For full details on how to submit a poster for BAPO Conference & Exhibition 2013 please see below, further details at www.bapo.com
The British Association of Prosthetists and Orthotists (BAPO) was established to encourage high standards of prosthetic and orthotic practice. It is committed to Continued Professional Development and education to enhance standards of prosthetic and orthotic care. BAPO is the only UK body that represents the interests of prosthetic and orthotic professionals and associate members to their employers, BAPO enjoys the support of a high majority of the profession as members.
Monday, 18 February 2013
BAPO 2013 Call for Posters - Chance to win £100!
Sunday, 17 February 2013
Printed Prosthetics
Traditionally, amputees have been offered one-size-fits-all prosthetics – functional but not particularly attractive. Now technology is blurring the line between medical devices and sculpture.
http://www.euronews.com/2013/02/13/printed-prosthetics/
Saturday, 16 February 2013
CAD tools for designing shoe lasts for people with diabetes
J Antonio Bernabeu, M Germani, M Mandolini… - Computer-Aided Design, 2013
... 2.3. Orienting and measuring the foot and the last. The InfoHorma (IH) software aims to extract
standard measurements from the geometrical shapes of digitised 3D feet or last models after
they have been aligned. ... 2.4. Modifying last geometry to ensure optimal foot–last fitting. ...
standard measurements from the geometrical shapes of digitised 3D feet or last models after
they have been aligned. ... 2.4. Modifying last geometry to ensure optimal foot–last fitting. ...
Friday, 15 February 2013
Improvements announced in NHS prosthetic care for war veterans
NHS services across the country are set to benefit from additional funding to improve prosthetic and rehabilitation services for ex-servicemen and women.
The government is making £11 million available over the next 2 years to ensure veterans are able to access a high level of prosthetic and rehabilitation care.
Nine NHS facilities across the country will receive a share of up to £6.7 million of the funding. They will be able to use this specifically to access the latest technology and provide the highest quality of prosthetic care for veteran amputees. The centres are:
- Bristol: Disablement Services Centre, North Bristol NHS Trust
- Leicester: Leicester Specialist Mobility Centre, provided by Blatchford Clinical Services on behalf of PCTs
- Sheffield: Mobility and Specialised Rehabilitation Centre, Northern General Hospital
- Carlisle: Disablement Services Centre, Cumberland Infirmary, North Cumbria University Hospitals NHS Trust
- Preston: Specialist Mobility & Rehabilitation Centre, Lancashire Teaching Hospitals NHS Foundation Trust
- Stanmore: Stanmore Prosthetic Rehabilitation Unit, Royal National Orthopaedic Hospital Trust
- Portsmouth: Prosthetic Regional Rehabilitation Department, Portsmouth Hospitals NHS Trust
- Birmingham: West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Trust
- Cambridge: Addenbrooke's Rehabilitation Clinic, Cambridge University Hospitals NHS Foundation Trust
Other services will benefit too, with a £1million fund to ensure that all prosthetics services across England improve. The remainder will go towards providing prosthetics.
Announcing the funding, Health Minister Dr Dan Poulter said:
"Ex-servicemen and women who have been injured in the line of duty deserve the very best possible care from the NHS. This is why we are making more funding available to improve veterans' prosthetic limb services – and £22 million in total between 2010 and 2015 to support veterans' physical and mental health.
"We want to ensure that our Armed Forces veterans have access to the very best healthcare services at specialist prosthetic and rehabilitation centres across the country. In time, these NHS centres will achieve the same high standards of care for veterans that are offered by Armed Forces rehabilitation centres, such as Headley Court."
Today's announcement is in response to recommendations made by Dr Andrew Murrison MP in a report, commissioned by the Prime Minister, about the provision of prosthetics for military amputees.
Dr Murrison recommended that a small number of multi-disciplinary centres should provide specialist prosthetic and rehabilitation services in England to ensure veterans have access to a similar, high quality of care to that which the Armed Forces provides.
Dr Jeff Lindsay, a Consultant in Amputee Rehabilitation at the West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Trust, said:
"Our aim is for ex-service men and women to maintain their level of independence, function and capabilities as they move from the military into civilian life.
"The additional funding will enable us to offer the highest possible standards of prosthetic provision and care for these brave men and women, as they leave the armed forces and their care is transferred to the NHS.
