Gloucestershire Podiatry Service referral form


Criteria for treatment and referral


Please read the following criteria carefully before completing this referral form.


The Podiatry Service is a specialist clinical service which provides highly-specialist podiatric care for patients with significant foot complications.

The Podiatry Service provides access for patients who require the following podiatric interventions:

  • High/moderate risk patients (foot health at significant risk of ulceration / amputation) requiring highly-specialist podiatric interventions
  • Wound care issues; i.e. diabetic foot ulcers, specialist wound care skills of debridement and offloading casting devices. Please include a photograph of the wound with your referral.
  • In-growing toe nail surgery
  • High/moderate risk diabetic foot screening – please note, low-risk diabetic foot screening is available from your GP practice
  • People with peripheral arterial disease and foot pathology
  • Painful musculoskeletal foot problems in children and adults
  • Severe foot deformities that may require surgery.


The Podiatry Service is unable to accept referrals for:

  • Toe nail cutting (all patients)
  • Verrucae
  • Fungal nail infections, fungal skin infections and other dermatological skin conditions
  • Footwear-related corns/callus
  • Foot deformities with no pain and/or minimal risk of wounds or infection
  • Minimal or non-painful corns
  • Adult MSK conditions that cause mild pain but are not affecting ability to work


Please note:

  • Domiciliary (home) visits are for housebound patients only. Patients must attend clinic if they can get out with alternative transport such as car, taxi or ambulance. Domiciliary visits can only be referred by registered healthcare professionals.
  • Patients must be registered with a Gloucestershire GP practice to access the Gloucestershire Health and Care Podiatry Service
  • Patients requiring general routine podiatry care who do not fulfil the criteria for treatment will be required to seek non-NHS podiatry services, i.e. HCPC-registered podiatrists. These can be found on the following websites:


What happens to the referral form?

  • The referral form must be completed in full with as much detail as possible and sent to
  • The referral form will be triaged according to clinical priority based on referral form information.
  • The referral form will be rejected in cases where insufficient information is provided.
  • The patient will receive notification of their virtual appointment if accepted.
  • It is important that the patient or their carer informs the Podiatry Service if they no longer require the appointment or unable to attend as we can offer the appointment to another patient.


What happens at the assessment appointment?

  • The patient will be assessed, and if appropriate a treatment agreed with the patient. All patients will be directed to self-management videos and advice on the Podiatry website.
  • A treatment plan will be developed for those patients requiring treatment.
  • The patient will be discharged from the Podiatry Service if the patient does not fulfil the Podiatry Service criteria. Advice and health education will be given.