The Orthotist works as part of a multi-disciplinary team, ensuring that the Orthotic prescription reflects the most appropriate solution to meet the clinical needs of the patient and that the patient’s wishes are given a high priority.
The aim of the Orthotic Service is to facilitate the treatment and rehabilitation of patients through assessing the need and provision of an orthosis to either remedy or relieve a medical condition or disability, or may prevent the development of the condition or disability. When necessary, we also provide support and reassessment of need once the orthosis has been supplied along with review, maintenance, and repair services.
An orthotic device is externally fitted to support any part of the body weakened by defect, disease or injury. The device is fitted in such a manner to reduce pain, improve function and mobility. The term ‘orthosis’ covers a wide range of products including lower and upper limb devices such as:
• Lumber supports
• Leg braces
• Footwear (made to measure and shoe alterations)
• Collars, Helmets
• Wrist splint
What do we do?
An Orthotist is a professionally qualified person who is able to fit a variety of orthoses. As part of the multi-disciplinary team the Orthotist contributes to the care of children and adults in both inpatients and outpatients, across a wide range of specialties. We offer assessment, advice and the provision of an orthosis that will influence the motion of one or more joints.
What happens at my appointment?
The orthotist carries out a full biomechanical evaluation of a patient’s needs, designs, takes the measurements required (which may include a plaster cast), provides full manufacturing specifications and fits the finished device to the patients. The patient may receive their orthosis at their first appointment but more often it will be specially made or ordered and a second appointment will be required. The orthotist will explain what the outcome measures of the orthosis should be and when and how to wear it.
Where Do We Provide Clinics
The Orthotics service operates 5 days per week Monday to Friday from 0830 – 1630hrs. We provide adult clinics at
• SMART Centre, Astley Ainslie Hospital
• Royal Infirmary Edinburgh
• Western General Hospital
• St John’s Hospital
• Roodlands Hospital
We also provide paediatric services within the SMART Centre, Royal Hospital for Sick Children, special schools and St. Johns Hospital.
At present the team consists of Advanced Orthotists, Orthotists, Appliance Officers, Technical Staff and is additionally supported by an external contractor to provide the suite of services in Orthotics across NHS Lothian.
For inpatient referrals, an Orthotic referral form (available on every ward) should be completed and forwarded to us. This can be found in the SMART website though professional login. Information such as reason for request, expected outcome, diagnosis and any relevant medical history should be included. The patient will be assessed by an Orthotist on receipt of referral.
For outpatient referrals from secondary care we accept referrals from medical staff and specialist Allied Health Professionals. The patient can self refer if they have had their last appointment over the last 2 years. All referrals should be sent direct to the Orthotic Department within the SMART Centre.
For GP referrals, the referral process is on SCI Gateway. Information such as, reason for request, expected outcome, diagnosis and any relevant medical history should be included. All referrals will be eTriaged through TRAK.
· Surgical/orthopaedic footwear
Footwear is supplied to patients where there is a clinical need ie when a patients feet cannot be accommodated in shop bought footwear. Very often a change of style of shop bought shoes is enough to accommodate a patients feet. When there is a clinical need for footwear a patient is entitled to one pair of shoes over a twelve month period. The patient will be asked to make their own arrangements to have their shoes repaired before they wear out. However if the shoes have adaptations to the sole and/or heel on the outside (e.g. a raise or wedge) the patient should arrange to hand the shoes in to be repaired, free of charge, on a regular basis; not only to prolong the life of the shoes but to check to see if any adaptions are necessary. The shoes will be replaced when they are either beyond economical repair, or if the patient’s presentation changes and the Orthotist feels they no longer provide the proper support.
· Boston Spinal Bracing
These are largely custom made and are replaced as required as the child grows. They are reviewed regularly within the spinal clinic but any problems outwith these appointments can be dealt with directly by Orthotics. Any repairs can generally be carried out at the SMART Centre Workshop while the patient waits. For a review appointment or information on vests please contact us.
· Spinal/abdominal supports
A patient is entitled to two supports; one to wash, one to wear. The hospital will repair the supports free of charge and will replace them when they are beyond repair or no longer fit properly.
These are transferable from shoe to shoe and only one pair will be supplied initially. A second pair will be provided if required at review. When the patient feels they are no longer providing adequate support it is the responsibility of the patient to make an appointment to see the Orthotist, no longer than 3 years from initial fitting.
· Shoe adaptions
The patient is entitled to have three pairs of shoes altered every 12 months. If for any reason the patient’s raise/adaption needs to be altered we will again alter three pairs of shoes.
Who to contact to find out more
The Orthotics Service can be contacted on tel 0131 537 9418.