"Furthermore, the additional funding will help to enhance both the knowledge and skills of our expert staff and improve available facilities for the benefit all patients, both ex-servicemen and women and civilians alike."
The additional funding and improvements that this will bring will mean that civilian amputees will also be able to benefit from advanced care in centres across the NHS in England.
The NHS Commissioning Board will work with military charities and the NHS to finalise the amount each service will receive.
Thursday, 14 February 2013
Clinical Responsibility and the Healthcare Professional BAPO short course 11th May 2013 BAPO Secretariat
Due to technical difficulties please use the link below for further information on the 'Clinical Responsibility and the Healthcare Professional' BAPO short course.
Further Information
Further Information
Wednesday, 13 February 2013
Clinical Responsibility And The Healthcare Professional - (Medico Legal) - BAPO Short Course on Saturday 11th May 2013
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NHSAcronym – the handy app at your fingertips
Download the new NHSAcronym app to your iPhone or iPad so you have the definition of over 500 commonly used acronyms in the NHS at your fingertips. Just search 'NHSAcronym' in the iTunes app store.
Wednesday, 6 February 2013
Life After Stroke Awards - Professional Excellence Award
The Stroke Association organises the Life After Stroke Awards to recognise the courage and determination of those people whose lives have been affected by stroke. The 2013 Life After Stroke Awards will be held on 26 June at The Dorchester, London.
This year sees the introduction of a new category – The Professional Excellence Award – you may like to nominate a colleague who has provided exceptional service in the provision of stroke care or prevention.
Nominations for the Life After Stroke Awards 2013 are open until 1 March 2013. Visit www.stroke.org.uk/lasa to nominate now. If you would like to be sent a nomination form in the post please email lasa@stroke.org.uk.
The Stroke Association has announced that Apprentice star, Businesswoman and West Ham boss, Karren Brady, is the charity's first Life After Stroke Awards Patron. She said: "I am thrilled and delighted to be the first LASA Patron and am calling on everyone affected by stroke to nominate someone they know for these very special awards.
BRITISH ASSOCIATION OF PROSTHETISTS AND ORTHOTISTS NOMINATIONS FOR EXECUTIVE COMMITTEE
At the Annual General Meeting in Telford on 23 March 2013 the elections for Executive Committee members will take place.
Three members of the committee have or will stand down, namely: Nigel Jones, John Head and Suzanne Faulkner. One member wishes to stand for election, namely: Nicola Eddison. The following members will remain on the committee; Steve Mottram, Jonathan Bull, Pamela Coulton, Sandie Waddell, Ian Jones and Paul Charlton thus nominations are invited for four vacancies.
A nominee must be a fully paid up Full Member and their nomination must be proposed and seconded by two current Full Members of the Association.
Nominations should be signed by the nominee, proposer and seconder. A summary of no more than 100 words should be attached, indicating:
· who the nominee is
· what they have done for the profession
· why they wish to be elected
· and how they see the profession and the Association going in the next two years
This should be addressed to the Secretary at the BAPO Secretariat to arrive by Friday 8 February 2013 (extended deadline date). It would be appreciated if nominations could be sent in as soon as possible.
Saturday, 26 January 2013
Friday, 18 January 2013
Critical Appraisal Skills BAPO Short Course 19 April 2013 Staffordshire University
For further information on the 'Critical Appraisal Skills' BAPO Short Course please follow the link below.
Further information
Further information
Wednesday, 16 January 2013
BAPO Short Course Kinesio Taping 21 & 22 June 2013
For further information on the 'Kinesio Taping' BAPO short course please follow the link below.
