Service Improvements to Orthotic Services across an

Acute TrustJuliet Sturgess BSc MBAPO

Orthotist and Orthotics Service Manager

Yeovil District Hospital NHS Foundation Trust

and

Dorset County Hospital NHS Foundation Trust

What we’ve achieved

• Amalgamation of the Orthotics Services in two Acute Trusts

• Larger Team so more sustainable• Fully integrated into MDT– no longer working in silos• Improved patient care• Financial savings

The story behind the changes

• Prior to 2007; contracted service, Orthotist present only 2 days per week, increasing spend.

• May 2007, decision to take service in-house. October 2007 in-house service created

• April 2008, £60000 saving with increased patient satisfaction

• November 2008 Diabetes Specialist Orthotist employed• 2009 – 2012, various service improvements

Dorset County Hospital

The Yeovil Project

• 16 week review – one afternoon a week• Reviewed all aspects of service

– IG– Patient pathways– Referrals– Products– Financial processes– DNA rates– Patient satisfaction

• Options paper

The Options for YDH

• An in-house orthotics service with shared management• YDH could take their orthotics service completely in-

house• YDH could extend current service contract and insist

staff use hospital based IT systems• YDH could retender the product and service contracts

separately

YDH’s Decision

• An in-house orthotics service with shared management– Directly employ an Orthotist– Share an Orthotics Service Manager– Staff transferred under TUPE from company to NHS– Directly procuring orthotics products– Integrated into MDT– Orthotist present throughout the week

What we’ve achieved

• Amalgamation of the Orthotics Services in two Acute Trusts

• Larger Team so more sustainable• Fully integrated into MDT– no longer working in silos• Improved patient care• Financial savings