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Service Improvements to Orthotic Services across an
Acute TrustJuliet Sturgess BSc MBAPO
Orthotist and Orthotics Service Manager
Yeovil District Hospital NHS Foundation Trust
and
Dorset County Hospital NHS Foundation Trust
What we’ve achieved
• Amalgamation of the Orthotics Services in two Acute Trusts
• Larger Team so more sustainable• Fully integrated into MDT– no longer working in silos• Improved patient care• Financial savings
The story behind the changes
• Prior to 2007; contracted service, Orthotist present only 2 days per week, increasing spend.
• May 2007, decision to take service in-house. October 2007 in-house service created
• April 2008, £60000 saving with increased patient satisfaction
• November 2008 Diabetes Specialist Orthotist employed• 2009 – 2012, various service improvements
Dorset County Hospital
The Yeovil Project
• 16 week review – one afternoon a week• Reviewed all aspects of service
– IG– Patient pathways– Referrals– Products– Financial processes– DNA rates– Patient satisfaction
• Options paper
The Options for YDH
• An in-house orthotics service with shared management• YDH could take their orthotics service completely in-
house• YDH could extend current service contract and insist
staff use hospital based IT systems• YDH could retender the product and service contracts
separately
YDH’s Decision
• An in-house orthotics service with shared management– Directly employ an Orthotist– Share an Orthotics Service Manager– Staff transferred under TUPE from company to NHS– Directly procuring orthotics products– Integrated into MDT– Orthotist present throughout the week