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. When necessary, we also provide support and reassessment of need once the orthosis has been supplied along with review, maintenance, and repair services.
The orthotist carries out a full biomechanical evaluation of a patient’s needs, designs, takes the measurements required (which may include a plaster cast or CADCAM scan), provides full manufacturing specifications and fits the finished device to the patient. The patient may receive their orthosis at their first appointment or it may be specially made or ordered and a second appointment will be required for fitting. 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.
Adult Clinics
- SMART Centre, Astley Ainslie Hospital
- Royal Infirmary Edinburgh
- St John’s Hospital
- East Lothian Community Hospital
Paediatric Services
- The SMART Centre,
- RHCYP Hospital
- St. Johns Hospital
Patients will be appointed to the most appropriate site to meet their orthotic needs.
At present the team consists of Advanced Orthotists, Orthotists, Admin staff and Technical Staff to provide the range of services in Orthotics across NHS Lothian.
Who to refer:
- All patients who need to be assessed for suitability for provision of an orthosis.
- Patients who have been seen by the orthotic service previously but haven’t had contact with our service for more than 2 years. This group of patients need referral to ensure we have up to date medical information
- See Resources and Links Tab for information regarding Patient Focused Booking (PFB) and Patient Initiated Follow Up (PIFU)
Who not to refer:
The Orthotics Service provides a comprehensive range of orthoses. Referrals for the following will not be accepted due to little or no clinical evidence of their benefit.
Foot/ankle:
- These items can be purchased from high street pharmacies and online retailers
- Silicone heel cups/pads
- Toe spacers /toe protectors
- Bunion protectors or pads
- Sorbothane/shock absorbing insoles
- Heated socks
- Forefoot cushioning pads e.g. silicone cushioning pads
Footwear:
Footwear advice alone.
Patients should be referred to the Orthotic Service to be considered for prescription footwear based on clinical need and when standard footwear is no longer appropriate, due to for example; swelling, rheumatoid disease, deformity, structural/biomechanical change.
The orthotic service does not supply footwear for feet which are simply unusual in size i.e. very wide, very slim, small or large feet.
Knee:
These items can be purchased from high street pharmacies and online retailers
Elasticated knee supports
Neoprene knee supports
Wrist/hand:
These items can be purchased from high street pharmacies and online retailers
Elasticated wrist supports
Neoprene wrist supports
Elbow:
These items can be purchased from high street pharmacies and online retailers
Tennis elbow support/brace
Elasticated elbow support bandage
Shoulder:
These items can be purchased from high street pharmacies and online retailers
Arm sling
Shoulder sling
Neck:
These items can be purchased from high street pharmacies and online retailers
Soft collar
Head:
see information under Resources and Links Tab
Helmets
Head protectors
Spine:
Back protectors
Waist supports
Lifting belts
Maternity:
see information under Resources and Links Tab
Maternity belts
Maternity support belts
Pelvic support belts
Orthoses for sport:
We will not provide an orthoses for the sole intention of participating in sport. In this instance we consider this part of the normal sport equipment and would expect patients to purchase these items themselves.
Most of the above items are easily commercially available either in pharmacies, high street stores or online.
Prosthetic Patients:
All prosthetic patients for artificial limbs should be referred to the Prosthetic service at SMART Centre. Contact 0131 537 9444.
How to refer:
We accept referrals from GP’s via SCI Gateway. We also accept referrals from Consultants and specialist Allied Health Professionals on pre agreed pathways. Patients can self refer to Orthotics if they have been seen within our services within the previous two years.(see PIFU details in Resources and Links Tab)
Referral should include the following:
- Full demographics with contact telephone numbers.
- Nature of condition and duration.
- Relevant past medical history.
- Results of previous x-rays (or other investigations) together with a copy of the reports
How to Contact Orthotics
Orthotics can be contacted via the following telephone numbers:
- SMART Centre, Astley Ainslie Hospital 0131 537 9418/9479 (NRIE, AAH, EL & ML and All Paediatrics in Edinburgh)
- St John’s Hospital, Livingston 01506 522108 (West Lothian patients)
