Policy number: SRP 077
Policy name: Orthoses/Orthotics
Status: Group Prior Approval/Individual Prior Approval
Effective date: 1 April 2024
Next review date: 1 April 2026
Mid and South Essex ICB commissions assessment and supply of orthoses/orthotics on a restricted basis.
Referrals for assessment for orthoses will only be accepted in the following circumstances.
1. Neurodisability
2. Talipes equinovarus
3. Adolescent tendinopathy at risk of developmental compromise
4. Post operative patients
5. Congenital skeletal abnormality
6. Burns
MSE ICB does not fund ‘off-the shelf’ orthoses/‘in-shoe’ appliances. Patients who have been funded for ‘off-the-shelf’ /’in-shoe’ orthoses by the ICB in the past will no longer be funded on this basis alone.
MSE ICB only funds customised orthoses for patients with circumstances as listed above and where the clinical needs of a patient cannot be met using an ‘off-the-shelf’ orthoses.
Patients with structural/flexible flat foot requiring arch supports/pronation control orthoses should not be referred but advised to purchase ‘off-the-shelf’ /’in-shoe’ orthoses if required.
Cervical Soft Collars
MSE ICB does not routinely fund cervical soft collars.
Lumbar Supports
MSE ICB does not routinely fund lumbar support orthoses other than custom moulded back braces when prescribed following consultation with NHS commissioned spinal specialist surgeons for which individual prior approval is required.
Funding outside these criteria will only be provided in clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Find out more information on applying for funding in exceptional clinical circumstances