Results and impact

The service for BCUHB went live in March 2020. A total of 34 patients have been treated through visits to hospitals close to their home. Although Covid-19 restrictions were in place, this compares with 23 patients who received treatment in 2019.

Improved outcomes of increased Range of Movement, improved fit of AFO’s, improved function, achieved patient goals and decreased pain have been reported. Due to the localisation of this service, reduced travel time and cost for the patient’s families have also been made.  The Adopter sites have issued a SMART survey to families after serial casting. 

Reduction in waiting times and costs

There had been a 6 month wait time for serial casting out of area and this has been reduced significantly to between 4 to 6 weeks.  In addition, Betsi Cadwaladr physiotherapists are able to use serial casting as a treatment option for more children due to the accessibility and flexibility of a local service.

It is estimated that there has been a saving of approximately £200 per contact with the service being delivered by BCUHB, this, with the current number of patients, would be approximately £7,000. The social return on investment for the families are an additional benefit with prudent and value-based healthcare principles being met through this service.


Successfully attained original goal of setting up local serial casting clinics across 3 areas of BCUHB.

The Bevan Exemplar played a key part in ensuring the successful implementation of the Adopter sites. The Covid 19 pandemic forced a significant change to the way training was delivered. Although virtual based training was less desirable than face-to-face and created more demands on the trainer, it was readily taken up because there was no viable alternative if the service was to go forward.

Following the introduction of this service, skills have been shared with other services including the adult neurology services and learning disabilities, and a train-the-trainer model is being used to make the service sustainable.