Prosthetic and orthotic care

• Work with patients to analyse their needs and involve them in the design and choice of their device as appropriate
• Analyse and critically evaluate the information collected
• Analyse and compare normal and abnormal gait, locomotor function and movement using both qualitative and quantitative means
• Select and use appropriate investigation and assessment techniques, completing an accurate clinical assessment
• Develop and implement a treatment plan, adjusting and changing as required to meet the patient’s needs (including necessary practical skills)
• Assess factors important to the relevant design, using appropriate techniques to capture body shape
• Develop the model required to manufacture the device and modify, adjust the model where necessary
• Prescribe orthotic or prosthetic intervention including, where necessary, the specification for manufacture
• Undertake analyses where required for unapproved combinations or applications of components
• Recognise when devices require rectification, repair and take appropriate action
• Demonstrate a logical and systematic approach to problem solving using research reasoning to determine appropriate actions

• The structure and function of the human body, together with knowledge of health, disease, disorder and dysfunction including: human structure and function of the musculoskeletal system; the aetiology and pathophysiology of human disease and general genetic principles; and a range of disorders that are amenable to prosthetic or orthotic treatment and their limitations
• Gait, locomotor and movement functions and ways to check them
• How to undertake and record a thorough, sensitive and detailed assessment
• How to formulate and evaluate a treatment plan for a patient including setting appropriate review goals and timelines; the range of prosthetic and orthotic devices available; how to position or immobilise patients correctly for safe and effective interventions including fitting a prosthesis or orthotic device
• The theoretical basis of prosthetic and orthotic science and design; a range of techniques for capturing body shape
• The structure and properties of materials and their appropriate application to prosthetic or orthotic hardware and clinical practice; a range of modelling techniques; how to measure and adjust a model
• Biomechanical principles and the appropriate application of forces to the human body following prescription and supply of a device in a manner which makes the application of such forces safe and effective in an episode of treatment
• How to undertake analyses when required for unapproved combiniations or applications of components
• How equipment works and how to maintain it to a high standard at all times, when and where to report faults; quality control and how it applies in prosthetic and orthotic design and delivery
• The range of orthotic and prosthetic products available allowing the most appropriate product to be provided and manufactured to meet the specific needs of the patient
• How to identify changes in the fit of prostheses and orthoses over time (due to changes in the patient and/or materials) and how best to return the device to optimum effectiveness or where appropriate to renew and replace

• Work in partnership with patients to assess their needs and exercise professional judgement, utilising the best research evidence available, clinical experience and patient aspiration
• Work in partnership with patients to identify goals and agree appropriate treatment plans and that work is based on mutual respect and trust-always maintaining high standards of care
• Apply a range of communication interventions and interpersonal skills to support patients receiving prosthetic and orthotic care

• Recognise and take account of the wide range of needs a patient has including physical, psychological, social and cultural needs (recognising when to refer to other professionals)
• Demonstrate clinical reasoning and the processes that underpin decision-making and problem solving
• Recognise the value of case conferences and other methods of review

• Equality, diversity and inclusion legislation; how to treat people with dignity and respect; how to assess the nature and complexity of a patient’s needs including how to empathise with patients; understanding how disability affects and influences prosthetic and orthotic management; the requirement to adapt practice to meet the needs of patients dealing with emotional needs due to a range of circumstances and experiences
• Ways to use your judgement to develop treatment plans that reflect a patient’s needs and preferences
• How to recognise how communication affects assessment and engagement of a patient and to be able to apply a range of communication techniques; taking into account a patient’s emotional state, The stages and processes of clinical reasoning and understand how they underpin effective decision making age, capacity, understanding, learning and physical ability, culture, ethnicity and religious beliefs
• Ways to assist the communication requirements of patients; including recognising the need to use interpersonal skills to encourage the active participation of patients; how to recognise the limits of prosthetic and orthotic practice in the context of patient care; including when not to proceed with a treatment intervention in the best interests of a patient
• The stages and processes of clinical reasoning and understand how they underpin effective decision making

Governance and safety

• Receive, act on and make referrals (to others) as appropriate
• Practice safely, according to available evidence and within competency level, maintaining fitness to practice
• Work collaboratively in partnership with other professionals, patients and carers focussed on achieving agreed goals
• Obtain informed consent for prosthetic and orthotic care
• Safeguard patients, including vulnerable adults and children
• Conduct risk assessment of the environment, patient and the device prescribed and supplied
• Safeguard confidential information relating to patients at all times
• Maintain records that are fit for purpose and process them accordingly
• Manage and lead colleagues and staff as appropriate
• Comply with local and national standards regarding reporting of medical device failures and incidents
• Practice within the scope of HCPC Standards of proficiency
• Evaluate research and other evidence to inform practice
• Work safely, including being able to select appropriate hazard control and risk management, reduction or elimination techniques in a safe manner in accordance with health and safety legislation
• Select appropriate personal protective equipment and use it correctly
• Establish safe environments for practice, which minimise risks to service users, those treating them and others, including the use of hazard control and particularly infection control

• How to work collaboratively with those who provide services to patients; recognising the limits of prosthetic and orthotic practice and when to seek advice and/or refer to another professional
• What is meant by fitness to practice; how to work within legislation, standards, protocols and codes of conduct (e.g. Medicines and Healthcare products Regulatory Agency HCPC); the limits of your own competence and role
• How to be able to apply professional knowledge, skills and experience as part of a multi-professional team to ensure a patient’s needs are met
• What is meant by informed consent and how to secure it across the age range and in line with cognitive ability; the importance of providing patients with information that allows them to make informed decisions and safely manage their condition and supplied devices
• What is meant by duty of care; medical ethics; safeguarding of adults and children and how it applies to your role
• Health and safety legislation, policies and procedures; ways to assess risks that ensures safety and security of the prescribed device; how to balance the needs of the patient and personal risk taking; a range of evidence-based models of risk assessment related to prosthetics and orthotics and your own role
• Concepts and theories of leadership and management and how they apply the clinical environment
• How to maintain confidentiality and apply the principles of information and clinical governance
• The importance of managing records and data in accordance with legislation, protocols and best practice
• The need to participate in training, supervision and mentoring
• Quality guidelines and device design principles that apply to patient devices; incident reporting and escalation
• The national standards and legal framework within your scope of practice; including maintaining a high standard of personal professional conduct; the need to keep skills and knowledge up to date and the importance of career-long learning
• Ways to reduce occupational stress and the importance of maintaining your own health and well-being
• The value of critical reflection on practice and the need to record the outcome of such reflection
• The structure and function of health and social care services in the UK
• A range of research methodologies