Service Development for Oxford Prosthetics Service: A Retrospective Analysis of Primary Assessments (June 2023– April 2025)

Abstract

Title:  Service Development for Oxford Prosthetics Service: A Retrospective Analysis of Primary Assessments (June 2023– April 2025)

Presenter:   Samir Al-Mitwally, Oxford Prosthetics Services, Oxford, UK

 

Background:

Timely prosthetic rehabilitation is associated with improved patient outcomes. However, access delays and regional variation persist. This evaluation reviewed referral patterns, timelines, and outcomes in a regional amputee service.

 

Aims:

To assess demographics, referral characteristics, and predictors of prosthetic suitability and function.

 

Methods:

We retrospectively analysed 203 referrals (June 2023–April 2025) to the Oxford Amputee Prosthetics Service. Data included age, gender, region, diabetic status, amputation details, and referrer type. Of these, 144 patients (71%) underwent primary assessment through the Combined Primary Assessment Clinic (CPAC), a multidisciplinary service. Timelines and predicted functional levels (A0–A4) were evaluated.

 

Results:

Mean age was 54.47±21.4 years; 90% were adults and 10% under 18. 73% were male. Vascular disease caused 76% of amputations; trauma 8%. Diabetics comprised 40% of referrals. Mean times: amputation to referral 23.32±18.8 days; referral to assessment 48.49±19.4 days. Amputation to prosthesis delivery ranged from 95.2 to 143.2 days regionally.

Those with recorded predicted function at primary assessment: A0(2%), A1(22%), A2(47%), A3(26%), A4(3%). Phantom and stump pain were reported in 60% and 32%, respectively. 12.5% had a pre-amputation consultation during the period assessed.

 

Conclusions:

While most patients were prosthetically suitable, disparities in access and functional prediction were evident. Pre- amputation consultation was inconsistently offered, representing a missed opportunity for early rehabilitation planning. Next steps could include implementing a pre-operative consultation pathway for elective cases, and engaging Integrated Care Boards to advocate for resource allocation and service-level agreements supporting timely, equitable access to care.

 

References

British Society of Rehabilitation Medicine. Amputee and Prosthetic Rehabilitation – Standards and Guidelines. 3rd ed. London: BSRM; 2018.