There are many research papers, academic studies and official reports that explain the importance of good orthotics care and outline the improvements needed. The table below provides links to some of these and are numbered as they are referenced in this site:

1Orthotic Service in the NHS: Improving Service Provision(2009) "Orthotic service provision has the potential to achieve significant health, quality of life and economic benefits for the NHS"...."for every £1 spent on orthotic services the NHS saves £4."..."A series of reports has been published over the years highlighting the lack of funding and accountability"..."Early orthotic intervention improves lives and saves money."
2The Orthotics Review: British Healthcare Trades Association: The economic impact of improved Orthotics Services Provision (2011)

For Government, a better functioning orthotics system would further the objective of a co-ordinated health and social care approach. The ‘health of the nation’, particularly of the elderly, can be expected to benefit from the improved quality of delivered care. But there will also be major net annual savings to the Exchequer because, as primary care trusts expand the level of provision of orthotic care, they will reduce the number of patients referred for acute procedures.

3My Feet Visible but ignored (2012)"This study has highlighted a polarity between what these participants need in relation to their foot symptoms and the management of them. That foot problems are often ignored is of concern at multiple levels."

Fully Equipped (2000)

Audit Commission National Report..."In 1992, a report described the NHS orthotics service as ‘rudderless and unco-ordinated’. Serious shortcomings remain in many parts of the country in the quality of the services received by 400,000 users."
5Fully Equipped Audit Commission Update (2002)22 per cent of patients reported that their orthoses were uncomfortable; average waiting times exceeded ten weeks from measurement to the supply of the orthosis; and 50 per cent of patients received no information about the use, care and repair of their orthosis.
6Therapeutic footwear – still a Cinderella service? A critical review of the literature (2007)"Lack of time for assessment, no information and no follow-up appointment were also identified as being problem areas that contributed to the failure of the footwear to meet the needs of the patient."
7Cinderella, you can go to the ball: inclusive footwear design at the intersection of medicine and fashion (2011) A participant summarised the conflict between achieving comfort and the socially undesirable aesthetics of therapeutic footwear: “They improve my mobility but restrict my activities…was invited to a wedding…didn’t go…just sat at home and cried.” .... Footwear had such a strong impact on some participants in this study that they felt they could no longer go out and interact socially.
8These Shoes are made for walking (2011)Report of a conference held in Leeds: “Over the years the money hasn’t been there to invest in the service in lots of different ways, in training, in the shoe industry, in training orthotists, the clinical side of things. Because there’s been no investment, and no change as things have moved on, it’s been left behind, and now it’s in a state of almost ‘no return'"
9Arthritis Research UK report: Providing better footwear and foot orthosis for people with rheumatoid arthritis (2012)"Without good quality therapeutic footwear people with rheumatoid arthritis are often left unable to walk, and the condition of their feet degenerates"

Patient Concerns over the Shortage of Prosthetists and Orthotists (2011)

Original source at:


A discussion paper on behalf of the National Allied Health Patients' Forum 'NAHFP'. "Patient needs are increasing. For instance the number of patients needing orthotic interventions are expected to grow rapidly, and whilst the major cause of amputation is peripheral vascular disease, with diabetes mellitus being a significant factor in up to 50% of cases; diabetes is now expected to increase from 7.4% of England’s adult population in 2010 to 9.5% or 4.6 million people by 2030 an increase of 28.4%. The UK is experiencing an ageing of its population which will place increased demands on prosthetic and orthotic services. This whilst the numbers of Prosthetists and Orthotists continue to decline!"


Orthotics Charter (2011)

Associate Parliamentary Limb Loss Group Charter. This details appropriate waiting times and the rights of the patient under the United Nations General Assembly convention on the rights of a person with disabilities. Original Source

 12Retrospective Cohort Study of the Economic Value of Orthotic and Prosthetic Services Among Medicare Beneficiaries. Dobson and DeVanzo (2013)This American study finds that patients who received O&P services experience greater independence than patients who do not.... It goes on to conclude that "This reduction in health care utilization ultimately makes O&P services cost-effective for the Medicare program and increases the quality of life and independence of the patient".  Original Source
Orthotic Pathfinder: NHS PASA (2004)
This is " a patient focused strategy and proven implementation plan to improve and expand access to orthotic care services and transform the quality of care delivered" Original Source
BAPO Position Statement (2015)
British Association of Prosthetists and Orthotists response to the NHS England's work stream on improving NHS Orthotics in England