Prosthetic and amputee rehabilitation - St George's University Hospitals NHS Foundation Trust (2024)

A prosthetic service has been available at Queen Mary’s Hospital since the First World War. It has developed into an internationally recognised service offering highly specialised services for amputees.

Our prosthetic team feature in this short film – you can watch to find out more about the important work they do:

Services offered

The service offers artificial limb assessment, prescription, manufacture, fitting and training for patients with upper and/or lower limb amputations, or limb deficiency. This is delivered by a multidisciplinary team and led by a consultant in rehabilitation medicine. The service works with clients to assess their needs, rehabilitate them into the community and help them achieve function, mobility and independence. This is available as either an inpatient or an outpatient.

Facilities

• Examination rooms
• Prosthetic cast and fitting rooms
• Prosthetic factory on site
• Therapy treatment gym
• Occupational Therapy functional assessment rooms

Amputee rehabilitation at Queen Mary’s

Amputee rehabilitation has been an established service at Queen Mary’s Hospital, Roehampton for over ninety years. The history of Queen Mary’s began with the rehabilitation of service personnel who had lost limbs during World War I. Amputee rehabilitation has continued to be a service at the hospital ever since.

In 2006, the Douglas Bader Rehabilitation Centre – named after Douglas Bader, the RAF pilot who lost both his legs in World War II – was created within the new Queen Mary’s Hospital and provides a specialised multidisciplinary service to amputees from south west London and the region extending to the borders of Surrey and Sussex. Referrals from further afield are considered and may benefit from the range of specialist services, clinical expertise and facilities available.

Amputees are rehabilitated as either inpatients on the Gywnne Holford Ward, which has 10 beds dedicated to amputee rehabilitation, or as outpatients.

All amputees must be referred to the centre by a GP or hospital consultant. A referral form must be completed or, in the case of being referred from out of the region, a letter must be sent to Dr Vijay Kolli, Consultant in Rehabilitation Medicine.

If you would like more information on amputee rehabilitation services or would like to feedback to us please do get in touch with us. You can find out how on the contact us section.

Contact details

Douglas Bader Rehabilitation Centre
Queen Mary’s hospital
Roehampton
London
SW15 5PN

Email
Sarah.smith2@stgeorges.nhs.uk

Telephone advice
020 8487 6030 – Vitali Clinic

Secretaries
020 8487 6800

Douglas Bader Centre reception
020 8487 6001

020 8487 6002

020 8487 6003

Vitali clinic (outpatients)
020 8487 6030

Gwynne Holford Ward (inpatients)
020 8487 6128

Prosthetics department
020 8487 6045

Physiotherapy (rehab gym)
020 8487 6042

Occupational Therapy
020 8487 6139

Social worker
020 8487 6810

Clinical psychologist
020 8487 6140

Bader Gymnasium
020 8487 6040

Opening hours

Monday to Friday 08.00-04.00pm

Location

Queen Mary's Hospital

Treatments

Who would benefit from coming to Queen Mary’s?

Following amputation surgery you will be referred to Queen Mary’s if the team in your hospital where you have had surgery believe you will benefit from the services we provide. If you are recovering well you will be seen within a few weeks.

The decision about whether to have a prosthesis depends on several factors, and every effort is made to make sure the right decision is made in discussion with you. As well as assessing you physically, your personal circ*mstances will be reviewed (for example, housing and family support) to establish whether you can manage the rehabilitation programme and will benefit from having a prosthesis. The team may decide you would benefit from having rehabilitation as an inpatient.

This careful assessment by the doctor and the team will identify if Queen Mary’s is the right place for your rehabilitation. A prosthesis is not always the best option following amputation, because it requires a lot of energy and hard work to learn to use it safely and properly. If during this assessment period you and the team decide that the use of a prosthesis is not the best option at this time, the team will suggest alternative options.

The rehabilitation process at Queen Mary’s Hospital, Roehampton – what happens?

The rehabilitation process starts when you have been assessed by the team and your suitability for rehabilitation and treatment goals have been discussed and agreed with you. In most cases, the main goal is for you to learn to use your prosthesis in the most functional and useful way, and to the best of your ability.

