1. Service Improvements to Orthotic Services across an Acute Trust Juliet Sturgess BSc MBAPO Orthotist and Orthotics Service Manager Yeovil District Hospital NHS Foundation Trust and Dorset County Hospital NHS Foundation Trust

2. What we’ve achieved Amalgamation of the Orthotics Services in two Acute Trusts Larger Team so more sustainable Fully integrated into MDT– no longer working in silos Improved patient care Financial savings

3. The story behind the changes Prior to 2007; contracted service, Orthotist present only 2 days per week, increasing spend. May 2007, decision to take service in-house. October 2007 in-house service created April 2008, £60000 saving with increased patient satisfaction November 2008 Diabetes Specialist Orthotist employed 2009 – 2012, various service improvements Dorset County Hospital

4. The Yeovil Project 16 week review – one afternoon a week Reviewed all aspects of service –IG –Patient pathways –Referrals –Products –Financial processes –DNA rates –Patient satisfaction Options paper

5. The Options for YDH An in-house orthotics service with shared management YDH could take their orthotics service completely in- house YDH could extend current service contract and insist staff use hospital based IT systems YDH could retender the product and service contracts separately

6. YDH’s Decision An in-house orthotics service with shared management –Directly employ an Orthotist –Share an Orthotics Service Manager –Staff transferred under TUPE from company to NHS –Directly procuring orthotics products –Integrated into MDT –Orthotist present throughout the week

7. What we’ve achieved Amalgamation of the Orthotics Services in two Acute Trusts Larger Team so more sustainable Fully integrated into MDT– no longer working in silos Improved patient care Financial savings