OCE
Oxford Centre for
Enablement
NHS
Nuffield Orthopaedic Centre
OCE
Oxford Centre for Enablement
Oxford Centre for Enablement
Nuffield Orthopaedic Centre
Windmill Road
Headington
Oxford
OX3 7LD
Main Reception:
01865 227600
Main Reception Fax:
01865 227294
OCE 2010 Version 3
© 2010 Nuffield 20
Orthopaedic Centre
www.noc.nhs.uk
CONTENTS
NOTES
Page
3
Core Values
4
Oxford Centre for Enablement
6
Neuro-Rehabilitation Service (NRs)
7
Continuing Disability Management (CDMS)
9
Community Support Team
10
Rehabilitation Engineering
11
Specialist Disability Service
13
Prosthetics Service
15
Orthotics Service
16
Motor Neurone Disease Care Co-ordinator
16
Education and Research
17
Are we speaking your language?
18
Notes
20
Contact details
2
19
NOTES
CORE VALUES
This leaflet briefly describes the services available and how
to access them. We believe that disabled people should be
respected and treated as full members of society. They
should expect equal opportunities, and that services will
respect individual differences in culture, religion, race, age,
and ability, including:
• ACCESS to effective and efficient health and social care.
• INFORMATION that is appropriate, accessible, accurate,
timely, and relevant, to enable individuals to make
informed choices and to participate in decisions that affect
their lives.
• CHOICE
about every aspect of their lives and, if
necessary, assistance with the expression and
implementation of their wishes.
• PARTICIPATION
in society
commensurate with their abilities.
• CONSULTATION
and
involvement in the planning
of services, along with users’
families,
voluntary
organisations with specialist
expertise, and other
appropriate groups.
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and
responsibilities
OXFORD CENTRE FOR ENABLEMENT
Services within the centre:
Neurological Rehabilitation Service.
Continuing Disability Management Service (CDMS)
Rehabilitation Engineering
Specialist Disability Service
Oxford Wheelchair Service
Prosthetics Service
Orthotics Service
Plus:
Motor Neurone Disease Care Co-ordinator
Dialability Advice Centre
Community Support Team
The Oxford Centre for Enablement was opened in July
2002 and brings together Oxford’s disability and neurorehabilitation services (previously located at Rivermead
Rehabilitation Centre, Ritchie Russell House, Tebbitt
Centre, and Mary Marlborough Centre) into one integrated
service located in new purpose-built accommodation.
Within the Oxford Centre for Enablement, the services are
linked in a way which makes best use of resources,
specialist skills, and advanced technology, making the
services more accessible to users. The services cover
everything from advice on an individual problem through
to the planning of a package of care which might involve a
number of the services for someone with complex needs.
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17
MOTOR NEURONE DISEASE CARE CO-ORDINATOR
Funded by the MNDA. The aim of the post is to support
people living with MND in the community. The MND care
coordinator liaises with a Multi-Disciplinary Team at the
Radcliffe Infirmary, the PIMS team at the OCE, and teams
in the community, to ensure people living with MND
receive co-ordinated care. The care centre is responsible
for various research projects and clinical trials. We are also
involved with the education and development of health
care professionals.
EDUCATION AND RESEARCH
‘Why am I unable to undertake the DIY activities I used to enjoy, and
what are you able to do about it?’
Variations on this question focussed on different activities
varying from dressing to working. The OCE research
programme investigates all aspects of both the ‘why’ and
‘what’, and the education programme transfers general
information on both questions to a wider professional
audience.
The centre provides a central
resource for people with
disabilities from Oxfordshire
and beyond and works in
partnership with community
and voluntary sector services,
as well as other health and
social care organisations.
All the services share a common goal — to provide a coordinated approach to assessing and resolving the
problems which occur in the daily lives of people who
have a range of disabilities.
The service is provided by skilled and experienced staff,
working as part of an interdisciplinary team, provided in
an environment that will enable users to reach their
maximum potential.
