ISPO UK ASM 2023 - Poster Exhibition
Implementing the NHS England Multi-Grip Hand Policy - Specialised Ability Centre Manchester's Experience
Presenter: Shannon Hughes, Prosthetist, Manchester University NHS Foundation Trust/Opcare, UK
Other authors: David Cumming, Helen Locke, Karen Milnes, Macrina Storer
In the summer of 2022, NHS England introduced a policy for the provision of multi-grip hands (MGHs) on the NHS, within a set budget and following strict criteria (1). This prescription is now available for suitable patients those who have undergone an upper limb amputation or have a congenital upper limb difference. The implementation of the policy followed a literature review by NHS England, which found sufficient evidence to support the provision of myoelectric multi grip hands (2). The main benefits noted were an increase in users’ perceived ease of activities of daily living in addition to improved results with the box and block tests.
At the Specialised Ability Centre Manchester (SACM), a multidisciplinary group was formed to discuss and plan the implementation of the policy. The knowledge and experiences derived from the microprocessor knees (MPK) pathway were utilised to create a MGH pathway and contract for patients for use during the trial. Additionally, members of the team attended the multi-centre meetings chaired by the policies author which allowed for sharing of expertise across prosthetic centres.
In total, 3 devices have been trialled within the centre: the COVVI hand, Ottobock Bebionic and the Ossur Ilimb. Each device has a variety of different control mechanisms and features. 5 patients in total have trialled at least one device and 3 patients have been successfully fitted with their definitive MGH.
The outcome measures used at SACM have been the COPM, box and blocks and the TAPES Revised questionnaire. Anecdotal feedback from patients referencing day to day function and useability of the MGH’s has been positive. Early data from the COPM has also shown that patients have reported improvements in in both performance and satisfaction with their activities of daily living goals when using MGH’s.
A key learning point has been the importance of trialling different devices to enable users and clinicians to make an informed decision on which MGH is most appropriate for individual needs. Comparison data for the available MGH’s has been compiled based on reflection and review of individual experiences, which will serve as a guide for future prescriptions.
In conclusion, the team has demonstrated that the MGH policy can be successfully implemented in a large-scale prosthetics centre, with positive early outcomes and patient feedback. The processes and learning points described here may provide guidance and support to other prosthetic centres in their implementation of this policy.
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