Postcode lottery for NHS orthotics patients

Author: Ingrid Torjesen

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Specialist orthotics care for patients with mobility issues varies significantly depending on where they live as major differences exist across orthotics services at various NHS trusts and health boards, research* from BMJ Open has uncovered.

Researchers at Staffordshire University sent Freedom of Information (FOI) requests to all NHS trusts and Health Boards in the UK. Responses were received from 61% (119/196) of trusts and health boards; there was an 86% response rate from Scotland (12/14) and Wales (6/7), 60% (3/5) from Northern Ireland and 58% (98/170) from England. The results highlighted large variances in the length of appointments, appointment waiting times, product entitlements for patients, and product lead times.

The findings showed that average and maximum waiting times for adult appointments were seven and 34 weeks, respectively; Scotland seemed to fair better in all of the reported measures as patients in Scotland had longer appointment times and the average waiting times were lower; and some trusts were not fully accommodating the needs of children.

Dr Aoife Healy who co-authored the study said: "Our results highlight that some of the trusts appeared to not accommodate the needs of children fully. Waiting times of 20 weeks for routine and 8.2 weeks for urgent appointments are unacceptable."

The researchers hope that these findings will prompt the NHS to instigate its own evaluation of services across the country. Ms Lynne Rowley, chair of British Association of Prosthetists and Orthotists (BAPO) said: "We welcome this study, which clearly showcases the inequalities across orthotic service provision in the UK. BAPO has been aware of this issue and has been working with NHS England. However, this study is timely and provides a push in the right direction."

Nachiappan Chockalingam, professor of clinical biomechanics at Staffordshire University, said: "Within the NHS, the Orthotics Service is poorly understood and low in priority lists. Therefore, it is essential to evaluate the current state of provision to ensure that services are capable of meeting future demands.

"In 2011, a report estimated there were two million orthotics users in England and assistive devices including wrist splints, custom footwear, foot and ankle support, back and neck braces are needed to alleviate pain, help patients recovering from injury and those with chronic conditions.

"In future, there will be an increased demand for orthotics services because of the projected population growth, the aging population and the rising prevalence of obesity, diabetes, cardiovascular and peripheral vascular diseases."

He added: "The UK NHS needs to establish appropriate processes to record the quality of service provision since this will enable improvements in clinical management and ensure good value for money."


*Chockalingam N, Eddison N, Healy A. Cross-sectional survey of orthotic service provision in the UK: does where you live affect the service you receive? BMJ Open 2019;9:e028186. doi: 10.1136/bmjopen-2018-028186

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