Both the research and the educational programmes are
tailored to the specific needs of any particular situation,
and both are flexible in responding to the needs of the
target group.
The educational programme draws not only on local
research (which is extensive) but on all published material.
The availability of local experts in many areas helps to
make education up-to-date and interesting.
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Photos: Patient areas
5
NEURO-REHABILITATION SERVICE (NRS)
ORTHOTICS SERVICE
NRS provides a specialist rehabilitation service to people,
who have sustained some form of acquired brain injury
(most commonly head injury or stroke).
The Orthotics Service at the Oxford
Centre for Enablement is one of the
largest NHS providers in the UK. It
provides orthotic clinical services and
manufacture of custom made orthosis
for the Nuffield Orthopaedic Centre
as well as local NHS Trusts.
The service offers specialist assessment and treatment on
an in-patient and out-patient basis, using an
interdisciplinary approach to address a range of physical,
cognitive and emotional impairments. The team includes a
full range of specialist rehabilitation therapists, as well as
clinical psychologists, social workers, nursing and medical
staff.
The in-patient service uses a client-centred approach to
goal planning with goals set by the patient, involving both
family members and the rehabilitation team. Treatment
plans are then tailored to the individual’s goals. The
treatment is then structured into a weekly timetable.
Patients stay at OCE for varying lengths of time,
depending on their needs.
The out-patient rehabilitation service offers input from one
or more departments within the service depending on
needs. Patients are referred directly or through assessment
clinics from community services, or offered this form of
rehabilitation following an in-patient admission.
Facilities at the centre include a gym, workshop and leisure
service as well as use of the hydrotherapy pool.
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Photo: Orthosis fitting
The service caters for a wide variety of needs from footwear, foot orthoses, and lower limb bracing to spinal bracing and upper limb orthoses. It covers all areas of orthotics
and is tailored to the individual requirements of each client. The department has close links with the orthopaedic
and therapy services providing a number of multidisciplinary clinics which offer specialist orthotic service in the areas of neuro-rehabilitation, foot and ankle, rheumatology,
spinal and paediatric services.
The referral pathways to the orthotics service are:
• Nuffield Orthopaedic Centre medical staff and allied
health professionals.
• Community Allied Health Professionals.
• Local or national NHS Trusts.
• General Practitioners.
The Orthotic Service is a training centre for undergraduates in prosthetics and orthotics from the University of Salford and is also involved in a wide range of research and
development projects.
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CONTINUING DISABILITY MANAGEMENT
SERVICE (CDMS)
Each prosthesis is custom
made. Most prostheses
are made from modern
materials (thermoplastics,
laminates and metal
alloys)
but
leather,
aluminium and wood are
still in use today.
Specialist prostheses are
provided
to
suit
recreational activities such
as swimming, running
and golf.
CDMS is a specialist service for adults aged 16-65 years
with physical disabilities living within Oxfordshire. The
service aims to help people live with their disability and
maintain their quality of life.
Referrals are welcomed from anyone, including selfreferrals. Common reasons for referral include:
• Assessment
The Prosthetics Service
has close links within the OCE, notably with the Posture,
Mobility and Independence Service and the Orthotics Service.
and advice on present and future
management.
• Need for more specialist or more intense,
multidisciplinary treatment than is available locally.
• Requirement for on-going monitoring for people with
complex needs, either day care or in-patient stays.
• Transitional care following an acute hospital
admission or rehabilitation, prior to discharge.
There are currently over 170 clients receiving support
from the service and there are approximately 60 referrals
per year. The majority of
clients have neurological
conditions such as multiple
s c l e r o s is ,
stroke
or
Parkinson’s disease. Some
remain users of the service
for many years.
Photo: Prostheses being made and used
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Photo: OCE Shop
7
The Day Room provides a central focus for all clients to
meet and socialise and to take part in a variety of activities
in a cheerful and informal setting, as well as enabling them
to receive the therapy and nursing care that they might
require. There are quiet areas, both within the building
and in the Courtyard Garden. In-patients generally have
their own room with shared en-suite facilities.
