Orthotics - FOI Response Register

Is there a prosthetic and / or orthotic service at this Health Board?

Yes

If the answer is ‘Yes’ - please continue to Q2 and the rest of the FOI.

If the answer is ‘No’ - no further information is required thank you.

If you have answered yes to Q1:

Q2. Please confirm how many whole-time equivalent clinicians work in this P&O service?

Number of prosthetists ______0_____________

Number of orthotists ________4 days approximately every 6 week, not fixed WTE

Q3. Is a nationally recognised Service Specification referenced/adopted for delivering this P&O service?

No – no specification currently exists

(1) https://www.england.nhs.uk/wp-content/uploads/2018/08/Complex-disability-equipment-prosthetics-all-ages.pdf

(2) https://www.england.nhs.uk/wp-content/uploads/2015/11/orthcs-serv-spec.docx

Q4. Did the output of 'Job Planning' define the number and role of staff required for the service for either NHS-employed P&O clinicians, or for sub-contract clinicians when the contract was tendered?   I.e. defining time for Patient-focused / Clinical Activity VS CPD/ Supporting Professional Activities time for each role?

Job planning not in place – sessions are purchased from provider but data used for planning model of service.

Q5. Please confirm if the P&O service is delivered by a third-party commercial P&O company?

Yes in part - go to Q6

Q6. Does the specification for this service explicitly require the cost of supporting non-mandatory training, education & development to be built in to the service fee / session fee charged to the Trust/Health board?  Where 'supporting' means, for example, the cost of courses, the cost of supervision, the cost of backfilling the clinicians CPD time.

No 

Q7. Outside the usual requirement for fire safety, information governance, health & safety type training, is protected Training, Education and Development / CPD time built in to the clinic timetable for NHS-employed and/or sub-contracted P&O clinicians in this service?

Yes – protected time is allocated as needed.

Q8. What outcomes do you see when protected time for Training, Education and Development is built in to the clinic timetable for P&O staff in this service?  Tick all that apply 

Good retention of staff

Good morale

Improved patient outcomes

Reduced returns / remakes

More MDT working

More advanced practice roles

More research / evidence

Other (please state) __    Not measured due to size of staff_

Q9. Does the service have any of the following barriers to undertaking protected Training, Education and Development time for the P&O clinicians in this service?   Tick all that apply

No barrier to undertaking protected Training, Education & Development time

Q10. How are the costs of supporting protected Training, Education & Development time funded in the P&O service? – For example, the course costs, the cost of supervision, the cost of backfilling the clinician’s CPD time?  Tick all that apply.

The cost is covered by the Trust/Health board via another form of training budget

Q11. During the last 12 months, on average how much protected Training, Education & Development /CPD time per week was taken per 'preceptor' (up to two years post graduate) - not including admin time related to patient treatment?

No preceptors in the P&O clinical team

Q12. During the last 12 months, on average how much protected Training, Education & Development /CPD time per week was taken per 'graduate' (2-4 years post graduate) - not including admin time related to patient treatment?

No graduates with 2-4 yrs experience in the P&O clinical team

Q13. During the last 12 months, on average how much protected Training, Education & Development /CPD time per week was taken per 'experienced/enhanced practice clinician' (4 years +) - not including admin time related to patient treatment?

In accordance with FOISA s 17(1), NHS Shetland confirms that it does not hold the information requested.

Q14. During the last 12 months, on average how much protected Training, Education & Development /CPD time per week was taken per 'advanced practice clinician' - not including admin time related to patient treatment?

No advanced practice clinicians in the P&O clinical team

Q15. Do all P&O staff in this service have access to Training, Education & Development to support practice across all 4 pillars of practice - clinical practice, education, leadership, evidence & research. Tick all that apply:

N/A

Q16. As part of Training, Education & Development of P&O clinicians, does the service have a preceptorship programme to support new graduates into the working environment?  Where preceptorship is defined as 'support to transition from an educational environment to a clinical setting to develop skills & confidence' (not onboarding / induction) 

Not applicable

Q17. During the preceptorship period (up to 2 years) at what point are new graduates expected to treat their own caseload of triaged patients in this service?

N/A

Q18. Does this P&O service have clinic space to accommodate a graduate during their preceptorship programme and/or when shadowing a senior member of the clinical team? 

N/A

Q19. Have any P&O clinicians in this service used the ‘Apprentice Levy’ to fund enhanced and advanced level practice qualifications?

No

Q20. Does the Trust/Health Board or Integrated Care Board request activity and patient outcome Key Performance Indicators (KPI) to be reported for the P&O service? 

  Yes – activity AND patient outcome KPI data is requested (Go to Q21)

Q21. If patient outcome KPI data is requested, what kind of patient outcomes are requested? Tick all that apply

Patient satisfaction

Q22. Does the service receive more funding if improved patient outcomes are achieved?

No

Q23. Does your patient records system support P&O patient outcome measures to be reported?

Yes

Q24.  Has the service employed support workers or technicians to see patients?

Yes (Skip to Q26)

Q25.  Do the P&O clinicians in this service see low complexity patients who could be seen by a support worker or patient facing technician because the service does not employ a support worker or patient facing technician? 

Yes, clinicians see low complexity patients who could be seen by a support worker or technician

No

Q26. Does the P&O clinical lead for this service have direct communication with the Trusts/Health Boards Lead AHP / Chief AHP / AHP Director/ Director of Therapies and Health Science?

Yes

Q27. Have any P&O clinicians in this service, recently or in the past, applied for a leadership role at the Trust/Health Board outside of the P&O service? 

No, unable to apply as not an NHS employee (sub-contractor)

Q28. To meet growing demand for P&O services, is an increase in overall costs for this service built in to the financial element for this service year on year?

Yes, staff salary increase in line with AfC (Agenda for change) staff costs is built in

Q29.  Has the service employed a graduate apprentice prosthetist or orthotist during the last 24 months?

No – go to Q31.

Q30. What salary do you pay the P&O graduate apprentices in this service during their apprenticeship?

AfC Band 2

AfC Band 3

AfC Band 4

Other (please state) ___________________________________________________

Q31. Does this service follow The British Association of Prosthetists and Orthotists (BAPO) recommended clinic appointment times of 30 minute and 60 minute time slots?

Yes along with 20 minute time slots where appropriate – orthotist may also recommend length of appointment time needed