Prosthetic Amputee Rehabilitation

Guy’s and St Thomas’ Prosthetic Amputee Rehabilitation Visiting Professional Programme gives international clinicians the opportunity to observe a leading London NHS amputee and prosthetic rehabilitation department.

Introduction

Guy’s and St Thomas’ NHS Foundation Trust Prosthetic Amputee Rehabilitation Visiting Professional Programme (VPP) is designed to provide international visiting professionals with the opportunity to experience and learn from the multi-disciplinary teams working across the pathway at the regional amputee outpatient service based at Bowley Close rehabilitation centre (BC), the 12 bedded Community Regional Amputee Rehabilitation Unit (ARU) and both St Thomas and Kings College Hospitals. Provision of highly specialised prosthetic rehabilitation for people of the South London Region, of all ages, having upper and lower limb amputation operates seamlessly across the whole pathway. Early expert MDT assessment and provision pre operatively influences the level selection and patient expectations of their post-operative rehabilitation during the hospital stay, specialist inpatient rehabilitation and lifelong prosthetic management. Post-operative hospital care is transferred as early as 14 days post op to either the Amputee Rehabilitation Bedded unit or as an out-patient travelling to Bowley Close prosthetics unit. Early input helps determine a clear rehab pathway for the patient.

Our Visiting Professional Programme is a unique development experience that allows visitors to observe our leading amputee and prosthetic rehabilitation MDTs in all its settings. The attachment will be tailored to the learning needs of the observer and linked to the specialist skills of the service. We are dedicated to broadening international professionals’ clinical expertise and enabling them to observe new skills that can be transferred back to their work place.


Programme aims

The programme is aimed at those who wish to extend their experience within Amputee Rehabilitation Services and who wish to gain an understanding of the way this is practiced and organised within the NHS and how it operates as an integrated patient care pathways.

The programme aims to include:

Individual weekly timetables will be created depending on each visiting professional’s requirements.

A Certificate of Attendance will be awarded to visitors upon the end of their programme.


Format

The observer will be nominated a supervisor to coordinate their individual programme and and monitor the learning experience each week.


Who can apply

This programme is intended for non-U.K. advanced trainee clinicians, AHP’s, nursing or medical professionals at the level of specialist registrar or consultant looking for exposure to a leading NHS MDT Amputee Rehabilitation care team.

Visitors can apply primarily for an observership (with no hands-on element) or a practical attachment programme.

Those wishing to apply for the practical attachment must have relevant HPCC, NMC or GMC registration. You can apply for GMC registration directly through the main GMC website. This is likely to take a considerable time to achieve and should be factored into an attachment application.


Programme duration

It is recommended to undertake a placement of four weeks for a typical observership. The experience may be tailored to the applicants needs from a generic overview of our Amputee rehabilitation services to a specialised observership focusing on one of the specialised clinical areas such as nursing.

If a shorter observership is requested, you may be asked which particular weeks of the timetable you wish to observe.

Please note that we are a small team and some time frames may not be able to be accommodated (typically July, August and December).


Regional Specialist Rehabilitation services

The services predominantly operate from Bowley Close Rehabilitation Centre which is located in Crystal Palace South East London. The services offer highly specialised management to people of all ages with long term physical disabilities. This management is often needed on a lifelong basis and intervention may be from one or more of the services at the centre and can be through a one stop approach during a visit. The staff, predominantly AHPs, adopt a multidisciplinary team approach to the management of the Clients and the client and carer are at the centre of the team working throughout. The service supports around 25,000 people across the region and provides care in the right setting by offering, in patient, outpatient and domiciliary care.

The centre offers rehabilitation and provision of specialised equipment alongside the manufacturing of made to measure prostheses, orthoses and special seating and assisted communication aids. This type of service is uniquely offered on a regional basis bringing together highly specialised staff of Consultant in rehabilitation medicine and Allied Health Professionals.