If the use of a prosthesis is appropriate you will be measured for and fitted with a prosthesis, and return for fitting and training. If you are a lower limb amputee it is recommended you attend therapy on a daily basis, mornings and afternoons, to learn to use your prosthesis most effectively; for upper limb amputees rehabilitation is weekly. As part of treatment you will receive advice, information and health education, and you will be encouraged to self-manage your rehabilitation programme. The team works closely with your referring hospital, social services and other organisations as necessary, for your benefit. Please see thepatient information leaflet below for further details of the rehabilitation process.

How long does the rehabilitation take?

As an inpatient you may arrive shortly after surgery and you will need a period of rehabilitation before you are ready to use a prosthesis. For all amputees learning to use your prosthesis safely and functionally can take anything from two to four weeks, sometimes longer. All patients will continue to receive rehabilitation for as long as is necessary. However, it may be necessary or more appropriate for you to continue part of your rehabilitation at your local hospital where the surgery was performed, and you will therefore be discharged within a shorter period. Some patients may have an initial rehabilitation period and then return some months later for further intervention.

Discharge planning

The team will carefully plan for you leaving Queen Mary’s and make sure necessary services are in place.

If you are continuing your rehabilitation at your local hospital, or from the community services, your therapist will discuss this with you and organise it before you are discharged.

If you need help with managing at home this will be organised between the occupational therapist and social worker at Queen Mary’s, their colleagues in your local hospital and/or social services. If it isn’t possible for you to return home you will be advised.

When you leave Queen Mary’s you will be given the names and telephone numbers of people to contact if you have any problems. You will be given a routine follow-up appointment for six weeks after you have been discharged from therapy to assess how you are managing. After that you can make further appointments as necessary.

The Roehampton Limb User Group is a patient run contact point for prosthetic and orthotic patients coming to Queen Mary’s. Bi monthly open meetings with an organised speaker on relevant topics provide contact and information. The Roehampton Limb User Group also meets socially and collaborates with other charities and other patient user and support groups. If you are already a patient at Queen Mary’s you can find out more on the lower ground floor reception notice board and in the fitting rooms or visit www.rlug.org.uk

Key staff

The amputee multidisciplinary team aims to provide a high quality service to upper and lower limb amputees, adults and children. Staff are committed to providing the most effective practice and service that is innovative and efficient, supported by on-site professional education, research and development. There is a range of different clinics including pain assessment and children. Please note that whilst amputation surgery is not performed at Queen Mary’s there is a pre-amputation consultation clinic.

The team works together with you and your family to optimize psychological, social and physical functioning with or without a prosthesis (artificial limb). The team aims to create a flexible and enjoyable environment where everyone is respected and valued.

“You will meet a wide range of health care professionals involved in your care. The amputee rehabilitation team is a specialist team led by the Consultant in Rehabilitation Medicine, Dr.V. Kolli.

• Consultant in Rehabilitation and the Medical Team
  The consultant is responsible for your overall clinical care and works closely with the other members of the team. The doctors, although not surgeons, are experts on amputation surgery, pain management, diabetes and other general medical problems relevant to amputee rehabilitation.
• Nursing Staff
  The nursing staff are responsible for helping you care for yourself during your stay if you are an inpatient. Nurses also run the outpatient clinics and give nursing care to amputees attending. The nurse’s role is both educational and advisory giving advice on stump care and the management of any wounds, and liaises with your district nurse to ensure continuity of your wound care.
• Prosthetists and limb manufacturing
  The prosthetist is the person who makes and fits your prosthesis. The Prosthetics Department based at QMH provides the limb fitting service and all the relevant expertise that surrounds it, both clinically and technically, supported by an on-site modern prosthetics workshop.
• Amputee Therapy Team
  Physiotherapists, occupational therapists and the rehabilitation assistant make up this team. The physiotherapist focuses on exercise, strength, balance and mobility, in particular with your prosthesis. The occupational therapist enables you to adapt and regain independence in every day activities, and may visit your home to recommend appropriate equipment and adaptations.
• Medical Social Worker
  A social worker is available to see you on the ward and also as an outpatient, and offers help and advice related to housing, care and benefit issues.
• Clinical Psychologist
  The psychologist provides emotional and psychological support to help you adjust to changes that amputation can bring to your life.

The team collaborates closely with, and has access to other on-site services and specialists including dietetics, a diabetes clinic, x-ray department, a fully equipped gymnasium, wheelchair services, special seating, orthotics and a gait laboratory.