What is the MARS project?

1000 lower limb amputations are performed annually in Greater Manchester (GM) of which half are preventable. The path to an amputation begins with an ulcer that is inadequately treated in people with diabetes, peripheral arterial disease, venous disease and lymphoedema.

MARS aims to reduce major limb amputations across GM and bring them, initially, in line with the national average (36% reduction). This will be achieved through the development and implementation of a commissioning strategy designed to prevent, manage and heal chronic foot and leg ulcers faster. Existing resources will be redistributed to create a single community referral pathway, a coordinated lower limb management pathway and specialist wound care teams. The strategy will be informed by a ‘whole systems analysis’ and deep dive service review to ensure population based service transformation.

The plan is to:

  1. Reduce inequity in service provision and outcomes by harmonising protocols and facilitating
    communication between health professionals and patients through technology
  2. Reduce prevalence of chronic wounds by 15% within 5 years
  3. Reduce the amputation rate to the national average within 5 years
  4. Reduce annual spending on chronic wounds by £70m within 5 years
  5. Put the patient experience first: https://goo.gl/j2t64k

The GM Challenge – in numbers

  1. £200m – estimated cost of foot and leg ulcer care 2017/2018
  2. £350m – estimated cost of foot and leg ulcer care 2021/2022
  3. £600m – estimated cost of managing ulcers and co-morbidities 2021/2022
  4. 70% – variation in amputation rate across GM
  5. 1000 – number of amputations performed annually across GM
  6. 330 000 – number of people with chronic conditions potentially leading to an amputation

The National Challenge;

  1. Every hour, in England, someone over 50 has a minor foot amputation
  2. Every two hours someone loses their whole leg
  3. The current focus is preventing diabetic amputations – but half of amputees are not diabetic
  4. The current annual cost of ulcer care is £4bn and predicted to rise to £7bn by 2022
  5. The burden on the NHS of patients with foot and leg ulcers is greater than obesity

The National Inequalities– in numbers

  1. 30% – higher amputation rates in Northern England compared with the South
  2. 50% – variation in amputation rates across the country
  3. 70% – higher amputation rate in Black than white populations
  4. 250% – higher amputation rate in men than women