Further Information
Further Information
Jeremy Hunt challenges NHS to go paperless by 2018
The NHS should go paperless by 2018 to save billions, improve services and help meet the challenges of an ageing population, Health Secretary Jeremy Hunt will say today. In a … Read more → - Jeremy Hunt challenges NHS to go paperless by 2018
Outcomes
Responsiveness of the Manchester-Oxford foot questionnaire (MOXFQ) compared with AOFAS, SF-36 and EQ-5D assessments following foot or ankle surgery
J. Dawson, I. Boller, H. Doll, G. Lavis, R. Sharp, P. Cooke, and C. Jenkinson J Bone Joint Surg Br 2012;94-B 215-221
Quote: The responsiveness of the Manchester–Oxford Foot Questionnaire (MOXFQ) was compared with foot/ankle-specific and generic outcome measures used to assess all surgery of the foot and ankle. We recruited 671 consecutive adult patients awaiting foot or ankle surgery, of whom 427 (63.6%) were female, with a mean age of 52.8 years (18 to 89). They independently completed the MOXFQ, Short-Form 36 (SF-36) and EuroQol (EQ-5D) questionnaires pre-operatively and at a mean of nine months (3.8 to 14.4) post-operatively. Foot/ankle surgeons assessed American Orthopaedic Foot and Ankle Society (AOFAS) scores corresponding to four foot/ankle regions. A transition item measured perceived changes in foot/ankle problems post-surgery. Of 628 eligible patients proceeding to surgery, 491 (78%) completed questionnaires and 262 (42%) received clinical assessments both pre- and post-operatively. The regions receiving surgery were: multiple/whole foot in eight (1.3%), ankle/hindfoot in 292 (46.5%), mid-foot in 21 (3.3%), hallux in 196 (31.2%), and lesser toes in 111 (17.7%). Foot/ankle-specific MOXFQ, AOFAS and EQ-5D domains produced larger effect sizes (> 0.8) than any SF-36 domains, suggesting superior responsiveness. In analyses that anchored change in scores and effect sizes to patients' responses to a transition item about their foot/ankle problems, the MOXFQ performed well. The SF-36 and EQ-5D performed poorly. Similar analyses, conducted within foot-region based sub-groups of patients, found that the responsiveness of the MOXFQ was good compared with the AOFAS.
This evidence supports the MOXFQ's suitability for assessing all foot and ankle surgery.
Tuesday, 15 January 2013
Foot posture is associated with morphometry of the peroneus longus muscle, tibialis anterior tendon, and Achilles tendon
Scandinavian Journal of Medicine & Science in Sports
Abstract
The aim of this study was to investigate the association between foot type and the morphometry of selected muscles and tendons of the lower limb. Sixty-one healthy participants (31 male, 30 female; aged 27.1 ± 8.8 years) underwent gray-scale musculoskeletal ultrasound examination to determine the anterior-posterior (AP) thickness of tibialis anterior, tibialis posterior, and peroneus longus muscles and tendons as well as the Achilles tendon. Foot type was classified based on arch height and footprint measurements. Potentially confounding variables (height, weight, hip and waist circumference, rearfoot and ankle joint range of motion, and levels of physical activity) were also measured. Multiple linear regression models were used to determine the association between foot type with muscle and tendon morphometry accounting for potentially confounding variables. Foot type was significantly and independently associated with AP thickness of the tibialis anterior tendon, peroneus longus muscle, and Achilles tendon, accounting for approximately 7% to 16% of the variation. Flat-arched feet were associated with a thicker tibialis anterior tendon, a thicker peroneus longus muscle, and a thinner Achilles tendon. Foot type is associated with morphometry of tendons that control sagittal plane motion of the rearfoot; and the peroneus longus muscle that controls frontal plane motion of the rearfoot. These findings may be related to differences in tendon loading during gait.
Monday, 14 January 2013
Adaptable prosthetics for amputees
Approximately one in every 1,000 people in the UK is an amputee. Many lose their limbs as the result of tragic accidents or due to active military combat and for some amputees losing a limb is a loss of freedom.
Bryce Dyer (pictured) is part of a team of design engineers and clinicians studying prosthetics at BU’s Design Simulation Research Centre: “Many prosthetic limbs remain unused simply because they can be so uncomfortable over time,” he says.
Fitting a false limb is currently “a bit of a black art” says Dyer. Prosthetists traditionally require decades of experience to do their job successfully and are dependent upon the subjective feedback of patients, with no other method of measuring fit. Additionally, current technology does not allow for changes in volume – patients’ stumps may swell and contract. “It’s like having your feet change size on a daily basis and expecting your shoes to still fit comfortably,” says Dyer.
Led by Professor Siamak Noroozi, the BU team are turning an academic concept into a practical product that could lessen the misery of thousands of amputees.
They are creating a ‘smart socket’ – a lower-limb prosthetic which can adjust itself to fit the changing shape of the limb stump it connects with. The design team say the fit will be so comfortable that amputee servicemen may even be able to return to active combat.
Calling on combined expertise, BU’s School of Design, Engineering and Computing is using artificial intelligence to create a self-learning system that will measure interactions between socket and limb stump during the fitting and wear.
