthcare providers to deliver care personalised to the needs and values of each patient. We have also seen how value-based health care (often referred to as outcomes-based care), represents the overarching operating model of care adopted by healthcare organisations whose purpose is to deliver to the patient’s personal value and outcomes.
In this final edition in the series, we will be exploring how patients of today are pushing the expectations of their healthcare delivery beyond just a patient-centred approach towards a patient partnership approach.
What is a patient partnership approach?
In today’s fast-paced, consumer-led world, and educated by the COVID-19 pandemic to take responsibility for their own health, Australians are stepping up to become a partner in their own health.
Less than a decade ago, many patients would have automatically consulted a medical professional to address a health issue and been a passive recipient of the health services prescribed. Now, armed with health education they have received via mainstream media, their own health data collected by wearable devices, the wealth of research they can undertake online and the proliferation of technology, the patient’s approach is rapidly shifting towards managing their own health and coming to consultations informed and ready to be an integral partner in the value creation process. No doubt you will have experienced this shift first hand in your practice or place of work.
In a true patient partnership model, the patient is considered a full member of the care team and their knowledge and decisions are valued and respected throughout the care journey. All members of the care team – including the patient, their family or carers and healthcare professionals – work together to achieve the agreed health outcomes.
Why move to a patient partnership approach?
Patients are becoming more connected and influenced by the seamless customer experiences they see in other sectors (like retail) and are demanding more from their healthcare experiences. Already, 50% of the Australian population and 46% of workers are millennials or generation Z. Millennials are set to make up 75% of the total Australian workforce by 2025. This group of digital natives have different perspectives and expectations of this generation on what they want from their healthcare delivery.
We are now at a tipping point, particularly during the pandemic, where consumers have made great strides forward in digital adoption, which has shifted their expectations towards being a full partner in their healthcare journey, and expecting it to be delivered in a way which is convenient and consistent with the services they access in other areas of their lives. If healthcare professionals do not embrace these shifting expectations and move from a provider-driven system to a patient partnership approach, then they risk patients simply seeking out alternative services which do cater to their needs.
Bringing it all together – a new way of working
All layers of the Australian healthcare system are currently considering newer, more contemporary ways of working and allied health, and more specifically, podiatry, is no different. This degree of change requires vulnerability and humility in leaders to encourage and listen to a broad diversity of views and experiences. Most importantly, it requires leaders to listen to their patients and incorporate the patient’s voice and the outcomes that matter to them, into every aspect of the design, development, and delivery of their services.
How to get started?
Through years of working with clients who are keen to embrace this change and move their practice towards a contemporary, patient-partnership approach, we typically find they may need help in their practice or hospital clinic across three key areas of capability.
1. Patient partnership
Embracing a patient-partnership approach sets an aspiration that drives a cultural and behavioural shift. The key to success is challenging every health professional to embrace each patients’ knowledge and lived experiences. Recognising the patient, family and carers as a key resource accelerates the change, shifting momentum from disengaged to empowered, and supporting staff and patients to drive the transformation. For example, you could consider including patient representatives on teams or committees designed to improve your place of work, to ensure your quality improvement efforts address issues that matter to patients.
2. Care delivery
As we discussed in the last article, adopting a value-based health care operating model provides a strategic focus and aligns transformation to the purpose of improving patient outcomes. When focus shifts to health outcomes rather than volume of activity, it encourages a strong focus on results oriented towards value and outcomes for patients. Measuring patient experiences, outcomes, activation and impact enables us to track performance, improvement, and celebrate our success. A great way to start is by implementing a PREM survey and a condition-specific PROM. Involve patients in their progress by repeating the PROM at regular intervals and sharing the results, so together you can track this over time.
3. Health ecosystems
Whilst acknowledging patients and healthcare professionals have different needs, we recognise we all benefit by shifting from siloed systems to a seamless health ecosystem. For patients, the focus is related to tracking outcomes by connecting their digital devices, wearables, health apps and platforms to help them achieve their goals. For podiatrists and practices, this digital transformation relates to big data and patient analytics, developing innovative tech partnerships and seamless ways of sharing information.
The bottom line; we all win when we have a health ecosystem underpinned by seamless technology experiences and interconnected services.
Typically, the transformation journey to a patient partnership approach happens in identifiable maturity stages. It can be a daunting prospect to take those first steps towards this new approach, but once patient-partnership innovation is deeply embedded in your practice or hospital clinic’s DNA, the shift is profound.
