Dr Jane McAdam is Director of Prosthetics & Orthotics and Podiatry at the University of Salford.
Here she talks exclusively to Exceed about her work at Salford and the challenges facing the podiatry profession.
Q: How did you start out?
I studied in Brisbane – I was actually taught by lecturers who had previously worked at the University of Salford- and qualified with a Diploma of Applied Science (Podiatry) and then began working privately because there isn’t the same kind of health service in Australia as there is in the UK.
However, I started to feel quite isolated – a common problem with podiatrists practising privately – and decided to study a completely different subject.
I then had the chance to go travelling to the World Championships in Oslo as part of the Australian Ultimate Frisbee Team and ended up in the UK. I had also heard a lot about the NHS and was interested in working in the public sector. I worked in London for several years and then an opportunity came up to move to Salford NHS to lead the orthotics service.
The service has changed a lot in the last 16 years. It is now far less of the Cinderella service than it was then. Podiatrists used to be less confident about doing orthotics work but this is much less the case these days.
Q: Tell us about your work at Salford.
I lead on two programmes at the University of Salford – podiatry and prosthetics & orthotics. My work involves supporting strategic and professional development, raising the profile of research in these fields and producing great students.
I have to keep a close eye on the changing face of the NHS and how this impacts on the private sector. Less graduates are able to go into the NHS which means they have to be better prepared for a life as a private practitioner. An increasingly important aspect of our programmes is teaching students about business skills.
Some of our podiatry students come to it as a second career, with some having already studied a health-related degree such as sports rehabilitation. At Salford and the UK in general, student numbers are strong. Students’ degrees are 100% funded by the NHS and they also receive bursaries.
Q: What are the challenges facing the podiatry profession.
We expect funding of the NHS to change, something which is a serious challenge, and we also have to work hard to prevent people from leaving the profession. Not only is it extremely wasteful to the economy, we just do not want people to walk away from a career in podiatry. If we don’t keep producing podiatrists, the expertise within the profession will surely shrink.
The problem at the moment is that the NHS is seen as a tough place to work. While some people will always choose the NHS route, an increasing number will not. Podiatry is not an obvious career and often people become interested after visiting a podiatrist themselves or with their children.
Another challenge is the rise of the foot healthcare professional, people who are unregistered, unregulated and have not studied recognised academic courses.
Funding is a serious issue given the amount of money that has to be saved. We need more nurses, but we also need more AHPs.
We have to prepare for a future when our students may not be 100% funded. It will be interesting in the future if some courses are funded (e.g. nursing) and others are not, as the challenge will be to attract students to fee-paying courses in health.
Q: Tell us about your work internationally.
We already have a growing number of international students choosing to study at Salford, often instead of the United States. We are now looking to develop a number of education and training opportunities overseas. We have set up our first international hub in Abu Dhabi. Diabetic foot is a huge problem in the Middle East but there are only a handful of podiatrists, orthotists and prosthetists in the region so the need for education and training is immense.
Q: How important is research at Salford?
I am hugely passionate about research but not just research for research’s sake. It has to be relevant day-to-day in a clinical setting. I am very lucky that I have four professors in my team at Salford and they produce world-class research. We work as a team and ensure that every programme is clinically relevant.
Q: Do you also work with industry?
The University of Salford has always had a business focus and enters into Knowledge Transfer Partnerships with industry. KTPs are funded by Innovate UK along with other Government funding organisations and allow universities and companies in need of expertise to work together effectively.
One of our senior lecturers, Dr Anita Williams, is very interested in working with industry and has done an extensive amount of research on footwear.
We also find that industry partnerships can create job opportunities for our students who are involved in research programmes.
Q: Do you still get people who think podiatry is all about in-grown toenails?
I think we have come a long way but the profession would certainly benefit from a national advertising campaign which informs the public about the range of work of a podiatrist.
We are living longer and therefore keeping people active is vital, hence the importance of mobility which is where the role of the podiatrist is so important. We literally have a role to play from cradle to grave.
I would love to see more people going direct to their podiatrist rather than via their GP. The public can self-refer to a podiatrist, but first they have to know what a podiatrist does.
Communication is the key and we give our students the confidence to educate the public about the work they do. I would love the profession to have a much higher profile with the public, i.e. foot problem = podiatrist!
The College of Podiatry does a lot, and recently has produced a series of films, but we need to do as much as we can to reach the end user.
Q: Tell us about the challenges you face on the P&O side?
P&O is a much smaller profession than podiatry with just the two schools in Salford and Strathclyde.
Prosthetics is more embedded in the NHS and has the higher profile due to returning service personnel and charities like Help the Heroes.
The growing need for P&O interventions is perhaps the biggest challenge facing P&O services. Growing numbers of younger men, in their 30s and 40s, are suffering from the complications of diabetes and there is the challenge of absorbing the care of those returning from combat.
I think there are some real challenges around the commissioning of orthotics, which is seen as a bit of a Cinderella service and can result in a postcode lottery in terms of the delivery of these services.
Orthotics needs the same kind of help raising its profile as podiatry but there is no question orthotists have an important role to play within the multidisciplinary team.