Reduce, Reuse, Recycle: Orthotics team helping create a greener OUH

A team at Oxford University Hospitals (OUH) that makes custom-made orthotic devices such as insoles and splints is making significant sustainability improvements while improving patient care.

The Orthotics department, based at the Nuffield Orthopaedic Centre in Oxford, is reducing, reusing, and recycling many of its materials, decreasing our carbon footprint, lessening the impact on the environment, and lowering costs.

Traditional materials used for devices, such as leg braces, include metal, Plaster of Paris (PoP), and thermoplastics - all of which are now used differently to be more sustainable and improve patient experience.

Now, the team breaks up used casts to remove and reuse the steel, a resource that has a very high environmental impact to produce. As a result, there has been an 80 percent reduction in usage of steel and 78 percent in spend.

Similarly, PoP, used primarily for the manufacture of spinal braces and foot impressions, is environmentally damaging and difficult to dispose of. However, at OUH, PoP has been replaced by computer assisted design, meaning patients are scanned and their bodies are carved from a type of foam instead of being wrapped in plaster bandage. This has resulted in a 69 percent reduction in usage and 78 percent in spend.

The 18-strong Orthotics team, which helped manufacture more than 100 protective screens earlier in the pandemic to keep patients and staff as safe as possible on our sites, has also recycled more than 3.5 tonnes of thermoplastic, used for moulding the final products, since 2018.

Speaking ahead of the start of COP26, the United Nations-run climate change conference, yesterday (Sunday 31 October 2021), Arron Jones, Orthotics Production Manager and OUH Sustainability Network Co-Chair, said: "Reducing the carbon impact of the Orthotics department has been a key objective for the entire team over the last couple of years, and I am so proud of the collective effort and work undertaken so far.

"In addition to successfully reducing our carbon footprint and reducing our spend, we are looking to go fully digital, increase our recycling even further, and we have ambitions to become a national orthotics 'recycling champion'.

"Although we know we can do more, we are delighted with what we have achieved so far, and we will be sharing our learning with other NHS trusts."

'Transforming' services

The OUH Orthotics team helps to treat and rehabilitate patients by providing orthoses, such as insoles, braces and spinal jackets, which are devices applied to the body to support, correct, prevent or compensate for a skeletal deformity or weakness. The team also provides a programme of maintenance, repair, and review of need once an orthosis has been supplied.

The correct supply and fitting of orthoses can help improve quality of life by reducing pain, keeping people mobile and independent and preventing more invasive and expensive interventions like surgery or amputation.

The greener approach to the production of orthotic devices also means a big improvement for patients as they do not have to go through the more invasive proves of having PoP applied to be measured for their custom-made orthoses and are scanned instead. In addition, specifications and prescriptions can be more easily refined if needed and, with digital storage, replicas are available if devices are lost or damaged.

Paul Horwood, Orthotic Service Lead and Senior Orthotist at the Trust, said: "Using digital scanning for scoliosis patients since late 2019 has transformed my spinal orthosis clinics.

"We primarily made this progression to improve patient experience in avoiding the use of PoP to create a body mould. This casting process is messy and, particularly for the age group we mostly treat for scoliosis, reducing body contact during the moulding process is important.

"We have received very positive comments from patients who have benefited from this digital approach - using an iPad with a scanner instead of being wrapped in bandages is very quick, mess free, and provides better patient dignity.

"This has also resulted in the significant reduction in the use of PoP materials and the difficult issue of disposing of them. Our environmental footprint has become greener, and it has also enhanced patient experience and staff benefit."

Arron Jones added: "The work of our team has highlighted that a sustainable approach can often be the most beneficial to patients, and by carefully considering how we use raw materials cost improvements can also be achieved."

COP26 - Together for our planet

Sunday 31 October 2021 saw the start of COP26 as delegates from around the world meet to discuss safeguarding the future of the planet and reversing the climate crisis.

Hosted in Glasgow until 12 November 2021, the conference will welcome around 120 world leaders and more than 20,000 delegates are also expected in the Scottish city. Each day of COP26 will focus on a different theme, from clean energy, zero-emission transport and protecting nature, across other themes such as science, innovation and inclusivity.

David Walliker, Chief Digital and Partnership Officer at the Trust, said: "As leaders from around the world meet to discuss what should be done on a global scale to help the planet, it is excellent that people are taking action at a local level to make a difference.

"The Orthotics team has been leading by example and they have done a great job in becoming more sustainable and improving patient care at the same time.

"We are really looking forward to outlining our ambition for 'Building a Greener OUH' soon, as we set out what we can do as a local, large organisation to make improvements that will benefit our patients, staff and population."

Pictured: OUH Orthotics team