Occupation

Abstracts
Posters
develops participative art projects. Before, she worked in health
research at University College London, King’s College London
and Brunel University. A long time ago, she also held posts as a
physiotherapist.
Lucinda works for Bridges self-management since October
2013 after being involved in delivering Bridges training for 4
years. She develops and evaluates Bridges training programmes
for health, social care and third sector workers in integrating
self-management support into daily practice. Lucinda is also an
honorary research fellow at the Faculty of Health, Social Care
and Education at St George’s University of London. She has a
Masters of Research in Clinical Practice and has worked as a
neurological Physiotherapist in both the acute and community
NHS settings.
P71
A pilot trial of compression gloves in early
inflammatory and rheumatoid arthritis
Hough Y 1 , Hammond A 2 , Prior Y 2 , Jacklin A 3 , Dooley M 4 ,
Perkins J 5 ,Durkin C 6 , St Helens & Knowsley Teaching
Hospitals 1 , Health Sciences Research Centre, University
of Salford 2 , Stockport NHS Foundation Trust 3 , Southport
& Ormskirk Hospital NHS Trust 4 , Central Manchester NHS
Foundation Trust Trafford General Hospital 5 , East Lancs.
Hospital Trust 6
Background: Compression gloves are provided in rheumatoid
arthritis (RA) to improve hand symptoms and function but
there is little evidence for their effectiveness. As a group of
Rheumatology Occupational Therapists we were unaware of
clinical evidence to support use of gloves. Financial constraints
lead to the need to justify effective use of resources. No recent
quality studies of compression gloves in arthritis were available a
feasibility study to support anecdotal evidence was required. The
study aim was to evaluate gloves’ effects on hand symptoms and
function.
Methods: Members of the northwest COTSSR met to agree
best clinical practice. Service users were involved. A systematic
review of compression gloves trials undertaken all Studies were
small and poor methodology. The last study undertaken was
21 years ago. The group agreed compression glove criteria,
hand assessment, treatment protocols and patient information
leaflet. Prior to recruitment the OTs attended a training day to
standardize assessments and study procedures.
A pre-post-test study was conducted. Participants wore Isotoner
¾ finger gloves. Hand assessments were completed at 0 and 4
weeks.
Results: Outcomes demonstrated significant improvements in:
pain, stiffness, swelling, finger flexion and hand function.
Conclusion: Compression gloves improved hand symptoms and
function. Lack of a control group means changes may not be
due to glove-wear. A randomized controlled trial is required,
including longer follow-up.
References
Braun, V, Clarke, V (2006) Using thematic analysisin psychology.
Qualitative Research in Psychology, 3 (2): 77–101
Dixon AStJ (1986) Trial for Isotoner gloves for morning stiffness
and pain in rheumatoid arthritis. British Journal of Clinical
Practice 40 (7): 271–272
Oostervelt FJG, Raskerr JJ (1990) The effect of pressure gradient
and thermolactyl control gloves in arthritis patients with swollen
hands. British Journal of Rheumatology 29:197–200
Keywords
Long term conditions, Research, Practice – present and future,
NHS
Contact E-mail Addresses
yvonne.hough@sthk.nhs.uk
Author Biographies
Band 7 Occupational therapist working within field of
rheumatology. Part of a MDT commited to providing best
practice to service users, commited to ensuring role of the OT
embedded into service. Active member of the northwest COTSS.
Professor Alison Hammond researcher Health Sciences Research
Centre, University of Salford.
P72
Independent living centres, do they represent value
for commissioners?
Cambridge S, Deakin I, Devon County Council
This submission will consider the rationale and evidence
for commissioning an Independent Living Centre (ILC). The
Community Equipment Service (CES) joint commissioners initially
funded this service in 2004. The CES has 1500 prescribers and
initially activities included: training clinicians in safe prescription,
new product awareness workshops, evaluation of stock items,
management of the web catalogue and a resource for the public
regarding private equipment purchase.
In 2011 the spend on equipment was unsustainable with a lack
of effective authorisation and limited reissue of high cost nonstock
items. For a 3 month trial period, commissioners funded
an increase in ILC staffing and prescribers sent all requests for
non-stock items to the ILC.
The ILC reviewed the clinical reasoning, offered alternative
solutions and searched returned stock for reissue. The trial
evidenced significant savings and the additional staffing was
made permanent. Savings now average £57,000/month.
The ILC also now reviews and authorises spend against the
Continuing Health Care (CHC) non-stock equipment budget.
The cost to CHC is £283/month with average savings of £8,000/
month.
Commissioners also targeted prescriber spend and behaviour
patterns against specific high volume items e.g. pressure
cushions where the ILC analysis led to the delivery of training
sessions in conjunction with expert tissue viability practitioners
to raise awareness of alternative preventative clinical practice.
This has reduced spend on these items by £8,000/month and
improved outcomes for service users.
Outcomes for commissioners: the total annual staffing cost of
the ILC is £80,000 with actual savings of £74,000 achieved
through prevention of spend using non-equipment solutions,
maximising reissue of stock and targeted spend using less
expensive alternative equipment.
Outcomes for service users: Timely clinically effective solutions.
References
Department of Health (2014) Care Act, London: DH. www.
legislation.gov.uk/ukpga/2014
Keywords
Managers, Service improvement or transformation, Leadership,
Inter-agency
Contact E-mail Addresses
sarah.cambridge@devon.gov.uk
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