Thousands of people are needlessly losing limbs every year because doctors are failing to spot the early signs of disease, The Mail on Sunday can reveal.
A landmark report which investigated the causes behind amputations in the UK concluded that quicker diagnoses could save around four out of five patients from the life-changing surgery.
Of the 3,000 amputations carried out in England and Wales each year, the vast majority are due to peripheral artery disease – when blood vessels in the limbs narrow or become blocked so blood is unable to reach the feet or hands.
However, according to Professor Athanasios Saratzis, a vascular disease expert at the University of Leicester who headed the report, GPs are rarely aware of the early symptoms of the condition.
On average, patients with peripheral artery disease are examined 19 times by a GP before they are referred to a hospital specialist for further investigations. By the time many are diagnosed, it is too late to save their damaged limbs.
One patient who has suffered from a slow diagnosis is Bryan Hoggard, 80, from Leicester.
The former railway worker was diagnosed with arthritis 20 years ago when he began to get agonising pain in his right foot. It was only five years later when he saw a podiatrist – a foot specialist – that concerns arose. ‘He put his hand on my foot and I jumped up with pain,’ says Mr Hoggard. ‘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 revealed two arteries in his leg were completely blocked. He was sent for surgery to open them up, but during the procedure he suffered a heart attack.
Former surgeon Allan Gayner, with two of his grandchildren, lost his right leg after ignoring pain while walking
Bryan Haggard, 80, lost his right leg below the knee after he developed foot ulcers which went undiagnosed
Bryan returned to surgery a few years later, but by that point it was too later to repair.
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 spotted years ago and avoided. But no one looked to see what was wrong.’
About a fifth of people over the age of 60 in the UK have some form of peripheral artery disease. But it is most common – and dangerous – in those with diabetes, high blood pressure and obesity. Smokers are also far more likely to develop it.
Retired surgeon Allan Gayner, 80, from Tyne and Wear, also lost a limb after failing to spot the symptoms of peripheral artery disease.
After working in the health service for more than three decades, he suffered a heart attack in 2012. During his recovery he noticed pain in his right leg while walking. ‘I assumed my circulation was just a bit sluggish after the heart attack,’ says the father-of-four. ‘It was only several years later, when I had developed ulcers on my heel, that I went to the GP.
‘I was sent for surgery to open up my arteries, and it was discovered I’d had an aneurysm in my leg.’
This is when a bulge forms in the vessel behind the knee, limiting blood flow to the region.
‘Eventually I was told I’d need to have the leg amputated,’ Mr Gayner adds. ‘I should have gone straight to the GP and asked to be referred to a specialist. An opportunity was lost to save my leg.’
And experts are now calling on the NHS to ensure all GPs know the early signs of these serious conditions.
‘We aren’t catching these diseases early enough, and even when we do offer treatment it’s not always the right option,’ says Professor Saratzis. ‘There are steps we can take much earlier to mitigate the risk.’
The best way to combat artery problems is to treat the underlying conditions – this may mean giving diabetes medicine, blood pressure tablets or diet tips to help them lose weight.
However, according to the new report, carried out in partnership with health firm Abbott, the early signs of peripheral arterial disease are repeatedly missed by the NHS, while Professor Saratzis says patients do not know what signs to look out for, meaning they do not visit a doctor. Symptoms are often pain or loss of sensation in the legs, constant pain during the night and small skin wounds.
Research also shows that many GPs do not recognise the condition when presented with it.
‘GPs are extremely busy, and you need to undress the patient, examine their foot and feel for a pulse to spot a problem,’ says Professor Saratzis.
When the disease becomes more advanced, the procedure to reopen the blockages, known as revascularisation is required. However, Professor Saratzis adds: ‘Waiting times to get these artery blockages treated are long and there are not enough slots for everyone who needs one.’
