An Orthosis is a device applied externally to any part of the body to support, correct, prevent or compensate for a skeletal deformity or weakness.  It may also be applied to assist, allow or restrict movement of any part of the body. 
Orthoses fall into many different groups such as:

•    Footwear and Insoles
•    Calipers and Splints
•    Spinal Braces
•    Knee Braces
•    Compression Hosiery

We commonly prescribe corrective insoles, shoe adaptations, footwear and bracing for the lower limb (legs and feet), upper limb (arms and hands) and the spine.
 

An Orthotist is a clinician who has obtained a professional degree qualification in Prosthetics and Orthotics and is required to be registered with the Health and Care Professions Council (HCPC). They assess, measure and provide a range of orthoses, braces and specialist footwear to aid movement, correct deformity and relieve discomfort. They will formulate a prescription to suit a patient’s specific needs working in conjunction with other health professionals such as doctors, physiotherapists, occupational therapists.

Eddie Gordon – Orthotic Service Lead 
Colin Gill – Highly Specialist Orthotist
Angela Myklestad – Specialist Orthotist
Christine Boardman – Admin
Elaine Alexander – Admin
Nadine MacDonald – Admin

There is an orthotic department on each hospital site:

•    Warrington: Surgical Appliances/Orthotic Department, Kendrick Wing, Warrington Hospital, Lovely Lane, Warrington. WA5 1QG
01925 662 446

•    Halton: Captain Sir Tom Moore Buidling (formerly Cheshire and Merseyside Treatment Centre (CMTC)) Outpatients Department,  Halton General Hospital site, Earls Way, Runcorn. WA7 2HH
01928 793 723

Warrington Hospital:

• Monday – Friday: 8.00am-12.00pm and 1.15pm-3.30pm

Captain Sir Tom Moore Building (formerly Cheshire and Merseyside Treatment Centre), Halton Hospital:

• Monday : 9.00am-12.00pm
• Wednesday: 9.00am-12.00pm and 2.00pm-3.30pm
• Friday: 9.00am-12:00noon
   

For your first appointment you will need to be referred by your GP, community allied health professional such as the podiatrist or physiotherapist or a hospital consultant.

You should be referred to the Department of Orthotics within the hospital in which you saw your hospital consultant; Warrington Hospital, The Nightingale Building (formerly Halton Hospital) Captain Sir Tom Moore Building (formerly CMTC.)

Once your referral has been accepted, it will be triaged by the Principal Orthotist based on clinical need and allocated to either the ROUTINE or URGENT waiting list as per referrer request. 

The waiting list is currently 20 weeks.

Access into Orthotics is by referral only.

The majority of people will be seen in the orthotic clinics where they are allocated an appointment time and will see the orthotist who assesses what kind of orthosis would be appropriate for your treatment and will measure and order the orthosis. Once it has been made you will be required to attend a fitting appointment.

What might happen at your first appointment?

Assessment

The orthotist will examine you and assess what the best treatment option is for you. You may need to undress for the assessment and measurement or plaster moulds may be take. Please wear loose clothing and avoid wearing tights.

If you wish, you may bring a relative or friend into the appointment with you.

A small range of orthoses are kept at the hospital.  We may give you one of these at your first appointment.

Most orthoses have to be ordered or made specifically for you.  We order the orthosis you need from different companies which can take some time to come back. One or more further appointments will be required to make sure that it fits properly once it arrives.

What happens after the appointment?

Fitting

When your orthosis is ready, it will be sent back to the orthotic department and you will be asked to come in for a fitting appointment. Due to the long waiting list this may take an additional 2 weeks on top of the time it takes for the orthosis to arrive, for you to be seen. 

A made to measure orthosis can take up to 4 weeks to be made. Footwear takes 6-8 weeks to be manufactured and will be sent back partially completed for you to try them on to make sure they fit you. They are then sent to the factory to be finished which takes 3-4 weeks.

The orthotist will check that the orthosis fits you properly. Adjustments may need to made and if this is the case, the orthotic device/footwear will be sent back.

Supply
When the orthosis has been completed you may be provided with this at your fitting appointment. If this is not possible you will need a supply appointment where your orthosis will be given to you and the orthotist will show you how to use it and look after it.

Reviews
Patients are reviewed on request if they have any problems with their orthosis. We aim to try and get you in as quickly as possible, though high risk patients take priority. 

Please note: If a patient requires a new orthosis a NEW REFERRAL must be sent from the GP, consultant or allied health professional.

Repairs
All repairs to footwear are carried out free of charge to the patient and it is their responsibility to ensure all footwear is kept in a reasonable state of repair. There are no limits to the amount of repairs carried out in a 12 month period. Any shoes bought privately will be charged. Other orthosis can be brought in for refurbishment.

Orthotic Allowances
Provisions of orthoses are limited to each patient as follows:
 

• Adult Footwear - 2 Functional Pairs. The 2nd pair will only be issued after an 8 week trial period has been completed. 
• Adapted Footwear or raises (adults and paediatrics) - 3 only in the first year with 2 further adaptions in any 12 month period thereafter.
• Paediatric Footwear & Piedros - 1 Pair due to rapid growth of wearers.
• Adult Insoles - 1 Pair 
• Paediatric Insoles - 1 Pair, but as required due to growth.
• AFOs - 1 Only 
• KAFOs - 2 (These MUST be serviced every 6 months) 
• Knee Braces - 1 Only 
• Corsets/Abdominal Supports/Truss - 2 (one for wearing and one for washing) 
• Stockings - 1 Pair, and then discharge to GP care
• All other orthoses – 1 only or a pair if required 

Please note if you require specific MTM items these are chargeable as follows unless medically exempt and can show this to your orthotist at your first appointment:

Surigcal Applicance Charges - April 2019 - 2020

• Spinal & Abdominal Supports - £44.55
• Stockings/Tights per pair - £18.00
• Acrylic Stock Wigs - £72.80
• Partial Human Hair Wigs - £192.85
• Full Human Hair Wigs - £282.00

This section provides clinical information for GPs and other healthcare professionals. 

For information for patients and their relatives /carers please see our Patients section 

Referrals are received in the Orthotic department from both Inpatient and Outpatients clinics. On receipt of all referrals they are triaged and then allocated to a clinic. Any referrals which are not appropriate are discussed with the referrer and forwarded to the correct department.

Upon referral the orthotics service will fully assess and provide the required orthoses to stabilise the patient’s condition in line with the treatment pathway - the agreed local access tariff will apply. Once stable the patient will be discharged by the Orthotics service back to the GP with guidance for the on-going management of the patient. Any replacement of prescribed orthoses should be referred back to the service by the GP using the Direct Access pathway.

The orthotic department provide advice and intervention relating to the following appliances:

• Soft collar x 1
• Zimmer collar x 1
• Velcro wrist splints x 1/pair
• Epicondylar clamps x 1
• Lumbar sacral support x 1
• Dorsi Lumbar support x 1
• Knee supports x 1
• Aircast ankle splints  x 1
• Drop foot splints x 1
• Orthopeadic shoes x 2
• Post-operative shoes x 1
• Insoles – Valgus type, metatarsal and/or combined x1

For any specialised orthoses, referrals are required from CONSULTANTS.

Please note if a patient requires new items due to being unrepairable a new referral is required
 

With effect from 1st July 2019, Warrington and Halton Hospitals NHS Foundation Trust will no longer be providing an Orthotic service to "Out of Area" patients. This decision falls in line with other hospital Trusts across the country who adopt a similar practice. Should your consultant require an Orthosis to manage or assess your condition, he will arrange this through your local hospital or GP practice.