The Services operating from Guys & St Thomas, Kings College Hospital and the Amputee Rehabilitation Unit are:


Example Timetable

Week 1

Monday morning

  • Bowley Close – meet with head of amputee rehabilitation services for overview of service, tour of building, meet the MDT and supervisor(s) 
  • Agree overall and weekly learning objectives

Monday afternoon

  • ARU to meet the senior MDT, tour of the ward, gardens and therapy gym

Tuesday morning

  • BC clinic with consultant in rehabilitation medicine

Tuesday afternoon

  • BC prosthetic workshop tour and manufacturing processes

Wednesday morning

  • ARU physiotherapy & prosthetic satellite

Wednesday afternoon

  • ARU physiotherapy & prosthetic satellite

Thursday morning

  • St Thomas Ward MDT ward round with consultant in rehabilitation medicine and ARU clinical lead

Thursday afternoon

  • GSTT vascular service & pathway overview & therapy teams

Friday morning

  • BC OT service overview and clinic – UL, LL, paediatrics

Friday afternoon

  • Bowley Close physiotherapy service overview LL, paediatrics, pre prosthetics

Week 2

Monday morning

  • Bowley Close 
  • Prosthetics MDT Referrals meeting 
  • Weekly objectives 
  • Clinic with consultant in rehab medicine

Monday afternoon

  • Clinic with consultant in rehab medicine +/- physiotherapy clinic

Tuesday morning

  • Prosthetics clinics – lower limb

Tuesday afternoon

  • Psych counselling service 
  • Service overview – inpatient, ARU and outpatients 
  • Pre amp 
  • Common themes 
  • Treatment concepts

Wednesday morning

  • ARU – Breakfast club 
  • Wound ward round ARU 
  • Prosthetic / therapy Clinic

Wednesday afternoon

  • ARU therapy garden group 
  • Concept, benefits, patient experiences 
  • Discharge planning of complex patients e.g. hording 
  • Patients having physio/OT rehab

Thursday morning

  • St Thomas ward round Or Complex case meeting at BC followed by ward round at ST Thomas

Thursday afternoon

  • Vasc / ortho / plastics involvement in amputees

Friday morning

  • Rehab engineer medical devices quality control 
  • Cad cam and advanced casting techniques, socket designs

Friday afternoon

  • NHSE service overview – the national picture of prosthetics 
  • MPK pathway and implementation at Bowley Close 
  • Week reflections

Week 3

Monday morning

  • Week objectives Prosthetics training / limb delivery

Monday afternoon

  • BC physiotherapy – longer term gait deviations and rehab

Tuesday morning

  • Kings College Hospital ward round with clinical lead and head of service

Tuesday afternoon

  • Upper limb assessment & rehab with occupational therapist 
  • OT clinic / community visit

Wednesday morning

  • ARU – joint prosthetic / physio limb delivery

Wednesday afternoon

  • MPK clinic at BC

Thursday morning

  • St Thomas ward round OR Vasc / ortho / plastics clinics

Thursday afternoon

  • Open wound pathway – history, implementation, current practice Orthotics clinic

Friday morning

  • Orthotics / wheelchair / assisted communication at BC

Friday afternoon

  • Orthotics / wheelchair / assisted communication at BC 
  • Reflective practice

Week 4

Monday morning

  • Week objectives 
  • Pre amputation MDT consultation 
  • Physio / consultant in rehab medicine

Monday afternoon

  • PLP and neuroma management signposting 
  • Acupuncture, GMI etc. 
  • Physio / consultant in rehab medicine

Tuesday morning

  • Joint vascular / diabetic foot ward round @ Kings OR wound ward round at ARU

Tuesday afternoon

  • AMPS and cognition screening in amputee patients 
  • BC or ARU 
  • Orthotics clinic @ kings DFC

Wednesday morning

  • Paediatric assessment, treatment and reviews Clinic with clinical lead and head of service

Wednesday afternoon

  • POPS ward round at ARU

Thursday morning

  • GSTT foot health clinic

Thursday afternoon

  • Rare levels of amputation: hip disarticulations / forequarter

Friday morning

  • Flexible space for additional identified leaning

Friday afternoon

  • Week reflections 
  • Reflections on observership & feedback

Fees

A course fee per week will be applied; this fee excludes accommodation and travelling expenses. To find out the fee amount please email [email protected].


Please note

Clinicians are able to offer bursaries or discounted placements on an individual basis. This is at the discretion of the Directorates of GSTT and does not affect the terms and conditions of the Visiting Professional Programme agreements.

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