A white paper focused on the future of lower-limb vascular care and peripheral arterial disease (PAD) in the UK has been published by the All-Party Parliamentary Group on Vascular and Venous Disease (VVAPPG).
Developed in collaboration with the Association of British HealthTech Industries (ABHI) and the Royal College of Podiatry (PCoP), the report proposes a prevention-led, community-based model of vascular care to improve patient outcomes.
In the report, the VVAPPG highlights vascular disease as one of the leading causes of preventable disability and premature death in the UK, with improvements in outcomes lagging behind those of cardiovascular conditions such as heart disease and stroke. The report notes that patients face delayed diagnosis, inconsistent referral pathways, and variable access to specialist care, which result in “avoidable harm and thousands of major lower-limb amputations each year”.
To remedy this, the report identifies a necessary shift toward earlier detection, consistent pathways, and community-based services through five key actions for national leaders:
- Fund and implement a National Foot Attack Pathway
- Establish community Foot Protection Services in every Integrated Care System (ICS)
- Set national maximum waiting times
- Reform commissioning to reward outcomes
- Accelerate proven innovation
“Together, these reforms would deliver faster urgent care, fewer amputations, improved healing rates and reduced hospital pressures,” the report reads.
Furthermore, the VVAPPG notes that these reforms support the ambitions of the National Health Service (NHS) England 10-Year Health Plan by “shifting care upstream, reducing hospital pressure, and accelerating innovation adoption”. The plan—‘Fit for the future’—was published in July 2025 and aims to reform the NHS by moving care from hospitals to the community, transitioning from analogue to digital, and focusing on prevention over sickness.
In a foreword to the new white paper, Jim Shannon, UK Member of Parliament (MP) and chair of the VVAPPG, highlights the “timely, achievable and politically visible” nature of the opportunity presented by the report. “By acting now, Ministers can demonstrate progress within a single Parliament, improve patient outcomes and deliver savings to the health and care system, while taking a decisive step towards ending avoidable lower-limb amputation. Above all, this package would show that the 10-Year Health Plan is not only a set of commitments but a practical programme that can deliver real change.”
Speaking to Vascular News following the report’s publication, Colin Bicknell (Imperial College London, London, UK) provided a clinician’s perspective on the scale of the issue at hand. “I have seen more and more admissions with lower limb ischaemia, but for many of these patients the treatment is far later than ideal, ending in amputation,” he said. “Examining the [UK] National Vascular Registry, it is striking that there is an increasing number of cases of complex lower limb intervention and a consistent increase in amputation. The NVR team has provided some unique research to understand associations and risk factors. What is needed is a comprehensive strategy for patients with lower limb vascular disease.”
The report, ‘Making the Case for Reform in the Vascular Sector’, was officially launched on 17 March.