“It is very much at a research and development stage,” says Dyer. Currently the team are also attempting to miniaturise the technology to make it light and portable as well as incorporating wireless technology.
BU scientists have teamed with commercial partners at prosthetics and orthotics supplier Chas A Blatchford & Sons, who work with the Ministry of Defence Medical Rehabilitation Centre in Surrey, where injured soldiers are sent following service in Afghanistan and Iraq.
“One of the great things about this industrial partnership is that we will be able to get feedback from the very kind of people we are trying to help,” says Dyer.
With better fitting false limbs, medical costs will fall, say BU designers. Prosthetists will be able to get it right first time and will require less experience to be able to do their job properly. Being agile enough to return to active service is a huge bonus for the rising numbers of amputee soldiers. “It will get them back in the field rather than being retired early or restricted in what they can do,” says Dyer.
Understanding how elite sprinters perform with artificial limbs or “blades” and how different types of prostheses compare is central to another strand of Dyer’s research. “Paralympic running world records are still being set on a near annual basis – the sport hasn’t settled down yet. I’m looking at how individuals should be grouped together or separated – how to give the fairest possible race.”
As well as informing future Paralympic Committees, the research will apply to disability in sport in general. Should someone who’s lost both limbs compete against a runner missing just one limb, for example? And how should technology be categorised, when variations in quality of false limbs may create substantial differences among international athletes?
“Some 30 years ago, it was all about enabling disabled people to take part in sport,” says Dyer. “But now the quality of performances and the sums of money involved are so great, there’s much more at stake. We don’t want to restrict technology but we need to find a way to measure it.”
Source: http://buresearchchronicle.org.uk/theme/technology/adaptable-prosthetics-for-amputees/
Tuesday, 8 January 2013
Triple Amputee takes on the Dakar Rally 2013
Ex-paratrooper Tom Neathway lost both legs and an arm in an explosion in Afghanistan but is tackling this grueling 5,000-mile race across South America.
This is the 34th edition of the race, which started in Lima on January 4 and ends in Chile on January 20.
There is the fund-raising side. Tom will be raising hopefully £1million for Help For Heroes and Tedworth House, one of the five recovery centres set up in partnership between the Ministry of Defence, Help for Heroes and the Royal British Legion.
Source: http://www.mirror.co.uk/sport/other-sports/dakar-rally-2013-preview-tom-1519172#comments
Sunday, 6 January 2013
UK's first hand transplant operation
A former pub landlord from West Yorkshire has become the first person in the UK to have a hand transplant.
Mark Cahill, who is 51, had been unable to use his right hand after it was affected by gout.
This procedure allowed very accurate restoration of nerve structures and is believed to be the first time this approach has been used, surgeons said.
Consultant plastic surgeon Professor Simon Kay, who led the surgical team, said: "This operation is the culmination of a great deal of planning and preparation over the last two years by a team including plastic surgery, transplant medicine and surgery, immunology, psychology, rehabilitation medicine, pharmacy and many other disciplines.
"The team was on standby from the end of November awaiting a suitable donor limb, and the call came just after Christmas.
Doctors say he is making good progress after an eight-hour operation at Leeds General Infirmary.
It is still very early to assess how much control of the hand will be gained - so far he can wiggle his fingers, but has no sense of touch.
Source: http://www.bbc.co.uk/news/health-20898940
http://news.sky.com/story/1033091/hand-transplant-completed-for-first-time-in-uk
Sunday, 30 December 2012
Failings in diabetes care 'cost thousands of lives'
'Diabetes care depressingly poor, say MPs', is the headline on the BBC News website. This is the damning verdict of a parliamentary report into standards of diabetes care in the NHS. The Public Accounts Committee reported that (in the words of the Daily Mail), "24,000 with diabetes 'are dying needlessly'".
The report was published by the Public Accounts Committee (PAC) – an influential group of MPs who have been given an oversight role to help ensure that taxpayers get value for money.
Based on official figures and spoken and written evidence from independent diabetes experts and officials, the PAC has set out recommendations for improved diabetes care in the NHS.
The report indicates that the NHS spent an estimated £3.9 billion on diabetes services in 2009/10. However, 80% of the costs are estimated to come from the management and treatment of avoidable diabetes-related complications, such as kidney disease and foot ulcers.
The report highlights that the number of people with diagnosed and undiagnosed diabetes is 3.1 million, set to rise to 3.8 million by 2020. This projected increase is likely to have a significant impact on NHS resources, the committee says.
