D04: Limb Preservation: Systems Thinking & Outcomes

A screening visit that did not happen, a referral sent to the wrong place, a vascular slot that was not available: each looks minor, and together they cost a limb. If amputation is a system failure, preventing it is a design problem. The local major-amputation rate becomes a barometer of the whole diabetes system, and the skill is finding the broken link.

The module sets out the burden a service exists to solve, the multidisciplinary team as the best-evidenced intervention and why a strong recommendation can rest on low-certainty evidence, and pathway design for time to treatment. It teaches why healing rate alone misleads and ulcer-free survival does not, a core metric set, national audit and registries, and stratifying outcomes by ethnicity, deprivation and geography. It closes with quality improvement and the remission paradigm at system level, including planning capacity for the growing number of patients in remission.

Content is tiered at Foundation, Core and Advanced level, with two algorithms and three case vignettes. You receive the Teaching Document, the Evidence Base, the slide deck, a narrated video and an audio overview.