Lower Limb Preservation Program

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What is the Lower Limb Preservation Program?

Ontario has one of the highest rates of lower-limb amputation related to diabetes and peripheral artery disease among publicly funded health systems. The statistics are stark:

  • 30% of Ontarians live with diabetes or prediabetes, with 10% diagnosed with diabetes.

  • People with diabetes are nearly 20 times more likely to be hospitalized for a non-traumatic lower-limb amputation compared to the general population.

  • Approximately 1,200 non-traumatic major lower-limb amputations occur in Ontario annually—that’s one every seven hours.

The good news? 85% of these amputations are preventable. By identifying risks early, providing timely interventions, and improving access to care, the Lower Limb Preservation (LLP) Program is working to change these outcomes.

Mid-West Toronto Ontario Health Team (MWT-OHT) was selected as one of the demonstration sites to test and assess opportunities to integrate service delivery model for lower limb preservation (LLP) through the OHT, including primary care, community-based and hospital partners.

Goals of the demonstration project are:

  1. To reduce avoidable, non-traumatic major lower-limb amputations in Ontario.​

  2. To improve equitable access to high-quality best-practice early screening, cardiovascular risk factor modification and integrated lower-limb wound care.

Key partners of this initiative include Auduzhe Mino Nesewinong, Open Door led by Access Alliance, Davenport-Perth Neighbourhood and Community Health Centre, Inner City Health Associates (ICHA), Michener Chiropody Clinic, Mid-West Toronto Seamless Care Optimizing the Patient Experience (SCOPE), Native Men’s Residence (Na-Me-Res), Ontario Health @Home, Parkdale Queen West CHC, Scott Mission, The Neighbourhood Group, and University Health Network (UHN).

This Lower Limb Preservation program is building upon existing community programs and organizations to enhance services and improve health promotion and wellness. The initiative has really showcased the strong relationship with community partners. Target population of this initiative include marginalized, underhoused, underserved and transient communities to address their social and health care needs in a holistic way.

The LLP program focuses on reducing unnecessary amputations by addressing underlying health issues early and ensuring patients receive the right care at the right time. By connecting local healthcare providers, specialists, and hospitals, the program makes accessing care faster, easier, and more equitable.

How the Program Works

  1. Identifying Patients at Select Community Clinics
    Individuals identified as being at high risk of foot issues are referred to the program by their care provider at select community clinics. Community Foot Screening Patients undergo a simple diabetic foot screen that helps find early signs of foot problems. This check helps us decide who needs more care.

  2. Referral to Care

    If extra care is required, they are referred to the UHN Connected Care Hub and an Integrated Care Clinician (a healthcare professional) works with the individual to create a care plan. This includes referrals to specialty doctors, surgeons, and other experts who can help with their treatment.

  3. Ongoing Support

    The Integrated Care Clinician stays in touch with the individual, making sure they are getting the care they need. They track progress and ensure that the individual is healing properly.

  4. Returning to Regular Care

    Once the individual has completed their care, they are assisted with returning to their regular care provider or are connected to a new one, if needed.

Who Can Join?

This program is for people who:

  • Are 18 or older

  • Live in downtown Toronto 

  • Score as moderate or high-risk on the foot assessment provided by a health practitioner at select community clinics

  • Have foot issues, like skin problems or numbness

  • Have diabetes or are pre-diabetec

  • Have trouble accessing healthcare due to challenges like language barriers, limited mobility, or a primary care provider

How to Join the Program

If you are at risk or have been referred by a healthcare provider, you can join the program. Your provider at your select community clinic can send a referral to the UHN Connected Care Hub where a healthcare professional will work with you to develop a care plan.

Benefits of the Program

  • Helps prevent serious foot and wound problems by catching them early

  • Provides a clear path for treatment and care

  • Connects people to the right doctors and specialists

  • Focuses on making healthcare available to people who might have trouble accessing it

The Lower Limb Preservation Program is a proud initiative of UHN in partnership with the Mid-West Toronto Ontario Health Team.