The report accepts that there is consensus about what needs to be done for people with diabetes. However, progress in actually delivering the recommended standards and achieving treatment targets has been 'depressingly poor', it says.
Who produced the report?
The report, 'Department of Health: The management of adult diabetes services in the NHS' has been published by the PAC.
The PAC is made up of MPs appointed by the House of Commons, and is responsible for overseeing government expenditures to ensure transparency, value for money, and accountability in government financial operations.
What are the main findings?
The main findings of the report are:
- an estimated 80% of the costs of diabetes come from the management and treatment of avoidable diabetes-related complications (such as diabetic eye disease and kidney disease)
- the Department of Health estimates that up to 24,000 people with diabetes are dying each year from causes that could be avoided through better management of their condition
- only half of people with diabetes receive all the basic tests to monitor their condition, and failure to carry out these simple checks heightens the risk of developing complications
- less than one in five people with diabetes have achieved the recommended levels for blood glucose, blood pressure and cholesterol
- despite the Department of Health improving information on diabetes, this information is not being used effectively to assess and improve the quality of care
- many people with diabetes develop avoidable complications because they are not effectively supported to manage their condition and do not always receive care from appropriately trained professionals across primary and secondary care
- the projected increase in the diabetic population could have a significant impact on NHS resources
The report states that the reasons these problems have arisen include:
- the fact there is no strong national leadership – each Primary Care Trust is largely 'left to their own devices' when it comes to how they decide to tackle diabetes
- there are no effective accountability arrangements for commissioners (those in charge of allocating funds to particular services)
- there are no appropriate performance incentives (rewards, usually financial, designed to encourage best practice) for the providers of diabetes care
Source: http://www.nhs.uk/news/2012/11November/Pages/Failings-in-diabetes-care-cost-thousands-of-lives.aspx
£5 million for veterans in need of new prosthetics
The Department of Health has £5 million available to spend on new prosthetics centres for veterans in 2013. The money is part of a £22 million package to support veterans' physical and mental health from 2010 to 2015.
So far this year, 32 veterans applied to get high specification prosthetic equipment, such as computer controlled knee units and specialist feet. The Department of Health has committed to funding clinically appropriate prosthetics for any veteran in England who has lost a limb in the service of their country.
There are currently an estimated 1,335 veteran amputees in the United Kingdom with the majority living in England. The Government wants to raise awareness of this funding so that all veterans who have lost a limb in the service of their country can benefit from the extraordinary, life-changing work the NHS can do with prosthetics. Find out more
Friday, 28 December 2012
NHS Pension Scheme contributions calculator for 2013-14 published
An NHS Pension Scheme contributions calculator for 2013-14 employee contributions has been published today. The employee contributions calculator enables NHS Pension Scheme members to calculate how much their contributions will increase, if at all, on a monthly basis, on both a gross and net of tax relief basis.
View the NHS Pension Scheme contributions calculator for 2013-14
Wednesday, 26 December 2012
Disabled boy, 4, receives prosthetic blade for Christmas just like his hero Jonnie Peacock
Rio Woolf, from Bushy Heath in Hertfordshire, had to have his lower right leg amputated after being born without a tibia, knee or ankle joint.
Full Story:
http://www.dailymail.co.uk/health/article-2253006/Disabled-boy-receives-prosthetic-blade-Christmas-just-like-hero-Jonnie-Peacock.html
Full Story:
http://www.dailymail.co.uk/health/article-2253006/Disabled-boy-receives-prosthetic-blade-Christmas-just-like-hero-Jonnie-Peacock.html
Thursday, 20 December 2012
NHS Mandate published
The first Mandate between the Government and the NHS Commissioning Board, setting out the ambitions for the health service for the next two years, was published on 13 November 2013.
The Mandate reaffirms the Government's commitment to an NHS that remains comprehensive and universal – available to all, based on clinical need and not ability to pay – and that is able to meet patients' needs and expectations now and in the future.
The NHS Mandate is structured around five key areas where the Government expects the NHS Commissioning Board to make improvements:
- preventing people from dying prematurely
- enhancing quality of life for people with long-term conditions
- helping people to recover from episodes of ill health or following injury
- ensuring that people have a positive experience of care
- treating and caring for people in a safe environment and protecting them from avoidable harm.
