Joint effects 2011 - An update of the involvement - 18 Weeks

Joint effects 2011
Hand Therapy Team
Sheila McLellan
sheilamclellan@nhs.net
01592 643355 ext. 23690
Integrated Pain Management Service
Melanie Hutchison
melanie.hutchison@nhs.net
01383 623623
Orthopaedic Foot and Ankle Service
Carolyn Todd
carolyntodd@nhs.net
Podiatry Musculoskeletal (Biomechanics) Service
Carolyn Todd
carolyntodd@nhs.net
01592 645218
The Hand Therapy Team consists of two specialist nurses, one full-time Advanced Occupational
Therapist, one part-time specialist OT and one full-time orthopaedic physiotherapy practitioner.
The team provides an out-patient service in both Queen Margaret Hospital (Dunfermline) and
The Victoria Hospital (Kirkcaldy). Assessment, intervention and rehabilitation is provided for
people who have either sustained hand/upper limb trauma, undergone hand/upper limb elective
surgery or who have a hand/upper limb condition. Referrals are accepted from AHP colleagues,
GPs and consultants. Services offered include thermoplastic static and dynamic splinting, sensory
assessment/re-education, injection therapy, wound management, functional assessment and
rehabilitation, strengthening programmes and pain management advice.
The Occupational Therapy Service provides assessment, intervention, rehabilitation and complex
case management for clients referred and triaged to the secondary care aspect of Fife Integrated
Pain Management Service. The services are in a variety of settings throughout Fife including: the
specialist out-patient unit in Queen Margaret Hospital, Victoria Hospital and Whyteman’s Brae
Hospital in Kirkcaldy, clients’ homes and workplaces, and local community health clinics.
The Foot and Ankle Team consists of two orthopaedic consultants, two registrars, two
podiatrists (one Extended Scope) and one orthotist. Referrals are received electronically from
GPs and triaged to the appropriate team member. There is access to diagnostic investigations
and imaging. Treatments can include biomechanical assessment +/– orthotic management,
insole management and footwear, exercises, steroid injections, acupuncture, onward referral to
physiotherapy and pain services, and where appropriate surgical intervention.
The Podiatry Department provides a comprehensive Fife-wide lower limb musculoskeletal
service. This is delivered by specialists who provide the assessment, diagnosis and treatment of
children and adults presenting with complex MSK conditions. There are combined clinics with
physiotherapists and late clinics to accommodate working patients. Direct access to orthotist
services has shortened the journey for patients who need footwear or modifications, with
bespoke and off-the-shelf orthoses being an integral part of providing the service. Work is
ongoing to introduce skill mix.
Improvements and outcomes: audit, patient survey, VAS Care Aims with mean VAS scores
improving following intervention.
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