PROSTHETICS SERVICE
This service provides a specialist service for amputees,
those considering amputation, and those with congenital
limb deficiencies. Every patient is assessed and, where
appropriate, they are provided with a prosthesis (artificial
limb) or other related appliances. Counselling and training
in the use of the prosthesis are provided, as is long-term
follow up for prosthetic users.
The team includes specialist rehabilitation therapists and
prosthetists in addition to a counsellor, nursing and
medical staff. A doctor must make the initial referral and
thereafter patients can self refer to any member of the
clinical staff.
Photo: CDMS Day Room
All people attending CDMS are reviewed on a yearly basis
and goals are set based on the client’s priorities. All
assessments and on-going treatments are provided by the
members of the multi-disciplinary team as required by the
client’s needs. This could include medical, nursing,
occupational therapy, physiotherapy, speech and language
therapy, psychology and counselling. In addition, staff
liaise and meet with community professionals such as care
managers, GP’s, district nurses and therapists in order to
share information and work effectively on behalf of the
clients.
8
The service serves people from Oxfordshire, Berkshire,
Buckinghamshire and most of Wiltshire. A few patients
come from further a field, both nationally and
internationally. There are approximately 2,750 patients
receiving support from the service, which receives about
250 new referrals per year.
The centre sees people of all
ages from the newly born to
the very elderly.
The
prosthetic needs of such a
large age range are very
different, and this is
reflected in the large variety
of prostheses (artificial
limbs) that the service
Photo: A selection of
provides.
prostheses
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The team comprises:
•
•
•
•
•
•
•
•
COMMUNITY SUPPORT TEAM
Occupational therapists
Physiotherapists
A speech and language therapist
A nurse
Technical instructors
A clinical scientist
A rehabilitation engineer
Information for Healthcare professionals
The community support team was originally set up to support district nurses in the training and monitoring of care
staff supplied by social services who care for clients in their
own homes.
They also provide support and practical advice to facilitate
the safe discharge of disabled clients from hospital to
home. That support then continues as needs arise.
They provide assessment visits to clients intending to use
the CDMS service for in-patient or day care, and support
staff working with clients with complex needs in acute areas.
The Community Support team is made up of a Disability
Support Nurse and a Multiple Sclerosis Specialist Nurse.
Both have a detailed knowledge of dealing with people
with complex disabilities.
Photo: The Community
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9
REHABILITATION ENGINEERING
Rehabilitation Engineers apply engineering principles and
technology in the provision of services to meet the needs of
individuals with disabilities.
We work closely with the Oxfordshire Wheelchair Service
and the Specialist Disability Service, issuing both standard
and custom built equipment.
This equipment includes:
Custom contoured seating systems for wheelchairs
Our range includes carved foam and moulded seat inserts
Moulded toilet seats
For people who are unable to be supported appropriately
on standard equipment
Adapted mobile arm supports
For people with motor neurone disease
Many unique designs have evolved over the years and
development work continues, for instance in the areas of
forward lean postures and driving a powered wheelchair
using the headrest as a joystick.
Our team has a wealth of experience in supplying
innovative solutions to meet the needs of the individual
and includes:
•
•
•
SPECIALIST DISABILITY SERVICE
We are an experienced team of people specialising in the
management of complex disabilities.
Our aim is to maximise a person's quality of life and independence.
We do this by providing comprehensive assessment, advice,
information, recommendations and where necessary the design and manufacture of customised equipment.
Our specialists combine their skills to problem solve complex
disability issues in the following areas:
•
•
•
•
•
•
•
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•
Alternative and Augmentative Communication
(communication aids)
Clothing and adaptations
Computer access service
Management of posture in severe physical disabilities
Mobile arm support services
Motor neurone disease service
Oxfordshire environmental controls service
Baby care for parents with a disability
Assessment can be carried out at the Oxford Centre for
Enablement or locally to the client. An inpatient stay can
be arranged if required.
A clinical scientist
Rehabilitation engineers and technicians
An upholsterer
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