Thousands of people lose limbs unnecessarily every year because doctors fail to spot the early signs of disease, The Mail on Sunday can reveal.
A landmark report examining the causes of amputations in Britain concluded that faster diagnoses could save around four in five patients from life-changing surgery.
Of the 3,000 amputations carried out each year in England and Wales, the vast majority are due to peripheral artery disease – when the blood vessels in the limbs narrow or become blocked, preventing blood from reaching the feet or hands.
However, GPs are rarely aware of the early symptoms of the condition, according to Professor Athanasios Saratzis, a vascular disease expert at the University of Leicester, who led the report.
On average, patients with peripheral vascular disease are examined by a general practitioner 19 times before they are referred to a hospital specialist for further examination. By the time many are diagnosed, it is too late to save their damaged limbs.
One patient suffering from slow diagnosis is Bryan Hoggard, 80, from Leicester.
The former railway worker was diagnosed with arthritis 20 years ago when he developed agonizing pain in his right foot. It wasn’t until five years later, when he visited a podiatrist – a foot specialist – that concerns arose. “He put his hand on my foot and I jumped in pain,” Mr Hoggard said. “He said I had neuropathy.”
Neuropathy is pain caused when the nerves in the limbs are damaged, and is often a sign of peripheral artery disease.
A scan showed that two arteries in his leg were completely blocked. He had surgery to open them, but during the procedure he suffered a heart attack.
Former surgeon Allan Gayner lost his right leg along with two of his grandchildren after ignoring pain while walking
Bryan Haggard, 80, lost his right leg below the knee after developing foot ulcers that went undiagnosed
Bryan returned to surgery a few years later, but at that point it was too late to recover.
In September 2022, Mr Hoggard had his right leg removed mid-knee. “I’m stuck in a wheelchair,” he says. ‘It’s all so frustrating, because this could have been discovered and prevented years ago. But no one was looking to see what was going on.”
About a fifth of people over the age of 60 in Britain have some form of peripheral artery disease. But it is most common – and dangerous – in people with diabetes, high blood pressure and obesity. Smokers are also much more likely to develop it.
Retired surgeon Allan Gayner, 80, of Tyne and Wear, also lost a limb after failing to notice symptoms of peripheral artery disease.
After working in healthcare for more than thirty years, he suffered a heart attack in 2012. During his recovery, he noticed pain in his right leg while walking. “I assumed my circulation was a bit slow after the heart attack,” says the father of four. ‘It wasn’t until a few years later, when I developed ulcers on my heel, that I went to the doctor.
‘I had surgery to open my blood vessels and it was discovered I had an aneurysm in my leg.’
This is when a bulge forms in the vessel behind the knee, restricting blood flow to the area.
“Eventually I was told I had to have the leg amputated,” Mr Gayner added. ‘I should have gone to the GP straight away and asked for a referral to a specialist. An opportunity to save my leg was lost.’
And experts are now calling on the NHS to ensure all GPs know the early signs of these serious conditions.
“We don’t detect these diseases early enough, and even when we do offer treatment, it is not always the right option,” says Professor Saratzis. “There are steps we can take much sooner to limit the risk.”
The best way to combat artery problems is to treat the underlying conditions – this may mean giving them diabetes medications, blood pressure tablets or diet tips to help them lose weight.
However, according to the new report, carried out in partnership with health company Abbott, the early signs of peripheral arterial disease are repeatedly missed by the NHS, with Professor Saratzis saying patients don’t know what signs to look out for, meaning they don’t. visit a doctor. Symptoms often include pain or loss of sensation in the legs, persistent pain throughout the night and small skin wounds.
Research also shows that many general practitioners do not recognize the condition when confronted with it.
‘GPs are extremely busy and you have to undress the patient, examine the foot and feel the pulse to detect a problem,’ says Professor Saratzis.
When the disease is more advanced, the procedure is needed to reopen the blockages, known as revascularization. However, Professor Saratzis added: ‘Waiting times to get these artery blockages treated are long and there are not enough places for everyone who needs one.’