Diabetic foot complications are the commonest cause of non-traumatic lower limb amputation in the UK. To help prevent unnecessary amputations, in June 2009, the Diabetes UK specialist foot care working services group produced a report issuing guidance to enable proper management of acute onset, or deteriorating, disease of the diabetic foot in the secondary care setting. This article summarises the results of a baseline audit, and describes the actions taken to address the weaknesses within the systems of care to improve the outcomes for this group of patients.