limb fitting centres
“Our aim is very
much to optimise an
individual’s care. To
do this we don’t just
look at their medical
and physical needs”
out what will be the right
prosthesis for them,” he says.
“We will also take a good
look at the prosthesis they’re
currently using. Some people
may use a number of different
ones. We’ll analyse which an
individual uses most and why,
take a look at their favourite
components and sockets,
and if there’s anything they
really like or dislike, we’ll
make sure our prosthetist
replicates (or avoids) it.”
Your career and hobbies
will also be taken into account by Dr Jepson and his
team. “There’s no stopping most of our patients – they
just want to get on with their lives,” he says. “So once
the initial consultation is done, we get straight on
to making the right prosthesis for that individual –
although many people are already quite happy with
their set up.” The next step is a session with the expert
Multi-Disciplinary Team, known as the MDT.
Meeting the Multi-Disciplinary Team
Once Dr Jepson’s team has established exactly what
you need, it is the job of the MDT to turn that into
a reality. “The Preston centre has a very big team,
with 26 staff in amputee rehabilitation alone, and
many more working on the admin side,” he says.
After the consultation a number of people are
available to provide help, direction and support.
Occupational Therapists help patients get used to
their new prosthetics and show them how to use them
correctly, as well as helping people to learn how to
walk and exercise again. Technicians working on site
at the centre design and build each prosthesis to
bespoke, carefully-tailored specifications. Other experts
are on hand to address any wheelchair needs, while
psychologists are available to help with any issues.
“Every patient is different, with different needs,”
says Dr Jepson. “Some have complex trauma and need
lots of help, while others just need a little fine-tuning.
The main thing is that we are a very cohesive team,
communicating and working to improve patient care.”
means if a patient is getting a new socket, for example,
or has a particular issue, it can be addressed that
week.” These changes were put in place at Preston
before the Murrison Report, a Government review
recommending investment of a further £15m into
prosthetics services for veterans, was published in
June 2011. But the report has given more access to
the Veterans Prosthetic Panel.
“If we can demonstrate that a patient would have
an improved quality of life with a certain component,
even if that might be expensive or difficult to get on
the NHS, we can access the necessary funds relatively
quickly through the Panel, who discuss and adjudicate
these matters regularly,” says Dr Jepson. “It allows us
to support our patients and offer them appropriate
technology quickly. We’re very proactive here on that
front – Preston has made more applications to the
Panel than any other Limb Fitting Centre.”
Keeping active
Preston’s proactive approach focuses on enabling
patients to lead fulfilling lives, and it is certainly
working. “We find that the younger veterans and
BLESMA Members are so active, they don’t intend
to let anything stop them from achieving their goals,”
says Dr Jepson. “They are an impressive bunch of men
and women, and they maintain such high activity
levels and have such high aspirations that we have
to make sure we keep up with them and match their
expectations. These are people who are out running
marathons, jumping out of aeroplanes, teaching
anything from skiing to golfing to rafting – they don’t
let up and need the right equipment for the job.”
To make sure nobody ever gets stopped in their
tracks by malfunctioning equipment Preston has
a policy which states that every patient must have
at least two prosthetists assigned to them. “So it’s not
like when your dentist goes on holiday and you can’t
see them,” says Dr Jepson. “It works very well. We had
a patient the other week who had broken his prosthetic
leg playing rugby – we patched it up immediately, and
concentrated on making a new leg at a later date.
“With other people, we work on specialist prosthetics.
We have made a water activity leg for a scuba diving
instructor, and we have very recently given someone
an electronic hand, which he is already becoming
incredibly skilled at using. The world of prosthetics
is constantly changing, and we’re changing with it.”
Recent changes
Preston is a model of organisation, with a brand-new
computer system created inhouse to make sure no patient
is ever overlooked. “We can find
out who all our veterans are
In 2010 Andrew Murrison was tasked with reviewing mental healthcare
at the touch of a button which
provision for ex-Armed Forces personnel. He found that Service charities and
means, when funding does
serving troops were becoming concerned with the help and treatment available
become available, we can do
for ex-Service amputees. Conflicts were increasing the number of amputees who
would leave the Forces in the