• Review finds ’unfair’ variation, including waiting times longer than a year
  • Follows concerns raised by Healthwatch

An NHS England review has found “avoidable and unfair inequalities” in access to splints, braces and other orthoses. 

Its report, carried out in response to concerns raised by Healthwatch England and published today, identifies unacceptable variation in provision and commissioning of orthotic services.

Orthotics involves the use of external devices such as splits, braces and insoles to improve body structure and function. These are commonly used by children and older people, and demand is growing linked to the ageing population and long-term conditions.

Data in the NHS England report from 55 providers indicates that, for adults, two had waiting times longer than 50 weeks, and five longer than 20 weeks. For children, one provider had waiting times longer than 50 weeks, and two longer than 20 weeks.

Analysis carried out for the review is “indicative of significant variation and lack of consistency of provision of orthotics services supporting the continued notion of postcode lotteries”, the report says. “For example, referral to treatment waiting times varied from one week to 58 weeks for both adults and children.”

Effective commissioning was found to be hindered by a lack of quality measures and accurate data, the review found.

A foreword by NHS England patient experience director Neil Churchill and chief allied health professions officer Suzanne Rastrick states: “Being able to access the right orthotics equipment, quickly, and with appropriate support, is of paramount importance. Unfortunately, this doesn’t always happen.

“People can find themselves waiting a long time for equipment and develop secondary health complications. Long waiting times mean that children in particular may have grown before their orthotics equipment finally arrives.”

Healthwatch England, escalated concerns about problems with orthotics to NHS England last year.

Based on data from 2004, the report estimated the annual cost of denied and delayed access could be up to £390m.

The report has been published today along with a new service specification and examples of good practice.

Healthwatch England chair Anna Bradley said its local groups had identified “a lack of access to the right orthotic services” which “can have a devastating impact on [people’s] physical and emotional health and wellbeing”. She welcomed the report and said the “onus will now be with local commissioners and services to fully understand their patients’ needs in order to improve”.

“It shows what is possible when the system listens to patients and redesigns services around their needs - people get the care and treatment they are entitled to and the NHS makes much needed efficiency savings,” she said.