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An exciting APodA event!
As podiatrists, we have a role in identifying whether our older clients are showing signs of depression and ensuring they know how and where they can access support. As part of our holistic person-centred approach, podiatrists also need to be considering management strategies that can reduce the risk of depression and actively engaging in referral pathways if we have concerns about client’s overall mental wellbeing.
Depression can be commonly experienced by older people, with more than one in ten older people, and more than three in ten people living in residential aged care experiencing signs of depression.
Depression can be defined as feeling down, or your mood affecting your ability to cope with everyday life for two weeks or more. It is common for older people to believe that their symptoms of depression are just a result of poor health or dementia.
While it is uncommon for people over the age of 60 years to develop depression for the first time, this can happen. Often older people don’t openly discuss their symptoms of depression as they feel a sense of shame, or they don’t like to admit that they aren’t coping. This can lead to not seeking help or delaying treatment that could assist in their quality of life.
This article’s scope
This is the second article for 2022 in this series on the topic of aged care, and it will explore the common condition of depression; specifically how it can affect older people. It highlights the importance of allied health professionals, such as podiatrists, regularly asking appropriate wellbeing questions and recognising when referral pathways are needed to support older people to remain mentally well.
In this article I will focus on:
- What is depression?
- What are the causes of depression in older people?
- What are the typical signs of depression in older people?
- Why is it important to recognise older people with depressive symptoms?
- What can podiatrists do to support our older clients who may be experiencing depression?
It is important to know that everybody responds differently to stressors in their life. Not all older people will become depressed even when they have the risk factors. Conversely, just because of your age there shouldn’t be an acceptance that you will become depressed, or that if you do have depressive symptoms that it can’t be treated.
What is depression?
While it is common to feel sad from time to time, depression is a constant feeling of sadness and loss of interest, which stops you doing your normal activities. There are a range of different types of depression that exist and symptoms can be relatively minor to severe. The most common type of depression seen in older people is non-melancholic depression, which is often linked to either psychological factors, stressful life events or personality characteristics. However, if there has been a history of depression throughout a person’s life then there are likely to be genetic factors contributing to a depressive illness. Typically, depression does not result from a single event but is often seen as a result of a number of events or factors. To learn more about these insights, head here.
What are the causes of depression in older people?
Physical ill health:
- There is a complex relationship between physical and mental wellbeing with many physical illnesses, such as cancer, thyroid disease, vitamin deficiencies and infections also causing depression via complex biological mechanisms. There is also increasing evidence that cerebrovascular disease is linked to later life depression.
- Many chronic disease conditions can impact mobility and self-care, which often results in frustration, a sense of burden on others and fears of being institutionalised.
- Several medications that are used to treat many physical conditions have been linked to depression, particularly some antihypertensives, steroids and pain medication.
Social isolation and loneliness:
- Many older people experience loneliness and social isolation, usually as a result of having to live alone, reduced close contact with family, and a lack of connection with their culture of origin or an inability to actively participate in the local community through lack of transport options.
- When this occurs in combination with mobility issues or chronic disease it increases the risk of depression.
Loss in older age:
- Depression is commonly associated with both real and symbolic loss. As we age, it tends to be a period where our losses are cumulative and frequent.
- While most older people are able to cope with the death of their partner, friends, pets, loss of independence, their health and impacts on their quality of life; for some, these cumulative losses can trigger depression.
What are the typical signs of depression in older people?
Unexplained physical symptoms:
- If there are physical symptoms that cannot be adequately explained, then you need to consider depression, which may become more apparent on questioning.
- Common symptoms can include insomnia, weight loss, dizziness, chronic pain or constipation.
- It’s important to understand that older people may deny that there could be a psychosocial element to their presenting symptoms.
- Depression can be commonly associated with memory loss, which sometimes ends up being the focus of the treatment rather than the depression itself.
- In the absence of a diagnosis of dementia related pathology, memory loss can improve if the underlying depression is well managed.
- Behavioural changes can be a warning sign that things aren’t right and should be considered as part of an overall assessment of an older person’s health and wellbeing.
- Changes commonly associated with depression can include avoiding leaving home, refusal to eat, alcohol abuse, and hoarding behaviours. Preoccupations on changing their will, talking about death, giving away personal effects or taking an interest in firearms also indicate there may be mental health concerns.
