UK Foot and Ankle COVID-19 National Audit (UK-FALCON)

COVID-19 has had a profound effect on healthcare systems in the UK is. On 23rd March 2020, the UK announced a national lockdown and surgical governing bodies issued guidance to temporarily halt elective activity to enable staffing and resources to be redeployed to trauma and emergency care. However, the incidence of COVID-19 in the population undergoing surgery was not examined.

There was therefore an urgent need to understand the incidence and impact of perioperative symptomatic COVID-19 in patients who had undergone foot and ankle surgery to estimate the possible risk going forward and to plan interventions to limit this risk. Such data could also be used to inform management and planning for subsequent waves of the disease.



To this end the UK-FALCON Audit was set up with the primary objective to determine the incidence of COVID-19 infection and 30-day mortality in patients undergoing foot and ankle surgery during the global pandemic. Secondary objectives were to determine if there was a change in infection and complication profile with changes introduced in practice. Further outcomes included examination of regional variations in activity and COVID-19 infection rate.



This was a multicentre retrospective national audit with data submitted on over 7,000 patients undergoing foot and ankle sugery from 43 units across the country. Data was analysed for the first UK national lockdown period and 10 weeks either side of this (from January 2020 to July 2020). This constitutes Phase 1. Phase 2 was performed using the same methodology and included the period of recovery post-lockdown and the second national lockdown (from September 2020 to November 2020). 



The final report incorporating the results from both Phase 1 and 2 can be accessed here.



Additionally, there were 3 associated publications:

The UK Foot and Ankle COVID-19 National (FAlCoN) audit. Bone Jt Open. 2021 Apr;2(4):216-226. 

The UK foot and ankle COVID-19 national (FAlCoN) audit - Regional variations in COVID-19 infection and national foot and ankle surgical activity. Foot Ankle Surg. 2022 Feb;28(2):205-216.

Rate of COVID-19 infection and 30 day mortality between blue and green (dedicated COVID-19 safe) pathways: Results from phase 1 and 2 of the UK foot and ankle COVID-19 national (UK-FAlCoN) audit. Foot Ankle Surg. 2022 Oct;28(7):1055-1063. 



We would like to extend our gratitude to all the members who participated in this important, first of its kind, national foot and ankle project – without your efforts this would not have been possible.

We would also like to acknowledge University of Leicester Hospitals Charity for funding the project, and NIHR Leicester Biomedical Research Centre for managing the data.