We have been running InS:PIRE clinics within NHSGGC for over 10 years. This page will answer some of the questions people often have about our clinic.
Who will get invited to attend InS:PIRE?
InS:PIRE clinics currently run at Glasgow Royal Infirmary (GRI) and the Royal Alexandra Hospital (RAH).
If you were a patient in ICU at one of these hospitals then your records will be reviewed when you go home from hospital. If your stay in ICU was longer than a week or involved support with a life support machine then you will be contacted by one of the InS:PIRE nurses to discuss attending the clinic.
We find that people get the most out of the clinic if they have been at home for a few months before attending InS:PIRE. This time at home gives you time to discover what issues you need help with. We aim to contact patients about 3 months after they have gone home.
What to expect when you come to the InS:PIRE clinic?
The InS:PIRE clinic runs several times per year. Unlike a more traditional clinic where you get one appointment on a single day, the InS:PIRE team will invite you to attend a session every week for 4-5 weeks.
Sessions at GRI are on Thursday afternoons.
Sessions at the RAH are on Wednesday afternoons.
If this is too much of a commitment, then virtual one-off appointments can be arranged. Over the weeks there will be group education sessions hosted by specialist staff and you will have one-to-one consultations with a variety of teams.
People you may meet…
ICU medical and nursing staff
You will meet members of the ICU team who will prepare a summary of what happened whilst you were in ICU. You can ask medical questions and any ongoing referrals or issues can be addressed.
Physiotherapy
You will meet with an ICU physio who can assess and advise you about with muscle, joint and activity level issues. They can make referrals to community services and will develop you a tailored exercise plan if you need one.
Pharmacy
An ICU pharmacist will speak with you and review the medications you are on after your hospital admission. They can make sure you are getting the correct medications and liaise with your GP if they need to.
Other teams and specialists
We also have input from a variety of other specialists who attend the InS:PIRE clinic sessions.
We ask for feedback after every block of InS:PIRE clinic appointments so that we can improve the support we offer to our patients. Some of our previous patients and their families have been kind enough to share their thoughts about attending the clinic in this video.
Creating a place where children can flourish in their early years is a national Public Health priority for Scotland.
This journey begins pre-conception and continues during pregnancy into the early days of life. Since 2017, the Scottish Government has set a strategic direction for maternity and neonatal services across the country with the Best Start five-year review plan. Within NHS Greater Glasgow and Clyde, our maternity and neonatal services continue to evolve, guided by the Best Start principles.
We have made significant progress over the last seven years to effectively implement many of the key recommendations set out in the Best Start review. We are committed to embed and develop further the implementation of the key recommendations and principles of Best Start, the Perinatal and Infant Mental Health Framework and the Women’s Health Plan over the coming five years.
The strategy will link to many other programmes and initiatives, particularly the NHSGGC Moving Forward Together programme, the NHSGGC Nursing and Midwifery Strategy, Digital, Mental health and the Public Protection and Quality Strategies.
The implementation of this strategy will take place in the context of other local work and the development of new national Scottish Government maternity and neonatal policy direction in the coming years.
This document will set the vision for maternity and neonatal services in Greater Glasgow and Clyde from 2024 to 2029.
Occupational Therapy is a person-centred health profession focussed on promoting health and wellbeing through occupation.
Occupational Therapy helps people of all ages regain or improve their ability to do the things that matter to them in their daily life. We focus on understanding what activities (occupations) are important to you and what barriers may be preventing you from participating in them. This could be due to mental or physical health challenges or limitations in your environment. By considering your interests, values, and what is meaningful to you, occupational therapy helps you achieve a healthy and fulfilling life.
Occupational Therapy is a registered profession through Health and Care Professions Council. The Health and Care Professions Council (HCPC, hcpc-uk.org). Occupational Therapists are duel-trained at point of registration and can support people who have both mental and physical health issues.
