Why pay more? A Scottish team make the case for state of the art prosthetics
Nominated Category: Care of Veterans Award
State of the Art Prosthetics
Team led by NHS Lothian SMART Centre, Astley Ainslie Hospital, Edinburgh
Veterans who wear limb prostheses are entitled to an equivalent level of service from the NHS as they would enjoy through the military healthcare system. In order to ensure this happens, this project was set up to review existing levels of service against what is provided via Headley Court. By raising civilian staff awareness and equipping the NHS appropriately to deal with state of the art prosthesis wearers, the patients will receive a service which more fully recognises their needs, ensuring a seamless transition from military to civilian life.
Civilian patients will also benefit from an improved knowledge base in terms of state of the art prostheses and the evidence for prescribing such high-tech components.
A national multidisciplinary steering group has been formed to gather evidence and study outcomes of high-tech prostheses use. All Scottish centres have been supplied with clinical equipment and trained in up-to-date equipment for the clinical fitting of these devices. This will assist in ensuring a consistent approach throughout Scotland in the development and delivery of services.
All five Scottish limb centres plus the University responsible for the training of prosthetists are members of this initiative; led by NHS Lothian’s SMART Centre, the team has forged links with veterans’ affairs at Scottish Government and Headley Court. Most importantly, the group includes an ex-military prosthetic user as a key stakeholder. His contribution has been invaluable in raising civilian staff awareness of military and veterans’ issues, such as the importance of understanding mental health issues associated with veterans.
Through establishment of this group and links to veterans’ affairs in the Scottish Government, the team has improved communication links between military healthcare and the NHS in Scotland. In this way, for example, the NHS can be alerted in advance to planned transition from military to civilian life of veterans. This allows the veterans’ local centre to be advised of their clinical needs and to establish early contact and transfer of records.
There have been significant challenges surrounding this initiative, in particular use of high-cost, high-tech state of the art components which are not routinely available under the NHS. There is a perceived gap between military service and NHS provision of these devices through limited available independent clinical evidence justifying extra costs. The group’s work includes promoting equity of access for Scotland and developing appropriate clinical guidelines.