For clinicians and amputees across Europe, finding the right information, qualifications, and processes for the fitting of a prosthesis can be daunting. All too often, information and policy can discourage those seeking functional equipment. Luckily, streamlined information exists to put clinicians and amputees at ease when weighing their options. This is true regarding a single or multi-grip prosthesis either through the National Health Service (NHS) or other means.

Prior to late 2022, the NHS only provided funding for the use of body-powered prosthetic devices and single grip myoelectric prosthetics. Body powered prosthetics utilize a hook and harness system, which relies solely on the user moving their arm and shoulder to open and close the hook or hand. Many users of this prosthesis have a number of complaints caused by the device, which include torn muscles, burns, and cuts. On the other hand, single grip bionic prostheses use myoelectric technology to open and close the hand. Users move muscles in their residual limb, sending signals via electrode sensors to open and close the hand. 

These devices would be fit by clinicians, either sought out by the patient or by referral from either their clinician – GP, consultant prosthetist, or physiotherapist. Before fitting and submitting a funding request to the NHS, the prosthetist would go through a requirement process with the patient, including information such as past experience with myoelectric arms, experience with body-powered devices, prior fitting, health, frequency of use, etc.

In August 2022, the NHS announced that they had conducted two studies and concluded that funding would be made available for the use of multi-grip myoelectric devices. These offer more grip options for users, making a wide range of tasks easier and more adaptive. Prior to this decision, multi-grip prosthetics were only available to military veterans. According to the NHS, eligible patients must have a minimum upper limb residual length requirement with active muscles that will send signals to the sensors attached inside the prosthetic that will create intuitive hand movements. Children as young as eight can use these devices, allowing them to improve their motion and learning activities. In a world where prosthetic devices can be unattainable for the average person who needs them, this is very welcoming news. However, more criteria exist in order to qualify as a candidate. 

The NHS requires an extensive training session, mandating that users seeking a multi-grip device must first demonstrate a successful trial of a single-grip device over a 12-month period. If the user successfully achieves this stage of the trial and continued use of the single-grip after that length of time, a multi-grip device may then be approved for funding. Continuous follow-ups are also required. One available multi-grip device under this new NHS policy is the Hero Arm by Open Bionics, the first medically approved 3D printed bionic prosthesis. Should a user opt for a Hero Arm after a 12-month trial of a single grip device, it is essential for NHS prosthetists to know they qualify.

“The Hero Arm is eligible, and your NHS prosthetist will be able to submit a funding request for you to get one.” said Open Bionics CEO Joel Gibbard.

To many, the idea of undergoing a 12-month trial with a less functional device prior to being considered for a multi-grip such as the Hero Arm is discouraging. This is especially true when options to test multi-grip control are widely available. Though not explicitly stated, this could come down to the allocation of funds in favour of one over the other. Luckily, if a patient is keen on looking for alternatives to acquiring their multi-grip prosthesis through the NHS, options do in fact exist. 

In September 2021, Open Bionics launched their first in-house clinic to assess, fit, and deliver the Hero Arm to patients, no NHS approval required. The clinic was among the top 4% of companies in the country to receive a grant under the UK’s Strategic Innovation Fund, which has enabled Open Bionics to become a clinical provider in addition to being a prosthetics manufacturer. Patients now have the option to travel to the Open Bionics clinic, located in Bristol city centre, to test the Hero Arm to determine control and eligibility, and discuss financial options which include crowdfunding opportunities. 

For those who prefer to embark on a shorter journey looking for their chosen prosthetic, instead of a 12-month trial of a device that may not suit their needs, the Open Bionics clinic may be a better option – especially as it provides a more patient-centered experience, rather than a process that relies on lengthy qualifications and requirements. 

If you are an existing Hero Arm user of 12 months or more, you could be eligible for immediate NHS funding for a new Hero Arm via your local NHS clinic or Enablement Centre. The NHS will accept the 12 months of continuous Hero Arm use in lieu on a single-grip trial. 

If you want to know more about how to get your Hero Arm funded via the NHS, please tell us! Email us here: [email protected] or [email protected]. To learn more about Open Bionics and the fitting process for a Hero Arm, visit https://openbionics.com/clinicians/ for all things clinic related. In addition, to view the full and detailed clinical commission policy from the NHS on multi-grip devices, check out https://www.england.nhs.uk/publication/clinical-commissioning-policy-multi-grip-prosthetic-hand-all-ages/ and scroll to the first linked .pdf document dated August 2022.