Home page – Diabetes Foot Screening

Evaluation

The Scottish Government and the Scottish Diabetes Foot Action Group would very much appreciate your feedback on this e-learning resource.

Important

If you require a response to your feedback please email us directly instead.

For the NHS Scotland version of this site please contact:
duncan.stang@lanarkshire.scot.nhs.uk

For the NHS England version of this site please contact:
joanne.paton@plymouth.ac.uk

Phase I – NHS Scotland version

The Foot Risk Awareness and Management Education (FRAME) project was commissioned by the Scottish Diabetes Foot Action group and funded by the Scottish Government to produce an e-learning resource to enable any Health Care Professional (HCP)/worker to gain knowledge of the theoretical and practical competencies to safely and effectively undertake the task of diabetes foot screening.

The recording of the information is shown using the Scottish Care Information – Diabetes system (SCI-D) which allows the information to be stored securely and shared with all HCP’s involved in the patients care in line with the action points set out in the Diabetes Action Plan 2021 and SIGN 116 Guidelines [.pdf].

The aim of the project is to provide an interactive way of learning and uses animations and case scenarios with the aim of standardising, in an evidence based manner, the way diabetes foot screening is performed throughout Scotland.

Phase II – NHS England version

Building upon this work a second project was commissioned by the SW Clinical Network in England in response to a peer review of diabetic foot services across the South West region that highlighted a need for education in the assessment of the diabetic foot.

The aim of this project is to modify and update the module content to reflect English NICE guidance, to provide an interactive way of learning with the aim of standardising, in an evidence based manner, the way diabetes foot screening is performed throughout England.

Certificates

On completion of either FRAME version the individual may opt to undertake case scenarios, and if completed successfully and passed, will gain a certificate of completion/competence.

Site launches

The original project was officially launched at The Scottish Diabetes Foot conference in Dynamic Earth, Edinburgh on 6th June 2011. The NHS Scotland version is being led by the Scottish Diabetes Group – Foot Action Group and the University of Edinburgh.

The NHS England version of FRAME was officially launched on 1st February 2017. The NHS England version of FRAME project has been led and funded by the South West Clinical Network.

Both versions of FRAME were officially re-launched in June 2021. This new version of the FRAME project was led the Scottish Diabetes Group – Foot Action Group and the University of Edinburgh. Funding was provided by both NHS Lanarkshire and NHS South West Clinical Networks.

Review

The NHS Scotland content was reviewed by members of the Foot Action Group which is a subgroup of the Scottish Diabetes Group, and Caledonian University.

The Foot Action Group is made up of Consultant Diabetologists Podiatrists, Orthotists and patient representatives covering the 14 health board regions throughout Scotland.
The remit of the group is to drive forward service improvement for people with diabetes throughout Scotland and to help minimise foot problems by improving the way services for the Prevention, Treatment and Management of diabetes foot disease are delivered according to the Diabetes Action Plan 2010.

The content of the NHS England version of FRAME was reviewed by:

Dr Richard Paisey: Honorary consultant and SW CVD SCN Diabetes Footcare Lead
Dr Julia Thomas: Consultant Physician and Endocrinologist at Musgrove Park Hospital
Anita Stuart: Diabetes Specialist Podiatrist at Derriford Hospital Plymouth
Alysia Kirby: Specialist Podiatrist- Diabetes at West Cornwall Hospital
Christiane Pankhurst; Senior Orthotist at Guys and St Thomas’ Hospital

Acknowledgements

Content provision

Written by: Duncan Stang, Chief Podiatrist, Hairmyres Hospital, NHS Lanarkshire

NHS England version modifications by: Joanne Paton, Podiatrist and NIHR Clinical Research Fellow, Plymouth University

E-learning consultancy and development

Provided by (2021): Jackie Aim, Stewart Lamb Cromar and Hristo Meshinski from the University of Edinburgh.

Provided by (2016): Jackie Aim, Stewart Lamb Cromar and Gavin McCormack from the University of Edinburgh.

Provided by (2011): Michael Begg, Stewart Cromar, Lynne Robertson from Learning Technology Section, University of Edinburgh

Links and resources

Links (key resources)

References

Crawford F, Inkster M, Kleijnen J, Fahey T. Predicting foot ulcers in patients with diabetes: A systematic review and meta-analysis. Q J Med 2007;100(2):65-86.
Lavery LA, Wunderlich RP, Tredwell JL. Disease management for the diabetic foot: effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations. Diabetes Res Clin Pract 2005;70(1):31-7.
Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths A et al. The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabet Med 2002;19:377-384.
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005;293(2):217-28.

Leaflets

Leaflets – NHS Scotland

The leaflets are available in the 5 most common non English languages and are available for download from the Diabetes in Scotland website.