Occupational therapists can empower you to manage your mental health by improving your daily living skills; for example: cooking and budgeting. OT’s can help you build a balanced routine, explore new interests, and re-establish your social roles. Additionally, they can work with you to modify your environment to support your needs. This might involve implementing strategies or introducing assistive equipment to make daily tasks easier. They can also equip you with coping skills to manage stress, anxiety, and low mood, while also supporting relapse prevention and the development of life skills for long-term well-being. We aim to focus on goals to promote your participation with day-to-day life, re-connecting or re-establishing your sense of identity and ability to cope with life challenges.
The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want, need, or are expected to do, or by modifying the occupation (everyday activities) or the environment to better support their occupational engagement (WFOT, 2012).
The process your Occupational Therapist will follow
Information gathering
In the initial stages your Occupational Therapist’s aim is to gather all information relating to your engagement with occupations in the past and what your current challenges are. This will include gathering information from you and other relevant people in your life, if appropriate, along with discussion with those already involved in care.
Assessment
The Occupational Therapist may complete various assessments to establish your strengths and challenges. These assessments may be observational, interview, or involve engagement in an activity.
Goal setting and planning
Following assessment, the occupational therapist will work with you to set goals and create an intervention treatment plan.
Treatment, interventions and monitoring
Treatment will focus on motivation, habits and routines, or skill building to improve participation in day-to-day life. The environment plays a crucial role in supporting recovery and enhancing daily functioning, as part of treatment the environment may be modified with use of equipment/ adaptations. Individual or group work may be used to support treatment for example: creative groups, community integration, recovery through activity, journey through dementia or home-based memory rehab.
Review outcomes and evaluation
The Occupational Therapist will review the effectiveness of your treatment and make informed decision about continuing, modifying or ending occupational therapy.
Occupations
Your Occupational Therapist will explore a range of occupations. An occupation may be:
Self-care
Self-care may include activities you do to care for your mental, physical or emotional health. This typically includes how you can manage your basic needs: hygiene, diet, sleep.
Leisure
Leisure activities.
Productivity
Productivity typically includes home or garden maintenance, fulfilment of roles and responsibilities, financial activities, educational pursuits or voluntary, or paid employment.
In a range of environments
Occupational therapy assessment and intervention can take place, in your home, hospital, clinic, community, or workplace settings. Sessions may take place face to face or virtually via telephone or digital platforms. Depending on your needs or preferences, sessions may be individual or in a group
Mental Health Occupational Therapy Services
We offer occupational therapy services to adults aged 18 and above who are currently receiving care and treatment from any of the following Greater Glasgow and Clyde mental health services including specialist areas:
Adult/Older people Community Mental Health Teams (located throughout NHSGGC resource centres)
Inpatient Mental Health Services (located throughout NHSGGC inpatient sites)
Specialist and additional occupational therapy services, which include:
ADRS
esteem
perinatal
eating disorders
forensic services
complex needs service
psychological trauma service
ADHD – assessment and intervention service (East Renfrewshire only)
‘You asked what I wanted to do with my day rather than just ask if I have been drinking and offer medication. Thank you.’
‘I love attending the poetry group, you learn and philosophise views of who and what we are collectively reading. We compose our own poems and perform them in this group setting which is supportive, makes you feel at ease and offers fair and balanced feedback. This group is so important to me.’
‘The Occupational therapist helped me leave my home for the first time in two years. Without them I would not have went across my door as my anxiety would stop me.’
‘I felt lonely, had no friends and everyday was the same. My occupational therapist helped me to structure my day and weeks. I joined new clubs, met new people and I now volunteer in my local charity shop. My live now has meaning.’
‘I was struggling at work to manage my ADHD. I couldn’t organise myself, I was missing deadlines and I was prioritising all the wrong things. My Occupational therapist helped me to adopt new strategies to support me in my work place to allow me to do my job.’
Useful Resources
The Royal College of Occupational Therapists have posters (A3 and A4) and leaflets available to download for your own use or to promote the value of occupational therapy in your workplace, community or event.
The posters and ‘Occupations matter’ leaflets highlight different ways occupational therapists support people.
Occupational Therapy is a degree-level profession, so you would need to complete a programme of study at one of the accredited higher education institutions that offer occupational therapy courses in the UK. We also have non-registered staff working in Occupational Therapy Support Worker roles. There are alternative ways to access undergraduate programmes, some people undertake a HNC in Occupational Therapy and enter the undergraduate course in Year 2. We are committed to offering student education in all our mental health services.