Through the Mandate, the NHS will be measured, for the first time, by how well it achieves the things that really matter to people.
The key objectives contained within the Mandate include:
- improving standards of care and not just treatment, especially for the elderly
- better diagnosis, treatment and care for people with dementia
- better care for women during pregnancy, including a named midwife responsible for ensuring personalised, one-to-one care throughout pregnancy, childbirth and the postnatal period
- every patient will be able to give feedback on the quality of their care through the Friends and Family Test starting from next April – so patients will be able to tell which wards, A&E departments, maternity units and hospitals are providing the best care
- by 2015 everyone will be able to book their GP appointments online, order a repeat prescription online and talk to their GP online
- putting mental health on an equal footing with physical health – this means everyone who needs mental health services having timely access to the best available treatment
- preventing premature deaths from the biggest killers
- by 2015, everyone should be able to find out how well their local NHS is providing the care they need, with the publication of the results it achieves for all major services.
Health Secretary, Jeremy Hunt said:
"Never in its long history has the NHS faced such rapid change in our healthcare needs, from caring for an older population, to managing the cost of better treatments, to seizing the opportunities of new technology.
"This Mandate is about giving the NHS the right priorities to deal with those challenges. By focusing on what matters to patients, and giving doctors and other professionals the freedom to deliver, we will make sure the NHS stays relevant to our needs and continues providing the best possible care for us all."
The Mandate has been drawn up following consultation with the public, health professionals and key organisations across the health system between July and September 2012.
Read the following documents:
- The Mandate: A mandate from the Government to the NHS Commissioning Board: April 2013 to March 2015
- The Government's response to the consultation on the draft mandate to the NHS Commissioning Board
- Equality Analysis
- Reference document for policy impact assessments
- Financial Directions to the NHS Commissioning Board
National Clinical Director Posts
AHPs are being encouraged to apply for National Clinical Director (NCD) posts. The post holders will take the clinical lead in driving improvement in quality across all relevant domains of the NHS Outcomes Framework. As part of that the NCD will be the architect of and responsible for successful design and delivery of a suite of commissioning tools to support system, professional and care pathway changes at a national and local level. The NCD will work collaboratively with other NCDs to ensure there is coherent commissioning guidance across CCG and specialised commissioned services. This is a great opportunity for Prosthetists and Orthotists to get involved in key roles that can influence services. Roles are by secondment and include:
Informatics
Maternity and Children
Mental Health
Urgent Care
Stroke
Rehab and Recovery in the community
Trauma
Spinal
MSK
Integration and Frail elderly
Dementia
CVD
Diagnostics and Imaging
Obesity and Diabetes
Renal
Heart disease
Enhanced recovery and critical care
Application is through the NHS Jobs site.
Friday, 14 December 2012
BAPO Conference & Exhibition 2013 - Early Bird Ends 31 December 2012
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Thursday, 13 December 2012
Review of NHS critical infrastructure risk initiated
A review of critical infrastructure risk (CIR) has been initiated to support the commitments under the NHS Constitution for the NHS 'to provide services from a clean and safe environment that is fit for purpose based on national best practice'. It may be risking regulatory requirements to ensure service users are protected against risks associated with 'unsafe and unsuitable premises'.
The review will build on existing practices, such as how backlog maintenance is currently determined, and ensure a system is put in place for the future that gets to the heart of the investment required to address risks that are critical.
NHS organisations are invited to participate in the Review of the NHS' recurrent reporting of a need for significant investment in maintenance of its facilities. This is to eliminate 'critical risks' to the safety of patients, visitors and staff; and the resilience of its services.
Monday, 10 December 2012
Creating change: Innovation health and wealth one year on
The report, "Creating change: Innovation health and wealth one year on" provides an update on the implementation of the NHS Chief Executive's report "Innovation health and wealth, accelerating adoption and diffusion in the NHS" published in December 2011.
The first report set out delivery for spreading innovation quickly and at a scale throughout the NHS. 'Creating change' demonstrates the progress that is being made at a time of great change in the NHS. It highlights what more should be done to deliver the improvements needed to fully embrace and embed innovation in the NHS and improve outcomes and quality for patients and the NHS and drive growth for the UK.
