A profession that values data, but struggles to use it 

Across healthcare, expectations are changing. Services are increasingly asked to demonstrate their impact, improve transparency and show how the care that they offer translates into outcomes. 

In podiatry, clinicians are increasingly expected to demonstrate impact, but the data to do that is not always available. 

A survey conducted at the Royal College of Podiatry’s conference in Glasgow in 2025 suggests a profession that recognises the importance of audit and data collection but does not yet use it consistently in practice. 

Responses from clinicians working across NHS services (61%), independent practice (35%) and academia and management (4%) tell us a familiar story – that podiatrists recognise the value of data, but that it’s not always embedded into their day-to-day work. 

The evidence gap and why it matters 

Podiatrists see the impact of their work every day. Improvements in pain, mobility and patient experience are often clear at an individual level. 

But at a national level, those outcomes are harder to demonstrate. 

The evidence base remains uneven, with limited large-scale studies capturing how podiatric interventions affect long-term health, independence or wider system outcomes. 

Without consistent, standardised data, the profession’s contribution can be difficult to quantify, particularly in a healthcare system increasingly driven by evidence, commissioning and measurable impact. 

Audit is valued but it’s not routine 

When asked about the importance of audit, respondents rated it highly, with an average score of 4.16 out of 5. 

Yet participation tells a different story. 

• 57% contribute to audit within their own practice  

• 60% contribute to service-level audit  

This suggests that while audit is widely seen as important, it is not consistently embedded. In many cases, involvement depends on local systems, expectations and awareness. 

What podiatrists are measuring

Where audit is taking place, the picture is varied. 

Clinicians report collecting data across a wide range of areas, including: 

• pain outcomes in biomechanics  

• nail surgery results  

• infection prevention and control  

• note-keeping and documentation  

• patient satisfaction and service performance  

There is also engagement with national programmes such as the National Diabetes Foot Care Audit and the Vascular Services Quality Improvement Programme. 

There is no consistent approach. Different services prioritise different measures, often reflecting local needs rather than a shared national framework. 

A fragmented approach to outcomes 

Most clinicians report collecting core demographic and clinical data, such as age, diagnosis and risk status. 

But outcome measurement is less consistent. 

Treatment outcomes are the most recorded, with pain scores widely used. Tools such as the Manchester-Oxford Foot Questionnaire are used by some, but more specialised measures are rare. 

Many clinicians also track additional metrics, from infection rates to referral pathways, but often in ways that are locally defined and not easily comparable. 

The result is data that is useful locally, but difficult to compare or use at a wider level. 

Systems, time and training are the real barriers

The survey points clearly to the practical challenges. 

Record-keeping systems vary widely. While most clinicians use digital platforms, some still rely entirely on paper records. Even where systems are digital, extracting useful data is not always straightforward. 

For some, audit becomes a ‘tick-box exercise’, something that is done for compliance rather than as a tool for improving care. 

More broadly, clinicians highlight three consistent barriers: 

• limited time within clinical practice  

• lack of training in data collection and interpretation  

• uncertainty about which outcomes should be measured  

Alongside this sits a bigger issue – poor integration between systems. This makes it difficult to build a joined-up national picture. 

A clear appetite for change 

Despite these challenges, there is strong support for doing things differently. 

Almost three-quarters (74%) of respondents said they would value a national dataset of podiatry outcomes. Many also highlighted the potential for benchmarking to drive improvements in care. 

Clinicians want data to be useful, meaningful and capable of informing practice, not collected simply for its own sake. 

What would make the difference? 

The survey points to three areas where progress is needed: 

1. Standardised outcomes 
A core national dataset would allow for consistent audit and meaningful comparison across services. 

2. Better digital infrastructure 
Systems need to support easy data capture, extraction and analysis. 

3. Time and capability 
Clinicians need protected time and the skills to use data effectively in practice. 

An opportunity for the profession 

Podiatry is not starting from scratch. Audit is already taking place, and clinicians understand its value and meaning. 

But the current model is fragmented. 

As healthcare becomes more data-driven, the ability to demonstrate outcomes will become increasingly important, not just for improving care, but for shaping services, influencing commissioning and strengthening the profession’s position within the wider system. 

The survey suggests the profession is ready to move forward. 

The challenge now is whether systems, structures and priorities can keep up. 

Links and references

National Diabetes Footcare Audit 

Manchester-Oxford Foot Questionaire 

Vascular Services Quality Improvement Programme 

About the authors 

Dr Helen Branthwaite is Chief Clinical Advisor at the Royal College of Podiatry, with over 25 years’ experience in musculoskeletal practice across NHS, independent and academic settings. 

Mr James Cowden is a podiatric surgeon at University Hospitals Birmingham and an elected member of the Faculty of Podiatric Surgery at the Royal College of Podiatry.