NHS HDL (2001)16
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NHS HDL (2001)16 |
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Health
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GUIDELINES FOR ORTHOTIC PATIENT REVIEW Summary 1. Guidelines for orthotic patient review are attached. 2. The Guidelines were prepared by the Scottish Rehabilitation Technology Providers Forum (SCOTRET) Orthotic Sub-Group to ensure that patients who have been provided with orthotic equipment receive appropriate and regular reviews so that they are able to get the most out of their orthotic provision. The Guidelines have been endorsed by the SCOTRET Co-ordinating Group and the Rehabilitation Technology Services Advisory Group. The 5 Scottish rehabilitation technology centres are represented on each group. Action 3. Chief Executives are requested to ensure that this letter and Guidelines are brought to the attention of all Directors of Public Health; Area Occupational Therapists; Area Physiotherapists and any other staff involved in the rehabilitative care of recipients of orthoses in their area. |
Addresses _________________________ |
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4.
Primary Care Trust Chief Executives should also arrange for this letter
and guidance to be available to all GP practices in their area.
5. Directors of Social Work should arrange for this letter and Guidelines to be brought to the attention of Senior/Principal Occupational Therapists and any other staff involved in the rehabilitative care of recipients of orthoses. Yours sincerely GERRY MARR ANNEX GUIDELINES FOR ORTHOTIC PATIENT REVIEW Introduction The review of patients following supply of orthoses is essential in order to confirm the efficacy of fit and function, user comfort and compliance, and is also an essential element of Orthotist training and professional learning. In addition to the clinical and technical necessity for patient review, this is also now essential in order to comply with the legislative requirements of Product Liability and the Medical Devices Directives, Quality Assurance, Clinical Governance and Audit. It must be realised that it is neither practical nor appropriate to set one rigid or uniform review procedure for all patients, as this will, in some instances, require to be tailored to reflect the needs of each individual in respect of their pathology and/or occupational or domestic circumstance. The following policy is, therefore, merely an outline of that which is considered to be the minimum necessary in order to meet the collective needs of the present clinical, technical, professional and statutory requirements. Review Categories (General) 1. ADULTS As a general rule, all patients should be reviewed within 1-4 weeks following initial orthosis supply, and a minimum of one yearly thereafter. 2. CHILDREN Due to the continuing changes such as occur in children consequent to growth, they therefore of necessity, generally require more frequent and continuous review than that of adults with similar pathologies/orthoses. Accordingly, they, following initial review of 1-4 weeks, should typically be reviewed on a 4-6 monthly ongoing basis. Special Categories 1. LOAD BEARING ORTHOSES In order to comply with manufacturers' guidelines in respect of compliance with Product Liability Legislation and Medical Devices Directives, load-bearing devices which incorporate mechanical joint mechanisms eg, Knee, Ankle, Foot Orthoses and Hip, Knee, Ankle, Foot Orthoses, after initial review of 1-4 weeks, should, in the interest of patient safety, be checked for structural integrity on a 6 monthly basis. 2. AT RISK CATEGORY PATIENTS Any patient deemed at risk due to their pathology will require to be seen, after initial review of 1-4 weeks, on a regular and ongoing basis within a typical minimum time scale of 4-6 months. For example, patients with neuropathic type disorders, such as diabetes mellitus, who are at risk of developing, or who have existing ulceration, or those who are suffering from other acute conditions will, of necessity, require to be seen on an even more frequent basis. Patient Information and Guidance All patients supplied with orthoses should be given clear and written instructions on the use and care of their orthosis, be made aware of their responsibility in complying with the review guidelines and of the importance of their advising the orthosis provider of any problems arising as soon as possible. Produced
by the Scottish Rehabilitation Technology Forum (SCOTRET) September 2000 |