Read Creating change: Innovation health and wealth one year on
New national model to tackle variation in specialist healthcare services
For the first time patients requiring specialised treatment can look forward to the same level and standards of care. The NHS Commissioning Board has published the new Operating Model for commissioning specialised services setting out how a single, national system will ensure patients are offered consistent, high quality services across the country. The number of patients requiring specialised services is small with services located in specialist centres in major towns and cities across England. Concentrating services to provide the same national standards of quality will ensure that specialist staff can be more easily recruited and the necessary levels of training maintained. The new Operating Model and associated Commissioning Intentions mark a clear move away from regional commissioning to a single national approach to both commissioning and contracting. By bringing together the current ten different systems for commissioning specialised services, it provides the opportunity to innovate and introduce new technologies to benefit patients and improve health outcomes in a systematic way. Underpinning the Operating Model are the Commissioning Intentions for 2013/14 ensuring for the first time that the delivery, quality and access for all prescribed specialised services is standard across the country. Ian Dalton, Chief Operating Officer and Deputy Chief Executive at the NHS Commissioning Board said, "This improved system will ensure national consistency in accessing services, reduce variation, and set clear quality standards leading to better health outcomes for patients. It will also allow us to start developing an outcomes framework for rare and specialised conditions, thus starting to move the focus of our discussions with providers from contract inputs to health outcomes. "This is a real opportunity to dramatically improve the way we provide services for people with rare and specialised conditions through having clearly articulated standards for services. "Our next step will be to shortly launch a public consultation on the first ever set of national service specifications and clinical policies for specialised services. This will be the first time we have had clear national policy and sets our clear intention for the future" The new system will provide a clear focus on a range of rare conditions and low volume treatments ranging from medical genetics, kidney disorders and uncommon cancers to complex cardiac interventions, burn care and some specialised services for children. James Palmer, the new Clinical Director for Specialised Services at the NHS Commissioning Board said, "Strong clinical involvement has been central to the development of this approach. We are working closely in partnership with Clinical Commissioning Groups and colleagues on the frontline to ensure the whole patient pathway is as seamless and locally responsive as possible in meeting patients' needs." Specialised services accounts for approximately 10% of the total NHS budget and accounts for approximately £11.8 billion per annum. More information is available in the specialised commissioning resources area. |
Friday, 7 December 2012
Latest NHS Commissioning Board CCG bulletin 27 November 2012
Latest CCG bulletin published by the NHS Commissioning Board.
The NHS Commissioning Board has published its latest bulletin for CCGs from Dame Barbara Hakin, national director for commissioning development.
Tuesday, 4 December 2012
Contractual ‘duty of candour’ to drive a more open NHS culture
New rules to toughen transparency in NHS organisations and increase patient confidence have been announced by Health Minister Dr Dan Poulter following a public consultation. The government will create regulations that require the NHS Commissioning Board to include a contractual duty of openness in all commissioning contracts from April 2013.
This means that NHS organisations will be required to tell patients if their safety has been compromised, apologise, and ensure that lessons are learned to prevent them from being repeated. Although all NHS organisations are currently expected to be open about mistakes, there is no contractual duty to hold them to account when this does not happen.
Dr Dan Poulter said:
"The importance of an open culture cannot be underestimated. We expect that Robert Francis will make further recommendations on duty of candour when the Mid Staffordshire Inquiry has been published, and we are committed to taking whatever further action we think is needed as a result. But we cannot simply wait when there are things we can already do – creating this contractual duty of candour now ensures that NHS contracts for the next financial year will champion patients' rights to always have basic honesty from our NHS, as well as safe care."
The responses to the public consultation and the government's analysis of them have now been published, alongside the impact assessment and equalities analysis of the proposed contractual duty of candour.
Sunday, 2 December 2012
Relationship Between Tightness of the Posterior Muscles of the Lower Limb and Plantar Fasciitis
Yolanda Aranda Bolívar, Pedro V. Munuera Martínez, and Juan Polo Padillo
Abstract
Background: The aim of this study was to determine whether tightness of the posterior muscles of the lower extremity
was associated with plantar fasciitis.
Methods: A total of 100 lower limbs of 100 subjects, 50 with plantar fasciitis and 50 matching controls were recruited.
Hamstring and calf muscles were evaluated through the straight leg elevation test, popliteal angle test, and ankle dorsiflexion
(knee extended and with the knee flexed). All variables were compared between the 2 groups. In addition, ROC curves,
sensitivity, and specificity of the muscle contraction tests were also calculated to determine their potential predictive
powers.
