Advancing Healthcare 2025 – Shortlist

I am honoured to be shortlisted for the 2025 Advancing Healthcare Award in the BAPO category for Evidencing Impact and Excellence in Prosthetics and Orthotics. I am also proud to be nominated alongside Laura Barr and Nikki Munro, whose projects are advancing our profession and delivering meaningful benefits to patients, orthotists, and the wider NHS.
Over the past four years, I have led a service evaluation at Oxford University Hospitals NHS Foundation Trust to understand which patients receive dynamic contracture bracing, and who benefits from it. I found that orthotists and referrers were uncertain when to prescribe these braces, and that orthotists were fitting the braces inconsistently. Some orthotists advised wearing them for a vague “few hours a day” or overnight, and orthotists set the brace up with different stretch settings. This variation meant patients received mixed messages, making it harder to use the braces effectively.
To address this, I worked with my team to review existing research, create a clear and consistent wear protocol, and assess its impact. We introduced a standard guideline recommending one hour of wear per day with a defined level of stretch. Our findings showed that this approach was equally as effective. We also discovered that only 20% of patients prescribed with a dynamic contracture brace saw an improvement in their contracture, but were unable to predict these patients using routinely collected clinical data. This highlights the need for further research to better understand who benefits from bracing.
This project was achieved with no additional funding, relying on strong collaboration and creative resource use. By embedding the evaluation within routine clinical practice, the entire team remained engaged in data collection over four years, even during the COVID-19 pandemic. Service users played a key role in shaping patient information and selecting outcome measures, ensuring that the project remained patient-centred and clinically relevant.

Bio: Laura graduated from the University of Strathclyde in 2007 and works as an Advanced Practitioner within the Orthotic and Orthopaedic services at NHS Greater Glasgow and Clyde.
 
Project description: The Orthotics Evidence Portal, formerly known as DEBOP, is a unique resource designed to facilitate access to the evidence-base regarding the orthotic treatment of patients with musculoskeletal pathology or diabetic foot conditions. The Portal is the product of a 10 year effort by a group of orthotists in the UK who want to improve access to the orthotic evidence-base. Since 2014, it has enhanced evidence-based practice in the UK orthotic profession, by improving accessibility to clinically-relevant publications in order to assist clinical decision-making.

Nikki Munro graduated from the University of Strathclyde in 1993 with a BSc Hons in Prosthetics and Orthotics and has worked as an Orthotist since graduation. She has worked in both the contracted and NHS sectors and has carried out a number of projects and secondments during her career. As an Advanced Specialist Orthotist she led in the specialist areas of Adult Neurology and Diabetes. She is currently Clinical Lead and Service manager for Orthotics in NHSGGC. She is also Professional lead for Orthotics within NHSGGC and lead for Quality Improvement for all AHPs in NHSGGC and holds a Scottish Improvement Lead qualification. She is Chair of the Scottish Clinical Orthotic Leads Group.

Nikki’s summary statement for her nomination:

Nikki has been a pioneering leader in Orthotics at NHS Greater Glasgow &Clyde (GGC) since 2016. She has developed some of
the UK’s first Advanced Practice roles for Orthotists, revolutionised patient care through ACRT (advanced clinical referral
triage), and championed staff development, creating lasting impact on both services and patients.