This provides you and your family with general guidance on how to care for your back following spinal surgery. It will concentrate on providing you with information on physiotherapy and what to expect following your surgery.
Most questions should be covered here however it does not replace discussion between you and your physiotherapist or surgeon.
The success of your operation is a team effort including doctors, nurses, physiotherapist, occupational, your family and most importantly you.
Immediately after surgery
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Pain Management
You will have some pain following your operation. Due to the wound and swelling around the nerves, you may also experience leg pain, but this is expected to settle within 6 weeks as the swelling subsides. A degree of pain is normal at this stage as the healing process starts. It is important you inform the nursing staff if your pain is increasing so we can help you manage this. Controlling your pain not only helps you move, and sleep better but also aids in your overall well-being. The anaesthetist and ward staff will discuss pain relief options with you, and a pain management nurse may visit you after the operation. It is important not to suddenly stop your painkillers but to gradually reduce your dosage. If pain or swelling significantly increases, please contact your physiotherapist, GP, orthopaedic clinic, or attend your local minor injuries clinic for advice. For details, see the information at the end of the booklet. It is worth noting that the primary goal of the surgery is to relieve leg symptoms. While you may not experience immediate relief from your back pain, as your pain gradually decreases and mobility improves, we hope to see an improvement.
Physiotherapy
We will aim to get you up after you have recovered from the anaesthetic, this can be on the same day as your operation, and it will likely be a Physiotherapist who will assist you. We will check your sensation and movement before showing you the correct way to get up out of the bed. We will then help you to start walking and if necessary, provide you with a walking aid to help you walk until you are independent. It is common to still have attachments such as a drip or catheter after surgery, but this will not prevent you from mobilising. Once you are independent walking, with or without a walking aid, you will be shown how to go up and down the stairs if you are required to do this at home. You will be taught exercises to increase the movement and strength of your back. This will ensure you get the best outcome out of your surgery. It will help if you start these exercises straight away although there may be some circumstances where your consultant does not want you to start exercises straight after your operation. If this is the case, then your physiotherapist will advise you. If you decide to take up the offer of Physiotherapy, your Physiotherapist will likely encourage you to continue progressing your exercises and walking while addressing any concerns you may have. You are likely to feel that your pain and function are already improving at this stage and may require very minimal input from our service. Physiotherapy input can vary depending on your pain, function and confidence levels. Physiotherapy will involve guiding you through and advancing your post op exercises to improve your overall function and address any concerns you may have during this period. Every person is different therefore your recovery may take longer or shorter than the timescales recommended. The most important thing is that you are improving and trying to move and do more each week.
Return to daily living
With all activities you should use your common sense and listen to your body. Mild aches after a new activity are acceptable but severe pain is not.
Improvements can continue for 18 months with the current evidence showing that a more active approach in your rehabilitation will have better outcomes.
Walking
It is important to keep moving after your surgery. Regular walking is highly encouraged as it plays a crucial role in aiding your recovery and overall function. Especially within the initial 6 weeks, it is advisable to gradually increase both the distance and pace of your walks as your pain allows, taking care not to worsen any discomfort. While there is no strict limit on the distance you can walk, starting slowly and gradually on even surfaces may provide greater comfort.
Sitting
You should gradually build up sitting during activities like eating or relaxing and this should be guided by your pain. Limit sitting to 15 minutes for the first few days after your surgery and once you are comfortable you can start to build this time up.
Work
You will need to be off work for between 2-6 weeks depending on your job. If your job involves heavier or more manual tasks, you may be advised to remain off work for up to 12 weeks This will vary from person to person and your surgeon will advise you about your individual case. It is also sensible to discuss with your employer if you can return to light duties initially or reduced hours, making sure that you can regularly move about. The hospital can give you a fit note (used to be known as a sick note) if necessary.
