National profile of foot orthotic provision in the United Kingdom, part 2: podiatrist, orthotist and physiotherapy practices

Abstract

BackgroundA national survey recently provided the first description of foot orthotic provision in the United Kingdom. This article aims to profile and compare the foot orthoses practice of podiatrists, orthotists and physiotherapists within the current provision.MethodQuantitative data were collected from podiatrists, orthotists and physiotherapists via an online questionnaire. The topics, questions and answers were developed through a series of pilot phases. The professions were targeted through electronic and printed materials advertising the survey. Data were captured over a 10 month period in 2016. Differences between professions were investigated using Chi squared and Fischer’s exact tests, and regression analysis was used to predict the likelihood of each aspect of practice in each of the three professions.ResultsResponses from 357 podiatrists, 93 orthotists and 49 physiotherapists were included in the analysis. The results reveal statistically significant differences in employment and clinical arrangements, the clinical populations treated, and the nature and volume of foot orthoses caseload.ConclusionPodiatrists, orthotists and physiotherapists provide foot orthoses to important clinical populations in both a prevention and treatment capacity. Their working context, scope of practice and mix of clinical caseload differs significantly, although there are areas of overlap. Addressing variations in practice could align this collective workforce to national allied health policy.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0250-9) contains supplementary material, which is available to authorized users.

Cross-sectional survey of orthotic service provision in the UK: does where you live affect the service you receive?

“…Variances in appointment times were evident between regions and between contracted and inhouse services, with all appointment times relatively short (average times between 18 and 41 min). This finding is confirmed by a recent study which examined foot orthotic provision in the United Kingdom25; reporting that the majority of orthotists (62%) had 15–30 min for clinical assessments and 15% reported having <15 min appointments. These appointment times were significantly lower than those reported for podiatrists and physiotherapists, who were 11.0 and 13.2 times more likely, respectively, to have 45–60 min appointments 25.…”

“…This finding is confirmed by a recent study which examined foot orthotic provision in the United Kingdom25; reporting that the majority of orthotists (62%) had 15–30 min for clinical assessments and 15% reported having <15 min appointments. These appointment times were significantly lower than those reported for podiatrists and physiotherapists, who were 11.0 and 13.2 times more likely, respectively, to have 45–60 min appointments 25. It also supports previous research which reported that when orthotists were asked if they provided AFO–footwear combination tuning 27% said they did not tune due to a lack of time 26.…”

“…In light of this, while we could consider it as a negative that the survey showed that most Trusts/HBs did not have access to facilities for patient assessments, even simple video analysis, given the current short appointment times it would not be feasible for orthotists to use these facilities even if they could access them. As research has found that orthotists reported that they didn’t have adequate time within appointments to complete AFO-footwear combination tuning,26 and that orthotists have significantly shorter appointment times than podiatrists and physiotherapists,25 further research is required to establish if orthotists working in the NHS have sufficient time to complete their patient assessments and design or evaluate a treatment plan.…”

Defining and grouping children’s therapeutic footwear and criteria for their prescription: an international expert Delphi consensus study

“…Despite the historical and relatively common usage of clinical footwear interventions in children with mobility impairment, 5 6 there has been a lack of common understanding of how to define and characterise this intervention. The collective opinion of the expert panel and the consensus formed through the inductive and iterative process of this study allowed novel ideas to be synthesised alongside previously published information.…”

How has the COVID-19 pandemic affected orthotic services in the United Kingdom?

“…In total, 76.6% of respondents reported that the amount of time they had per face-to-face appointment had increased compared with before the pandemic, which is in line with previous research which reported that orthotic appointment times were on average between 15 and 40 minutes which are below the recommended appointment times advised by BAPO. 4,12 Most orthotists surveyed reported that they continued to remain at work during the pandemic, with only 9% (n 5 7) reporting that they were furloughed, all of whom reported being employed by a contractor.…”