Background Diabetic foot ulcers (DFUs) and infections remain a major cause of hospitalisation, disability and lower-limb amputation. Their management requires timely recognition of both vascular insufficiency and structural foot pathology, making multidisciplinary care essential. Nepean Hospital has established a dedicated inpatient ortho-vascular model aimed at enhancing limb preservation and improving overall coordination of diabetic foot care. Methods The model integrates vascular surgery, specialised foot and ankle orthopaedic surgeons, endocrinology, infectious diseases and allied health professionals within a structured inpatient pathway. Key elements include joint ward rounds, rapid access to imaging and diagnostics, early involvement of orthopaedic subspecialists, and standardised protocols for revascularisation planning, surgical debridement and off-loading. The framework is designed to support seamless communication and shared decision-making. Results Since implementation, the ortho-vascular model has streamlined clinical workflow and facilitated earlier identification of limb-threatening pathology. Enhanced collaboration between vascular and orthopaedic teams has supported more comprehensive assessment of perfusion and foot biomechanics, allowing more targeted and timely interventions. This coordinated approach has strengthened limb-salvage strategies, promoted continuity of care and reduced delays commonly seen in fragmented service structures. Conclusion The Nepean Hospital ortho-vascular model highlights the value of a purpose-built, multidisciplinary approach for managing complex diabetic foot conditions. By embedding vascular and orthopaedic expertise within a unified care pathway, the model provides a practical framework for improving clinical efficiency, optimising limb preservation and supporting best-practice diabetic foot management. Its structure may be adaptable for other centres seeking to enhance outcomes in patients with DFUs and related complications.