Purpose: The prevalence of diabetes is increasing at an alarming rate in New Zealand. 50% of diabetics will develop significant peripheral neuropathy and vascular disease, with people of Māori, Pasifika and South-Asian ethnicities bearing a disproportionate burden of the disease. In an effort to reduce these poor outcomes in the Wellington region, the High-Risk Diabetic Foot Clinic (HRDFC) was established in 2017. To support and sustain the patient outcomes, the Clinical Nurse Specialist (CNS) Vascular Surgery role was implemented in 2022, to provide coordination and leadership of patient/whānau care and health professionals. Methodology: In a retrospective study, data were collated from electronic medical records to identify all the patients that were treated through the HRDFC between 2018 and 2022. Data for these patients were compared with patients treated with diabetic foot disease during 2013-2017, prior to implementation of the clinic. Outcomes assessed included minor and major amputation rates, and the level of engagement of more vulnerable demographic groups. Survey data were collected on the quality improvement of the CNS Vascular Surgery role. Results: Minor amputation rates reduced from 77.1% to 57% of cases, and major amputation rates reduced from 29.8% to 11.9%. The HRDFC helped to engage more Māori and Pasifika patients compared to pre-HRDFC with a proportional increase of Māori from 7.8% to 11.9% and Pasifika from 15.7% to 23%. Survey data for the CNS vascular surgery role demonstrated timely access to the tertiary vascular service for support and advice and improved transition of care across regional services. Conclusion: The HRDFC has demonstrated a reduction in amputation rates and an increase in Māori and Pasifika engagement. The Vascular CNS role supports improved delivery of care across the patient continuum.