Driving
We do not recommend sitting for extended periods after your surgery, including driving. However, if you have no altered sensation or weakness in your legs, you may resume driving when you feel confident and safe to do so. Generally, we advise waiting a minimum of 2 weeks before driving, although this could be extended to 4 weeks depending on factors such as pain levels, the need for pain relief medication, and the ability to safely perform an emergency stop. If you do require to drive longer distances, ensure you take regular breaks to stretch your legs. Before leaving the hospital, please discuss driving with your surgeon and remember to check with your insurance company.
Early Stage Exercises (0-4 weeks)
Static Abdominals
Static Glutes
Prone Lying
Knee Hugs
Sit to Stand
Intermediate Stage (4-8 weeks)
Gradually increase walking tolerance slowly and incrementally. Generally, walk for 10-15 minutes and gradually increase as you feel comfortable. Monitoring your step count can be a helpful guide with this. You can also begin to add in these exercises which will help with regaining your movement and strength. You may feel some pain at your back while doing these exercises however it should settle back down to normal within 15 minutes of completion. Use your own pain and function as a guide however we would recommend doing between 8-12 repetitions of each exercise 2-3 times per day
Range of Movement (ROM) exercises
Flexion in lying (knees to chest)
Extension in lying
Childs pose
Flexion in sitting
Slouch overcorrect
Spinal flexion/extension in 4-point kneeling
Neuro mobility
Neural flossing in lying with hip and knee at 90 degrees – straighten leg until tension is felt – do both legs, one at a time – operated and non-operated.
Can progress this same exercise to sitting as able.
Strengthening exercises
Glute Bridge
Can progress onto single leg once you can do about 20 reps comfortably
Sit to stand/half squat to a bench
Bird dog/Superman’s
Dead bug
Advanced/ later stage exercises
Continue with intermediate ROM exercises and aim to try and increase your flexibility particularly with movements that still feels tight or restricted.
You should continue to work on your strengthening exercises and as time progresses and your symptoms allow, you can continue to challenge yourself with these exercises by either increasing the frequency, speed, repetitions or adding an additional weight/resistance band..
Sports and Hobbies
Gentle low impact and non-contact sports can start at 4-6 weeks, e.g. – cycling and swimming.
Contact sports should be avoided at first but, you can get back to them after 10-12 weeks however it is sensible to be undertaking other types of exercises such as walking, cycling, and gym work before returning to contact sports. If you need specific guidance and advice on returning to your preferred sport, your physiotherapist can guide you.
You can return to jogging around 10 weeks and it is advisable to gradually build up your time and distance. It is also never too late to start, and jogging/running has so many beneficial health benefits you may wish to look at the NHS Couch to 5k App for a more specific training plan. Get running with Couch to 5K – NHS
As your function improves remember the UK Government guidelines for physical activity levels:
Some people will notice improvements immediately after surgery and others will be feeling much better by around 6 weeks. However, everyone is different, and improvements can continue for 18 months with the current evidence showing that a more active approach in your rehabilitation will have better outcomes.
Contact Information
In an emergency
In an emergency go immediately to your nearest Accident and Emergency (Take your GP letter, procedure information sheet and any tablets issued by Day Surgery).
If you have any further queries regarding your operation, please contact the Day Surgery Unit where you had your operation. Queen Elizabeth University Hospital (Ward 10A/10B/10C/ 10D) 0141 452 2700 8.00am – 7.00pm Monday to Friday Out with these hours, if further help or advice is required, contact NHS 24 Telephone No: 111.
If you have any concerns regarding your physical recovery within the first 4 weeks, please contact the physiotherapy team on 0141 452 3713 (Monday – Friday, 8.30am – 4.30pm). Out with this 4-week period, please discuss with your musculoskeletal physiotherapist.
This appointment will vary depending on why the patient is here.
If it is not the their first time at the clinic then we will;-
Assess the artificial eye for fit, comfort, cosmesis, and condition.
Wash and polish the artificial eye to remove any blemishes and restore shine.
Invite the patient back to have a new fitting carried out if required.
Advise the patient to contact us to arrange an annual check-up if everything is okay.
This appointment will take around 20 minutes.
If the patient is attending after surgery and is wearing a conformer then we will;
Remove the conformer and assess the healing of the socket.
