David Holmes EMEA Business director

A simplified version of a complex system

Family Doctor Shop Pharmacy Blood tests Nurse X-ray Physio- therapy Hospital consultant

Very few exist due to improved hospital and private facilities offering better technology and expertise

Only sell wheelchairs, walking aids, crutches, seating accessories etc. Only to the private market Orthotics/Prosthetics/Rehabilitation equipment supplied from hospitals or specialist centres.

Hospital Consultant Orthotics Prosthetics Physiotherapy

University education at O&P colleges 3 Years plus 2 years intern Option of extra year to obtain Masters Degree

Central Government National Insurance Patient Contribution

Pharmacy medication GBP 7.40 Orthotic devices Hosiery GBP Fabric supports GBP Prosthetics – standard limbs free Rehabilitation equipment - free

Individual hospitals control their own budget for the provision of orthotics, prosthetics and rehabilitation equipment

 Mainly private companies  Competitive tenders (1-5 years) for service and/or products  Few government workshops - excluded from tender process

 Competitive tenders for bulk purchase  Individually negotiated prices

Hospital Care Home with resident nursing staff Patient’s own home Team decision

Equipment installed Visiting nurses (24 hours if necessary) Visiting therapists Transport for hospital visits

National Institute for Clinical Excellence N.I.C.E. Cost effectiveness Product testing

Bio-engineers Doctors Therapists Orthotists/Prosthetists

Function Material testing Clinical trials Studies

Sweden is divided into 20 County Councils each having its own O&P facility 7 owned by County Councils 13serviced by private companies selected by tenders (3-5 years) Facilities situated mainly in major hospitals

Same system as U.K.

Mostly qualified physicians Family doctors Physio. And Occupational Therapists

Custom made orthotics and prosthetics funded by Social Security (Taxation) Ready made supports called “self care devices” partly paid by patients (Euros 25-65) Orthopaedic Shoes Patient pays Euros children Euros adults

Chronic patients (rheumatoid arthritis, diabetes, stroke etc) free of charge Amputee patients receive limbs free

To return the patient to as near normal function as possible

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