It is well documented that diabetic patients at risk of ulceration which if not managed appropriately can result in sepsis, limb loss and loss of life. This requires timely intervention to prevent the devastating sequelae. There is good evidence to support that MDT involvement has a positive impact on outcomes including reduction in rates of major limb amputation and shorter hospital stays. The high risk foot service (HRFS) at the SCHHS is evolving: between 2017-2022 it consisted of podiatry, endocrinology and infectious disease specialists. Surgical input was limited to on-call vascular or orthopaedic registrars or outpatient referrals, often resulting in delays. Since 2022, the model of care has been aligned with the National Association of Diabetes Centres (NADC) recommendations and now includes routine vascular surgery involvement. The updated HRFS model offers regular MDT clinics and a weekly inpatient ward round to assess high-risk cases. At the SCHSS between 2022-2024 there have been 143 documented major amputations between. Of these, 80 where deemed to be patients with ‘high risk feet’, which could indicate a preventable cause. Of these 80 patients, 43 were known to the high risk foot service. Prior to the introduction of routine vascular involvement in the HRFS between 2018-2022 the mean rate of major limb amputations was 3.4 /100,000. Since the change to the HRFS in 2022, the rates have halved to a mean of 1.6/100,000. Rates of minor amputations have increased. Major amputations known to the HRFS have decreased from 64% to 44% since 2022. This evidence suggests that the evolution of the HRFS has had a positive impact on limb salvage. Further evaluation will be undertaken to assess the impact on additional factors including length of hospital stay. Raising awareness of and access to the HRFS could further improve limb salvage.