Fit and supply a temporary artificial eye if the socket is healing well. This artificial eye will be worn until the definitive one is made.
Teach the patient how to handle and care for their new eye and answer any questions or concerns.
Answer any questions or concerns.
This appointment will take around 1 hour sometimes longer
The Impression
At this appointment we will;-
Take an impression of inside the eye socket using a cold cream (alginate). This only takes a few minutes
Collect accurate colour samples to match the patients own eye
Write detailed notes to help us reproduce the iris in oil paint
Take a close up photograph of the patients natural eye
This appointment takes around 30 minutes
The Fitting
At this appointment we will;-
Insert a wax model of the eye into the eye socket and assess.
Make alterations to gain the optimum combination of comfort, appearance and movement.
Attach the iris specially painted to the model.
Note details such as white colour and veining to assist us when manufacturing the artificial eye.
Show the patient the model in situ.
This appointment will take around 1 hour
The patient will not take possession of the eye at this appointment.
The Supply
After approximately 6 weeks we will have manufactured the new artificial eye and it will be ready for collection.
At this appointment we will;-
Insert and assess the new artificial eye
Make any necessary modifications.
Discuss with patient any issues or suggestions they may have.
There are several different types of artificial eye which can be worn in the eye socket for different purposes. Here you will find an explanation of what each one is and why it is used.
Types of ocular prosthesis
Conformer
Clear silicone or acrylic conformers retain socket shape post surgery whilst healing process is underway. They should stay in place until approximately 6 weeks after surgery.
Artificial Eye
Worn inside the eye socket in the absence of an eye(s) due to enucleation/evisceration to treat cancer, traumatic eye injury, blind painful eye or anophthalmos (born without an eye). Made from PPMA (Poly Methyl Methacrylate) – Acrylic. A unique artificial eye is produced from a mould taken of the individuals socket. A moulded eye ensures the best possible fit and maximises any movement from underlying muscles upon directional gaze. Painted by hand to best match the fellow eye.
Cosmetic Shell
Worn over a blind, shrunken and cosmetically poor eye. Essentially a cosmetic shell is the same as an artificial eye but usually much thinner to accommodate the underlying eye. To enable wearing of a cosmetic shell the eye must be somewhat shrunken (phthisical) to allow for space to insert the shell without the eye looking too large. It also allows the Ocularist to paint on the surface. Fitting a cosmetic shell can be trickier than an artificial eye due to the irregular nature of the underlying eyes surface and sometimes because of eye sensitivity. A trial period is necessary with a cosmetic shell to assess whether it is a viable option or not. A cosmetic shell is not intended to be worn permanently.
Socket Expander
Socket expansion is often necessary for children with anophthalmia or microphthalmia (no eye/eyes or very small eye/eyes). An ophthalmology Consultant will refer a child to our service if they have been born with one of these conditions. A course of intensive treatment will take place to try and expand the dimensions of the socket as the child grows. A series of clear conformers, increasing in size will worn. The aim of this is to promote growth within the socket and to support bone growth as the child develops. After reaching an optimal size, a painted artificial eye will be an option.
Insertion and removal of an artificial eye
Always handle an artificial eye with clean hands!!
The eyelids hold an artificial eye inside the socket. To remove the artificial eye gently pull down the lower lid until the edge of the prosthesis is visible. Using a fingertip, ease the bottom of the artificial eye out. Looking upwards can also make it a bit easier to come out. Plastic extractors and rubber suction cups can also be provided by the clinic for anyone who struggles to get their prosthesis out using this method.
To reinsert an artificial eye is the reversal of the previous method. Start by holding the artificial eye with the most pointed area towards the nose, lift the upper eyelid and slide the prosthesis directly up and into the socket. Then pull down the lower lid, and secure the eye inside the lower lid. Useful tip – the artificial eye will slide in easier when wet, so running under water or using artificial tears can help.
Care of an artificial eye
How often someone removes their artificial eye for cleaning is mostly down to personal preference, although it is something we encourage.
