Arthiritis Research have recently undertaken a piece of research based on service user interviews to look at the state of orthotics provision in the NHS… The report has thrown up all the same issues that private Podiatrists and Orthotists have been hearing from their patients…
NHS Orthotics are difficult to fit into the sort of shoes people want to wear, appointments are like gold dust, GPs, Nurses, and OTs are being discouraged from referring to the Podiatry service because they are over worked and under staffed and there is no money to solve the chronic gap in provision.. When they do give an appointment it is often 6 weeks or more before the first 15 minute appointment with the relevant specialist.
I have included an excerpt of the report – the last paragraph I have copied here is the most telling — interviewees expressed concern at the need to be proactive to access services.
The profile of service users who agree to participate in these interviews is not representative of all those in need — many people who lack the background or language skills to be ‘proactive’ simply get passed over — and these are the same people in need who can least afford to be spending their own money– for a service they have ‘already paid for’ with their income tax and NI contributions!
If the NHS cannot cope, its time to overhaul the cumbersome referral process and outsource some of the work to private practitioners – as is happening in Physiotherapy, Urology, minor surgery etc.
the press release is here:
and the full report .pdf is here:
ACCESS TO SERVICES
‘Generally it’s quite difficult to access services quickly. I [as an occupational therapist] was trying to refer regularly but was told that funding was not in place for the podiatrists to be able to respond to the volume of referrals, therefore patients were redirected to the community where they didn’t seem to be a priority or they have to pay for services/devices.’ – Service provider
‘When the orthotist is in for half a day a week it’s not surprising that it’s three months before you see them for your initial
– Service user
‘I can’t directly talk to the orthopaedic foot department – it has to go back via GPs so that’s another waste of time and
frustration from my part and obviously the patient.’
– Service provider
‘I think you pay about £70 to go and see him but it’s like the convenience of being able to go after work, not miss time off work, the follow-up service, the fact that he’s interested…I think even when I’m not working that’s going to be one of the last things I’m going to have to let go…it is really is worth it’ – Service user accessing private healthcare
Access to an orthotist or podiatrist is often inconsistent with referral pathways, unclear and subject to frequent delays. Two out of three respondents had to self-refer back to the service if there was a problem – and when this occurred, they had to follow the same pathway of going back to their GP or rheumatologist and asking for a follow-up appointment. Most said this was unsatisfactory and expressed concerns about the need to be proactive to access services.