Diabetic foot ulcer
Holiday feet
Low Risk of Developing Non-healing Foot Wounds
Moderate Risk of Non-healing Wounds and Amputation
High Risk of Non-healing Wounds and Amputation
Looking After Your Foot In Remission
Advice on Footwear

Leaflets – NHS England

Troubleshooting

If you are experiencing technical problems with any of the training sites please refer to the Frequently Asked Questions page.

Frequently Asked Questions (FAQ)

Technical help

For information on technical issues with the site please refer to the frequently asked questions below.

If none of the solutions solve the problem you are experiencing please email: diabetes-support@mlist.is.ed.ac.uk

Q. I have completed the module test successfully but cannot print my certificate

Q. I cannot see any of the interactive content on my computer

Q. My browser is reporting an issue with firewalls

Q. Are the materials available in print format?

Q. I have completed the module test successfully but cannot print my certificate
A. The module certificate appears as a downloadable pdf on completion but is also emailed to the address you entered at the start of the quiz. Check if you are able to print any other documents from the computer you are using. If not, then you should contact your local IT department or check your printer connection.

Q. I cannot see any of the interactive content on my computer
A. Make sure you have a modern and up to date browser and Javascript is enabled.

Q. My browser is reporting an issue with firewalls/IP restrictions
A. If you are viewing this website from an NHS computer, University or corporate network it is possible some content is being restricted because of a firewall. You may need to contact your local IT department for support with this matter. You may need to create an ‘exception’ for this website around the firewalls.

URL: http://www.diabetesframe.org/
- IP address: 129.215.10.97
- TCP port: 80

Q. Are the materials available in print format?
A. Unfortunately, no. As these web resources are highly interactive and contain animations and quizzes they are therefore not suitable for print.

Contact us

If you would like more information regarding this project or have a technical problem, contact us below.

Subject help

For subject specific help about the NHS Scotland version of this site please contact:

duncan.stang@lanarkshire.scot.nhs.uk

For subject specific help about the NHS England version of this site please contact:

joanne.paton@plymouth.ac.uk

Technical issues

If you are experiencing technical problems with this site please refer to the Frequently Asked Questions page.

For more information on technical issues with the site please contact:

diabetes-support@mlist.is.ed.ac.uk

Accessibility statement for Diabetes FRAME

Website accessibility statement in line with Public Sector Body (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018

This accessibility statement applies to:

https://www.diabetesframe.org/

This website is run by the Interactive Content Service within the Information Services Group at the University of Edinburgh. We want as many people as possible to be able to use this application. For example, that means you should be able to:

Customise most of the website using browser settings

zoom in up to 300% without the text spilling off the screen or without loss of content

Navigate most of the site using keyboard only

use the website without encountering any inactivity time outs

We’ve also made the website text as simple as possible to understand. However, some of our content is technical, and we use technical terms where there is no easier wording we could use without changing what the text means.

Customising the website

AbilityNet has advice on making your device easier to use if you have a disability. This is an external site with suggestions to make your computer more accessible:

AbilityNet – My Computer My Way

With a few simple steps you can customise the appearance of our website using your browser settings to make it easier to read and navigate:

Additional information on how to customise our website appearance

If you are a member of University staff or a student, you can use the free SensusAccess accessible document conversion service:

Information on SensusAccess

How accessible this website is

We know some parts of this website are not fully accessible:

Some colour contrasts do not meet minimum requirements

Links are not underlined by default, meaning some links are conveyed by coloured only

Focus displays sometimes have colour contrast issues, or are fully obscured by other content

Compatibility with assistive software may be limited due to issues such as buttons not being labelled correctly, frames not having accessible names etc

Tooltips may not be shown when navigating by keyboard or by assistive software

There are PDFs that are not fully accessible

Not all images have alt text

Certain heading elements are blank

Some text content is only found in images, without a plain text alternative

Some links open in a new window or pop up without alerting the user of this

Certain features are found in mobile navigation without being usable through mobile screen readers.

Forms may give little feedback to the user about the correctness of their submission

Feedback and contact information

If you need information on this website in a different format, including accessible PDF, large print, audio recording or braille:

Email: interactive-content@ed.ac.uk

Telephone: Information Services Helpline – +44 (0)131 651 5151

British Sign Language (BSL) users can contact us via Contact Scotland BSL, the on-line BSL interpreting service.

We’ll consider your request and get back to you within 5 working days.

Reporting accessibility problems with this website

We are always looking to improve the accessibility of this website. If you find any problems not listed on this page, or think we’re not meeting accessibility requirements, please contact:

Email: interactive-content@ed.ac.uk

Telephone: Information Services Helpline – +44 (0)131 651 5151

British Sign Language (BSL) users can contact us via Contact Scotland BSL, the on-line BSL interpreting service.

We’ll consider your request and get back to you within 5 working days.

