The Provision of Orthotic, Prosthetic and Rehabilitation Equipment U.K. Model

THE PROVISION OF ORTHOTIC, PROSTHETIC AND REHABILITATION

EQUIPMENT

U.K. MODEL David Holmes

EMEA Business director

A simplified version of acomplex system

The U.K. National Health Service principle for all

treatments.

Free at the point of supply

Referral System

Family Doctor

Shop Pharmacy Bloodtests

Nurse X-ray Physio-therapy

Hospitalconsultant

Medical Aid Shops

Very few exist due to improved hospital and private facilities

offering better technology and expertise

Medical Aid ShopsOnly sell wheelchairs, walking

aids, crutches, seating accessories etc.

Only to the private market

Orthotics/Prosthetics/Rehabilitation equipment supplied from hospitals or

specialist centres.

Hospital Consultant

Orthotics Prosthetics Physiotherapy

Orthotic/Prosthetic Practitioners

University education at O&P colleges

3 Years plus 2 years intern

Option of extra year to obtain Masters Degree

FUNDING

Central Government

National Insurance

Patient Contribution

Charges to patientsPharmacy medication

GBP 7.40

Orthotic devicesHosiery GBP 15.30

Fabric supports GBP 37.90

Prosthetics – standard limbs free

Rehabilitation equipment - free

Individual hospitals control their own budget for the provision of

orthotics, prosthetics and rehabilitation equipment

O & P Service Provision Mainly private companies

Competitive tenders (1-5 years) for service and/or products

Few government workshops - excluded from tender process

Rehabilitation Equipment

Competitive tenders for bulk purchase

Individually negotiated prices

Patients with Chronic Conditions

HospitalCare Home with resident nursing

staffPatient’s own home

Team decision

Home Care

Equipment installed

Visiting nurses (24 hours if necessary)

Visiting therapists

Transport for hospital visits

Value for moneyNational Institute for Clinical

ExcellenceN.I.C.E.

Cost effectivenessProduct testing

Product testing

Bio-engineersDoctors

TherapistsOrthotists/Prosthetists

Product testing

FunctionMaterial testing

Clinical trialsStudies

Less expensive v More expensive

SWEDEN MODEL

Sweden is divided into 20 County Councils

each having its own O&P facility7 owned by County Councils13serviced by private companies

selected by tenders (3-5 years)Facilities situated mainly in major

hospitals

Orthotic/Prosthetic Practitioners

Same system as U.K.

Prescribers

Mostly qualified physicians

Family doctors

Physio. And Occupational Therapists

FundingCustom made orthotics and prosthetics funded by Social

Security(Taxation)

Ready made supports called “self care

devices” partly paid by patients(Euros 25-65)

Orthopaedic ShoesPatient pays Euros 35-60 children

Euros 75-120 adults

Chronic patients (rheumatoid arthritis, diabetes, stroke etc) free of charge

Amputee patients receive limbs free

Objective and Conclusion

To return the patient to as near normal function as

possible

Thank youfor

yourattention