1. David Holmes EMEA Business director

2. A simplified version of a complex system

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

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

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

8. Hospital Consultant Orthotics Prosthetics Physiotherapy

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

10. Central Government National Insurance Patient Contribution

11. Pharmacy medication GBP 7.40 Orthotic devices Hosiery GBP 15.30 Fabric supports GBP 37.90 Prosthetics – standard limbs free Rehabilitation equipment - free

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

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

14.  Competitive tenders for bulk purchase  Individually negotiated prices

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

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

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

18. Bio-engineers Doctors Therapists Orthotists/Prosthetists

19. Function Material testing Clinical trials Studies

22. 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

23. Same system as U.K.

24. Mostly qualified physicians Family doctors Physio. And Occupational Therapists

25. 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 35-60 children Euros 75-120 adults

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

27. To return the patient to as near normal function as possible

29. Thank you for your attention