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50
The Domiciliary Service is provided for incapacitated patients
who are unable to attend for treatment at one of the regular clinics.
The number of patients referred increases as the existence of the
service becomes more widely known. The time is approaching when an
increase in the establishment of chiropodists will become inevitable
if we are to expand this extremely useful service for housebound
patients in addition to meeting our other commitments. Nevertheless
the recruitment of additional staff for domiciliary work might well
prove extremely difficult for the reasons mentioned in my report for
1962.
The statistical details of new cases and attendances are given on
page 68 . Of a total of 20,701 treatments given 8,013 were for the
priority categories (expectant mothers, physically handicapped and
persons over 65 years of age), and a balance of 12.688 for non
priority patients. It can be estimated from these figures that the
introduction of a restricted priority service involving the exclusion
of other patients, would reduce the average period between treatments
from 13 weeks to less than 6 weeks. Such a policy, while probably
receiving a satisfactory reception from the priority classes, would
be unlikely to find favour among the non priority group since an un
restricted service has been operated in this Borough since 1930.
The following brief case history refers to an unusual foot
condition recognised by a member of the chiropody staff, and
illustrates the diagnostic function of the Chiropody Service which
is less well known than the facilities for treatment
Mrs. H. Aged 68. Housewife.
Patient attended Low Hall Lane Chiropody Clinic complaining
of chillblains.
On examination extensive scar tissue was seen on sole of
foot.Patient said it was the result of treatment for a
wart.By the extent of the scar tissue it was suspected
that a melanoma (malignant cancer) had been removed.
Further examination revealed a small lump, indicating
that the growth had become active again.Patient stated
that she was under six months surveillance at Hospital
but was not due to return for two months.It was
explained to her that she should report back to Hospital
but this she was reluctant to do as she was about to go
on holiday.The Chiropodist emphasized the extreme
urgency of the matter and she agreed to attend Hospital
that day and was thereupon admitted for an operation on
the following day.
This simple observation made at the Foot Clinic in all
probability saved her life.