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ‘accessibility regulations’). If you’re not happy with how we respond to your complaint please contact the Equality Advisory and Support Service (EASS) directly:

Contact details for the Equality Advisory and Support Service (EASS)

The government has produced information on how to report accessibility issues:

Reporting an accessibility problem on a public sector website

Contacting us by phone using British Sign Language

British Sign Language service

Contact Scotland BSL runs a service for British Sign Language users and all of Scotland’s public bodies using video relay. This enables sign language users to contact public bodies and vice versa. The service operates from 8.00am to 12.00am, 7 days a week.

Contact Scotland BSL service details.

Technical information about this website’s accessibility

The University of Edinburgh is committed to making its websites and applications accessible, in accordance with the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018.

Compliance Status

This website is partially compliant with the Web Content Accessibility Guidelines (WCAG) 2.2 AA standard, due to the non-compliances listed below.

The full guidelines are available at:

Web Content Accessibility Guidelines (WCAG) 2.2 AA standard

Non-accessible content

The content listed below is non-accessible for the following reasons.

Non-compliance with the accessibility regulations

The following items do not comply with the WCAG 2.2 AA success criteria:

Not all non-text items have alternative text

- 1.1.1 – Non Text Content

<ul> and <ol> sometimes directly contain elements other than <li>, <script> or <template>

- 1.3.1 – Info and Relationships

Links are not underlined by default

- 1.4.1 – Use of Color

Not all colour contrasts meet the required standards

- 1.4.3 – Contrast (Minimum)

Elements, including focus indicators do not always meet minimum contrast ratio thresholds

- 1.4.3 – Contrast (Minimum)

- 2.4.7 – Focus Visible

Text content is found in images where this is not essential to the conveying of the information

- 1.4.5 – Images of Text

Tooltips are not keyboard accessible

- 1.4.13 – Content on Hover or Focus

Empty heading elements are present

- 2.4.6 – Headings and Labels

Focus indicators are at times fully obscured by author created content

- 2.4.11 – Focus Not Obscured (Minimum)

Links open in a new tab or pop up without alerting the user of this

- 3.2.2 – On input

The site is not fully compatible with assistive software e.g. not all frames have an accessible name

- 4.1.2 – Name, Role, Value

There are PDFs that are not fully accessible

- 2.1.1 Keyboard

- 4.1.2 – Name, Role, Value

We aim to improve the accessibility of our websites on a regular and continuous basis. See the section below (‘What we’re doing to improve accessibility’) on how we are improving our site accessibility.

We are working towards solving these problems and expect several improvements by July 2026. The site is fully within our control.

Disproportionate burden

We are not currently claiming that any accessibility problems would be a disproportionate burden to fix.

Content that’s not within the scope of the accessibility regulations

At this time we believe no content is outwith the scope of the accessibility regulations.

What we’re doing to improve accessibility

We will continue to address and make adequate improvements to the accessibility issues highlighted. Unless specified otherwise, a complete solution or significant improvement will be in place by July 2026.

While we are in the process of resolving these accessibility issues we will ensure reasonable adjustments are in place to make sure no user is disadvantaged. As changes are made, we will continue to review accessibility and retest the accessibility of this website.

Preparation of this accessibility statement

This statement was prepared on 17^th July 2025. It was last reviewed on 21^st July 2025.

The website was last tested on 15^th July 2025. The testing was carried out by the Interactive Content Service within the Information Services Group at the University of Edinburgh using both automated and manual methods. The site was tested on a PC, primarily using Google Chrome alongside Mozilla Firefox and Microsoft Edge.

A recent world-wide usage levels survey for different screen readers and browsers shows that Chrome, Mozilla Firefox and Microsoft Edge are increasing in popularity and Google Chrome is now the favoured browser for screen readers:

WebAIM: Screen Reader User Survey

The aforementioned three browsers have been used in certain questions for reasons of breadth and variety.

We ran automated testing using WAVE WebAIM and AXE browser extension (for Google Chrome) and then manual testing that included:

Spell check functionality

Scaling using different resolutions and reflow

Options to customise the interface (magnification, font, background colour, etc)

Keyboard navigation and keyboard traps

Data validation

Warning of links opening in new tab or window

Information conveyed in the colour or sound only

Flashing, moving or scrolling text

Use with screen reading software (for example JAWS)

Assistive software (TextHelp Read and Write, Windows Magnifier, ZoomText, Dragon Naturally Speaking, TalkBack and VoiceOver)

Tooltips and text alternatives for any non-text content

Time limits

Compatibility with mobile accessibility functionality (Android and iOS)

Any drag functionality and alternatives

Consistent help function

No need to re-enter data already submitted

Any cognitive tests.

Privacy Policy

Who we are

Suggested text: Our website address is: http://www.diabetesframe.org.

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For users that register on our website (if any), we also store the personal information they provide in their user profile. All users can see, edit, or delete their personal information at any time (except they cannot change their username). Website administrators can also see and edit that information.

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