the provision of orthotic, prosthetic and rehabilitation equipment u.k. model
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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
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