Why is it important to recognise older people with depressive symptoms?
Depression is commonly not recognised and can go on for months or years if left untreated. Untreated depression can have many negative effects on a person’s life, including their engagement with podiatric treatment and management of their overall health, particularly if they have a number of chronic conditions. Early identification and treatment of depression in older people can also reduce functional decline, prevent hospitalisations and improve overall quality of life.
Many older people also perceive there is stigma associated with depression and are often unwilling to admit or talk about their feelings. Some older people believe that depression is a sign of weakness rather than appreciating that it is a medical condition. Therefore, it is really important that we identify potential symptoms early and actively encourage our older clients to seek support so that interventions can be implemented.
What can podiatrists do to support our older clients who may be experiencing depression?
We need to be aware that some older people find it difficult to talk about personal matters and they may never have really talked about how they are feeling, as this was not common practice when they were growing up. While others really worry what will happen to them as a result of sharing what is going on for them, they don’t want to be perceived as a burden or be treated differently. Some older people also worry that asking for help will be seen as a sign of weakness.
It is important that we are regularly checking in with our older clients on how they are feeling and coping in general and make note of any changes that may be occurring. By beginning the conversation, you may be able to make a real difference in someone’s life by reducing the stigma associated with depression and providing them with the encouragement to seek professional support. If an older client does open up to you and share that they are struggling, then some useful conversation starters can include:
- “I can see this is a really hard time for you.”
- “I know it doesn’t feel like it now but there is hope that things can get better.”
- “Have you thought about seeing your doctor about this?”
Other strategies can include:
- Incorporating and encouraging lifestyle changes such as diet, exercise and social activities into your management plans, and reinforcing positive actions.
- Actively encouraging life-style changes from mid-life to prevent the risk of older age depression through reducing hypertension, cessation of smoking, and reducing cholesterol and lipid levels.
- Referring for a medication review if clients are on medications known to increase the risk of depression.
- Encourage strategies to reduce anxiety such as relaxation and mindfulness techniques.
- Encourage clients to regularly talk about their mood as part of your overall assessment and respond with respect but gently challenge negative thoughts by providing alternative perspectives. It is important to avoid dismissive statements such as, “It can’t be that bad”.
- Having further resources and information about the causes of depression, range of treatment options and where to access help, readily available in your practice.
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Dr Shan Bergin, Chair of the Australian Podiatry Education and Research Foundation (APERF) shares some recent changes as new Trustees join APERF, and previous Trustees leave to pursue other exciting opportunities.
During 2021, two long-standing contributors to the Australian Podiatry Education and Research Foundation (APERF) decided that it was time for them to move on and embrace new and exciting opportunities.
Dr Anita Raspovic joined APERF as a Trustee in 2011 and during her time with the Foundation, she provided a wealth of knowledge and expertise in the areas of high risk foot, plantar pressure analysis, qualitative study methodology and higher education. Anita has recently been awarded her Master of Psychology and is now turning her attention to working in this field as well as continuing in her role as Course Coordinator at La Trobe University.
Dr Susan Nancarrow also joined APERF in 2011 and was the Foundation’s ‘source of truth’ for anything related to health services research and workforce development and capability. Susan was also a passionate advocate for building research capacity within the allied health professions, including podiatry. Susan is currently CEO of HealthWork International, an organisation that seeks to increase workforce effectiveness, efficiency and quality for health care organisations, government, and professional associations.
Whilst the remaining Trustees were sorry to lose such amazing friends and colleagues from APERF, we are excited to introduce you to our newly appointed Trustees, who we know will re-invigorate the Foundation with their clinical and research expertise and their passion for all things ‘podiatry’.
Welcome aboard, we look forward to a long and happy association with each of you.
Dr John Arnold
John is a Senior Lecturer in the Allied Health & Human Performance Unit at the University of South Australia (UniSA). Prior to joining UniSA, John was a postdoctoral research fellow at the Institute for Rheumatic and Musculoskeletal Medicine at the University of Leeds funded by a National Health & Medical Research Council Early Career Fellowship.
His research and clinical expertise are primarily in musculoskeletal conditions of the foot and ankle, and he has worked in roles across the public and private sectors, including orthopaedic triage.