Results: Differences between the 2 groups for the tests used to assess muscular shortening were significant (P < .001) in
all cases. The straight leg elevation test and ankle dorsiflexion with the knee extended presented respective sensitivities of
94% and 100% and specificities of 82% and 96% as diagnostic tests for the participants in this study.
Conclusion: Tightness of the posterior muscles of the lower limb was present in the plantar fasciitis patients, but not in
the unaffected participants.
Clinical Relevance: The results of this study suggest that therapists who are going to employ a stretching protocol for
treatment of plantar fasciitis should look for both hamstring as well as triceps surae tightness. Stretching exercise programs
could be recommended for treatment of plantar fasciitis, focusing on stretching the triceps surae and hamstrings, apart from
an adequate tissue-specific plantar fascia-stretching protocol.
Level of Evidence: Level III, case control study.
--
Jonathan
Thursday, 29 November 2012
Rocket-Powered Prosthetics Will Allow Us to Compete With Our Robot Masters
The world of prosthetics is reaching critical turning point. Though the goal in the field has always been to replicate and replace human limbs as accurately as possible, we're now able to see a future where mechanical enhancements may make people stronger and faster than when they were whole. There's no reason why prosthetic-wearers shouldn't be allowed to live as discrete super-human cyborgs, though. Researchers at the University of Alabama are trying to make their new rocket-powered ankle more discrete than those controversial prosthetic blades from a few years back.
Most prosthetic leg-wearers are forced to make a choice when picking an artificial limb: Either choose a light, inanimate object, or an extremely heavy model that features a motor and power supply able to simulate the action of taking a step. The designers behind the rocket-powered ankle are trying to make the best of both worlds, building a lightweight frame that can house something powerful enough to generate a natural-feeling walking motion.
The key to making a lighter self-propelled prothetic, it seems, is actually the fuel. The "rocket-ankle" uses a special liquid fuel called "monorepellant," which can be activated with only a very small amount of catalyst. The minimalistic fuel-type cuts out a lot of the mechanical elements that weigh down most active prosthetics. The ankle also uses a sleeve muscle actuator, an artificial muscle designed to allow for a more natural-feeling stride.
Of course, there are still problems. For starters, the ankle produces a fair amount of hot exhaust. The device also may or may not have a tendency to overheat, which I would assume can get pretty uncomfortable. According to the University, designers hope that the leg will be at least theoretically functional, if not actually in use, by 2016. More importantly, the designers say that, for better or worse, the ankle is being built to simulate human motion, and not turn people into cyborg super-heroes.
Source: http://www.geekosystem.com/rocket-powered-prosthetics/
Tuesday, 27 November 2012
Influence of malalignment on socket reaction moments during gait in amputees with transtibial prostheses
Highlights
► Effect of malalignment on socket reaction moments in transtibial prostheses was investigated. ► Socket reaction moments were measured at the base of a socket using an instrumented prosthesis alignment component. ► Both coronal and sagittal malalignment significantly affected the socket reaction moments. ► Socket reaction moments could be biomechanical effects of prosthetic malalignment.
Abstract
Alignment – the process and measured orientation of the prosthetic socket relative to the foot – is important for proper function of a transtibial prosthesis. Prosthetic alignment is performed by prosthetists using visual gait observation and amputees' feedback. The aim of this study was to investigate the effect of transtibial prosthesis malalignment on the moments measured at the base of the socket: the socket reaction moments. Eleven subjects with transtibial amputation were recruited from the community. An instrumented prosthesis alignment component was used to measure socket reaction moments during ambulation under 17 alignment conditions, including nominally aligned using conventional clinical methods, and angle perturbations of 3° and 6° (flexion, extension, abduction, and adduction) and translation perturbations of 5
mm and 10mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. Coronal alignment perturbations caused systematic changes in the coronal socket reaction moments. All angle and translation perturbations revealed statistically significant differences on coronal socket reaction moments compared to the nominal alignment at 30% and 75% of stance phase (P<0.05). The effect of sagittal alignment perturbations on sagittal socket reaction moments was not as responsive as that of the coronal perturbations. The sagittal angle and translation perturbations of the socket led to statistically significant changes in minimum moment, maximum moment, and moments at 45% of stance phase in the sagittal plane. Therefore, malalignment affected the socket reaction moments in amputees with transtibial prostheses.
Source: http://www.gaitposture.com/article/S0966-6362(12)00374-8/abstract
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