Jonathan Bull
BAPO chair
www.bapo.com
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Autonomous registered
HCPC practitioners
Gait analysis and
Engineering solutions to
patients with limb loss
Mechanics, Bio-mechanics,
and material science
Anatomy, Physiology and
Pathophysiology.
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Competent to design and provide prostheses
that replicate the structural or functional
characteristics of the patients absent limb.
Qualified to modify CE marked prostheses
or componentry taking responsibility for the
impact of any changes.
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Includes –
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congenital loss
loss due to diabetes
reduced vascularity
infection
trauma
Military personnel
Whilst they are autonomous practitioners they
usually work closely with physiotherapists and
occupational therapists as part of multidisciplinary
amputee rehabilitation teams.
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Autonomous registered
HCPC practitioners
Gait analysis and
Engineering solutions to
patients with problems of
the neuro, muscular and
skeletal systems
Mechanics, Bio-mechanics,
and material science
Anatomy, Physiology and
Pathophysiology.
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Competent to design and provide orthoses that
modify the structural or functional characteristics of
the patients' neuro-muscular and skeletal systems
enabling patients to mobilise, eliminate gait
deviations, reduce falls, reduce pain, prevent and
facilitate healing of ulcers.
Qualified to modify CE marked orthoses
or componentry taking responsibility for the impact
of any changes.
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Include ◦
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diabetes
arthritis
cerebral palsy
stroke
spina bifida
scoliosis
MSK
sports injuries
Trauma
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Often work as autonomous practitioners
Form part of multidisciplinary teams such as within
the diabetic foot team or neuro-rehabilitation
team.
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Predominantly Contracted Model
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6 Prosthetists
◦ 8 Skilled and Experienced Prosthetic Technicians
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9 Orthotists (equates to 6-7 WTE)
◦ 12 Skilled and Experienced Orthotic Technicians
◦ 3MTO – 1 in Muckamore, 2 in Royal
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Reduce ulceration risk
Increased mobility
Better quality of life
Reduced NHS costs
Able to maintain employment
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Quicker rehabilitation – less need for multiple
therapists if correct orthosis is used
Early mobilisation
More independence
Earlier discharge
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Reduction of Hospitalisation
Better independent mobility
Improved balance
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Fully Equipped 2000
Fully Equipped 2002
Orthotic Pathfinder Report 2004
APLLG Orthotics Charter 2008
Hutton York Economics Report 2009 – Cost saving
case studies
AFO Best Practice Statement following Stroke 2009
CEBR Report 2011
BAPO Standards for best practice
Prosthetics and Orthotics Career Framework,
Education and Preceptorship Guides
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'The current fragmentation of the Orthotics Service.all with
their own standards and policies, is a recipe for inequity and
inefficiency' (Audit Commission, 2000)
'Orthotic Services should be managed within one Clinical
Directorate, with a dedicated budget' ( British Society of
Rehabilitation Medicine , 1999)
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'Develop protocols and guidelines for direct referrals by
health professionals to Orthotic Services' ( South Thames
Health Authority, 2002)
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'Implement condition-based direct GP Access' ( Orthotic
Pathfinder PASA , 2004)
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The cost to the NHS of delaying implementing
of these changes is £390m per
annum.(£1.1million per day)