John’s other research interests more broadly include biomechanics with applications in clinical populations and human performance. John has authored over 50 peer-reviewed journal articles and is on the editorial board of the Journal of Foot and Ankle Research and BMC Musculoskeletal Disorders.
Dr Sheree Hurn
Dr Sheree Hurn is an Ahpra-registered podiatrist and emerging leader in the field of clinical foot and ankle research. She completed her PhD at the University of Queensland in 2013 and is currently a Senior Lecturer in Podiatry at Queensland University of Technology (QUT), School of Clinical Sciences.
Dr Hurn has 16 years of post-graduate experience including clinical, research and education roles. Her research interests include lower limb musculoskeletal disorders, footwear and falls prevention. Her areas of teaching expertise include sports and exercise medicine, gait analysis, evidence-based practice, and clinical education.
She has served on the Boards of the Australian Podiatry Association (Qld) and Menzies Foundation and holds a current Ahpra appointment to the Podiatry Accreditation Committee’s list of approved accreditation assessors.
Dr Peta Tehan
Peta is a Senior Lecturer in the School of Clinical Sciences at Monash University. She has worked in a variety of areas within podiatric practice, including private practice in both rural and regional areas, and public practice in a high risk foot clinic.
This gives her real world experience that students appreciate in their clinical education. Peta has post-graduate qualifications in wound care from Monash University and frequently lectures to the Wound Management Association and her local Hunter Wound Interest Group.
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Associate Professor Caroline Robinson and Dr Shan Bergin share the latest news regarding the burgeoning collaboration between the Australasian Council of Podiatry Deans and the Australian Podiatry and Education Research Foundation.
About the ACPD
As you may already know, the Australasian Council of Podiatry Deans (ACPD) is an ASIC registered company that was formed in 2019. The membership of ACPD includes representatives from each of the podiatry education providers in Australia and New Zealand, including a member from the Australian College of Podiatric Surgeons (ACPS).
The guiding purpose of the ACPD is to promote excellence in podiatry education and this group is supported by an annual financial contribution from each of the member organisations. ACPD members do not receive payment for their services.
You are no doubt familiar with the Australian Podiatry Education and Research Foundation (APERF), which was established in 1990 to advance research into the causes, prevention and treatment of foot pain to help keep Australians healthy, active and productive. Since that time, APERF has supported more than 70 research projects.
A precursor to collaboration
Podiatry education research is core business for the ACPD in meeting the company’s objectives to facilitate the best educational environment that will produce competent graduates; raise awareness of the role of podiatry education; and to proactively identify and address matters that impact podiatry education locally, nationally, and internationally.
The ACPD and APERF have begun discussions about a potential collaboration that would leverage the knowledge and skills of both organisations, to enable a funding mechanism for podiatry education research. Fund management through APERF would ensure a transparent and rigorous process, with the ACPD providing eligibility criteria for project submissions.
Collaborations already underway
Currently, ACPD members are leading two research projects which received funding from the Australian Podiatry Education and Research Foundation (APERF) in the 2020 round:
- Motivators and barriers to studying podiatry in Australia and New Zealand; and
- Consensus-based guidelines for the assessment of clinical competency in podiatry-related work integrated learning (WIL).
A memorandum of understanding (MoU) is under development and APERF will likely be ready to administer this dedicated funding stream for the 2022 round. This collaboration is a significant investment for the ACPD, ensuring an ethical and fair approach to supporting podiatry education research which will benefit the profession locally, nationally, and internationally.
The importance of employee engagement
Have you seen the most asked member question lately? Our monthly Member Benefits Bulletin has this covered! We encourage you to keep an eye out for it when it hits your email and in the meantime, head to this webpage for a breakdown of other questions commonly asked by members in months gone by. You never know what you will find!
Question: Do I need to complete a service agreement for a self managed NDIS participant?
Although it is not mandatory to do so, it provides a clear understanding of what each party has agreed to. To access this information and more APodA member NDIS resources you can visit our website here.
Due to the changing nature of the NDIS, it is always recommended to regularly visit the NDIS website for any updates that may impact you and your business. Here is a quick snapshot of some of the APodA-created resources that offer guidance and support on working with the NDIS.
- For guidance on report writing for plan reviews click here
- For information on writing progress reports click here
- The APodA has developed through the consultation of a working group a member-only Service agreement template, available here
- Things to consider when making a service agreement, available here
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