No. Referrals from clinicians are helpful but not necessary.

Self-referrals are welcome. I also accept referrals from case managers and support patients following NHS discharge. If you are unsure what type of appointment you need, contact by phone or email with a brief summary of the problem and I will advise the most appropriate next step.

The first appointment is assessment-led. This typically includes history, goals, a physical assessment, footwear review where relevant, and observation of how you stand and walk. You’ll then be given clear options (custom vs off-the-shelf vs composite where appropriate), what each option is likely to achieve, expected timelines, and the follow-up plan.

Off-the-shelf devices can be appropriate when sizing and alignment are straightforward and the required level of control is moderate. Custom-made orthotics are usually better when fit is difficult, control requirements are higher, symptoms are complex, or comfort/skin tolerance is a concern. The aim is to match the device to your function and safety needs—not to use custom by default.

Composite orthotics are typically considered when you need a lighter device with higher stiffness-to-weight than standard plastics, or when you need a more streamlined profile. They’re commonly used in AFO and KAFO applications where the goal is stability, improved control, and reduced fatigue. Suitability depends on your presentation, activity demands, skin tolerance, and footwear.

Timescales depend on the type of device and whether it’s off-the-shelf or custom-made. Off-the-shelf solutions can sometimes be fitted quickly if appropriate. Custom devices require assessment, manufacture, fitting, and usually a review appointment for fine adjustment. When you contact, you’ll be given an estimated timeline based on what you need.

Often, yes. Orthotic and prosthetic devices frequently need fine adjustments once you’ve worn them in daily life. Follow-up is used to optimise comfort, alignment, skin tolerance, and function. For children, follow-up is especially important because growth can change fit and effectiveness over time.

An AFO supports the foot and ankle and is commonly used for toe clearance (drop-foot), ankle stability, and positioning. A KAFO extends support to the knee and is usually considered when knee instability and or hip control issues create a safety risk or significantly limit walking. The correct option depends on the source of instability, strength/control, and your functional goals—this is determined during assessment.

Bring the footwear you use most often, any current orthoses/prostheses, and any relevant clinic letters or discharge notes if available. If you have specific goals (work demands, sport, stairs, distance walking), note them down—this helps match the device choice to real-life requirements.