Journal Articles

Foot protection service redesign: an adaptive leadership approach

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Foot protection service redesign: an adaptive leadership approach

David Wylie
4 June 2020

The need to implement and deliver radical service redesign continues to present NHS systems and services with significant challenges. Leadership is frequently cited as being a key determinant of success in such large-scale redesign programmes. This paper describes the application of one leadership model – adaptive leadership – to the redesign of a complex set of clinical and inter-professional challenges that saw NHS Greater Glasgow and Clyde (NHSGGC) Podiatry Service take full responsibility for all foot and ankle wounds across all operating units in the Board area. The model is described, with practical, applied examples of the approach taken at each stage of the process. Qualitative and quantitative outcomes are reported, with the NHSGGC Podiatry Service now actively involved in all aspects of foot and ankle pressure damage for all patients, regardless of underlying pathology, with significant improvements delivered across all metrics, including a 56% reduction in Grade 2 and above hospitalacquired foot and ankle-tissue damage; a 55% improvement in the number of wards reporting more than 300 pressure ulcer-free days and a 107% improvement in the number of patients with diabetes receiving foot checks on admission.

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