Limb loss and limb difference: Serious injury lawyer explores rehabilitation provision for amputees with key charities

April is Limb Loss and Limb Difference Awareness Month and, as a serious injury lawyer, I had the privilege to record a podcast with Emma Joy Staines of Steelbones and Josephine Bridges of Positive Bones

We explored the provision of rehabilitation for those with limb disability, discussing the biggest challenges first faced by patients following amputation, the types of support typically requested from charities, the positive and negative changes to amputee rehabilitation in recent years, and what best practice rehabilitation could look like. 

Emma and Josephine were able to share their invaluable experiences and insight during a hugely fascinating conversation. 

A significant and continuing need

Each year in the UK more than 5,000 people undergo a major limb amputation.  Whilst the largest number of amputations occur in the over 50s, data shows a significant number of amputations for children under the age of four.  Over 2,400 amputees under the age of 18 live in England alone.

It's estimated that NHS England spend £60million annually on services for patients with an amputation or congenital limb deficiency. There's clearly a significant and continuing need for amputation rehabilitation for the NHS to fund.

Several years ago the NHS commissioned a prosthetic review, but as I write the review has still not yet been published.

Private v state funding

During my conversation with Emma and Josephine, we explored the significant difference between privately funded rehabilitation provision versus NHS provision. 

The clients I act for who have suffered life-changing amputations have access to privately funded prosthetics, aids and equipment and accommodation, which optimises their rehabilitation. Early access to optimal rehabilitation is crucial in any serious injury case, and a good lawyer will help drive forward the rehabilitation package. 

Unfortunately, the experience of amputees relying on state funding can be very different. 

We also discussed the variations in rehabilitation provision across the country, who both described a “postcode lottery”, namely that access to rehabilitation can vary greatly dependent upon which part of the country the amputee resides in.

Psychological support

During the recording of our podcast, both Emma and Josephine explained the strain placed on an amputee’s mental health following the loss of a limb. This life-changing event can cause anxiety, anger, loss of confidence and self esteem and feelings of isolation.  Emma and Josephine described it as a grief type reaction. This can further be compounded by an initial lack of knowledge as to where an amputee can access appropriate support, which is why the work of charities is so crucial. 

Statistics highlight that approximately 21% to 35% of patients who have undergone amputation go on to experience a depressive disorder.  Scopes disability survey on Covid in 2021 showed that 28% of disabled people feel increasingly forgotten. 

This is clearly a significant issue to be addressed and one in which I hope will form part of the NHS prosthetics review when it is finally released. 

As long ago as 2018 the NHS commissioned a prosthetic patient survey in which patients highlighted that psychological support should be an important part of prosthetic service, but that it wasn’t easily accessible in all of the prosthetic centres across the country. 

Emma and Josephine highlighted their concerns at the long waiting lists for prosthetic rehabilitation, worsening since Covid.  However, Emma felt that a positive to come out of Covid was that the NHS is talking more now to external organisations such as charities, which is really encouraging. 

Best practice

I asked what ‘best practice’ rehabilitation provision might look like and Emma felt that it would be a dedicated rehabilitation centre by every NHS facility, where patients could engage for four to six weeks with an appropriate amputee support worker along with a multi-disciplinary team. 

Josephine highlighted that greater access to equipment for trials was key, including not just prosthetics but aids and equipment to enable patients to rediscover a quality of life and to provide opportunity for increased independence. 

Collaboration and support

We all agreed that collaboration and peer to peer support is so crucial in amputee rehabilitation.  There are many helpful and accessible organisations available to support amputees at any stage in their lives. 

It can be a daunting for someone in need of help to find the right support.  Emma and Josephine highlighted Limb Loss & Limb Difference UK, an extremely useful website which unites a number of amputee specialist charities across the country, all providing support to anyone impacted by life changing amputation or limb difference. 

Podcast

To hear our discussions in full, please visit our podcast.

If you want to know more about amputation claims and how Irwin Mitchell can help, visit our dedicated section on the website.