“This innovative service means patients can be seen and monitored much closer to home, outside of the often busy hospital environment. This is better for the patients and is also easing the pressure on our foot clinic at the hospital. We are very happy to be collaborating with EMAHSN, the community health team in Derbyshire and Entec Health in order to put this technology into practice.”
Professor Fran 
Game, Consultant Diabetologist, Derby Teaching Hospitals NHS Foundation Trust


EMAHSN is working with Derby Teaching Hospitals NHS Foundation Trust, Aranz Medical Ltd, Derbyshire Community Healthcare Services NHS Foundation Trust, Derbyshire CCGs and Entec Health Ltd to implement a new 3D wound imaging and information system called Silhouette® in order to enable routine diabetic foot ulcer treatment to be delivered in the community rather than in the acute outpatient setting.


It is vital that all patients with diabetic foot ulcers receive regular treatment and check-ups. Currently these all take place in acute hospital outpatient clinics placing a severe strain on this service and requiring patients to travel substantial distances for their appointments. The Silhouette® project provides care for patients closer to home in the community reducing amount of travel on a weekly or fortnightly basis. 

At least 6,000 people with diabetes have leg, foot or toe amputations each year in England many avoidable. Providing access to correctly resourced multidisciplinary teams can improve diabetic foot ulcer outcomes, which could result in avoided amputations and improved quality of life and mortality. 

What's the impact?
  • Projected savings if deployed across the East Midlands: £0.9m-£1.8m per annum
  • Moving 30% treatment sessions to community clinics forecast to reduce the overall diabetic foot ulcer service costs by 15-20%. (Health Economic Paper available on request from April 2017)
  • Opportunity to scale Silhouette® across and beyond the East Midlands
  • New business secured for both a UK SME and an international company
  • The digital wound assessment system (Silhouette®) is now being considered across other chronic wound management pathways including Tissue Viability services to deliver further quality improvements and savings
  • Between September and December 2016 140 patients were seen in the community
What's next?

The solution model is ready for replication in other parts of the NHS. The implementation is rapid and straight-forward. A health economic model is available to show potential return on investment in other health economies.