An artificial eye requires minimal maintenance as long as there is no discomfort or excessive discharge. It should always be in the socket including when sleeping. We strongly discourage leaving the artificial eye out for long periods. Although rare, sockets will sometimes contract (shrink) if the eye is not in for a period of time. Removing the eye for only a short time when cleaning, can hopefully avoid this from ever happening.
Note for cosmetic shell wearers – Typical wear time for a shell is 8-12 hours and the wearer should always remove it before sleeping. The underlying eye needs a rest and if worn constantly could lead to the eye becoming red and very painful possibly sustaining further damage.
Some stickiness upon waking in the morning is normal. Most wearers report this to be the case and they can clean it away without actually having to remove the eye.
Should the artificial eye become irritable removing and washing can often resolve the issue. Sometimes a build-up of dirt on the surface can result in a gritty feeling when blinking. A foreign body such as a trapped eyelash can also cause irritation.
When washing, use warm water and whichever hand soap you like, many prefer a fragrance free soap. Rub the artificial eye between the fingers and thumb to remove any surface deposit and rinse the eye well before re inserting. Tip – always make sure the plug is in the sink when cleaning an artificial eye as if it drops down it is gone!
No specialist cleaners required. It is not advisable to use boiling water, abrasives, chemicals or detergents as these can permanently damage an artificial eye.
Will my eye move?
Many people are surprised to find that an artificial eye can actually move.
In most cases of surgery when removing an eye the surgeon will insert an orbital implant into the socket. This ball shaped implant which is buried under the surface (you cannot see it) serves to replace the lost volume. This means the artificial eye made to fit the socket will often be lighter and thinner which helps gain better movement.
This obviously can vary from person to person depending on how they lost their eye in the first instance but usually there is some degree of movement. We always hope that the eye can attain what we call “conversational movement”. This is the small movements your eyes make when talking to someone rather than the extreme side to side and up and down movements.
How long does an artificial eye last?
There is no definitive answer to this question. Whilst we recommend someone have their artificial eye checked every year, this does not mean they need a new one each time!
Common reasons for replacing an artificial eye
Damage – a crack or chip which we are unable to simply repair. Or the material may have become worn or degraded over time.
Colour change – changes to the real eye or paint fade in the artificial eye may mean it no longer matches the fellow eye well.
Poor fit – surgical alteration or natural changes ie weight change can impact the fit of an eye.
Children usually need their artificial eye replaced more frequently as they are still growing. However adults who take good care of their eye and have no issues can wear their eye happily for many years.
Does having an artificial eye mean I am partially sighted?
In most cases no it does not, although it is easy to understand why people would presume this.
Often people who have only one eye have better eyesight in their remaining eye than people who have both eyes. If a person is struggling with their vision they will need to get a referral from their G.P. to an Ophthalmologist who will assess their eligibility for sight impairment registration. This is not something we can assess at the artificial eye clinic.
Can I swim with an artificial eye?
People do not have to give up swimming if they wear an artificial eye. However, we do advise wearing goggles. Especially if diving in a pool or sea swimming. If the eye happened to become dislodged the chances of finding it again are very slim!
The Ocular Prosthetic Service (Artificial Eye) is based in the Ophthalmology Department of Gartnavel General Hospital. It provides treatments to patients living in the West of Scotland.
The Ocularists role is to supply bespoke, hand crafted artificial eyes and cosmetic shells, created to match the patient’s own natural eye. Aftercare is also provided to maintain the fit and condition of the prosthesis with the aim of ensuring optimal cosmesis and a healthy eye socket.
About the Team
There are two full time members of staff working in the clinic who provide treatment Monday to Friday 8.30am – 4.30pm.
Patients will see one of our Ocularists. Kirsty Craig and Claire Moore, both highly skilled with many years of experience in the field of ocular prosthetics.
Referral and contact information
If you are a patient who requires an appointment and it has been less than 2 years since your last visit then you can simply give us a call on the contact details below to arrange this.
*Note if you phone and it rings out please call back at a different time – we are most likely treating a patient and unable to answer.
If however, it has been longer than 2 years since you last attended the service or you have never been before then a new referral will be required. Your own Optician or your G.P. practice can send this. Most often you will not have to book an appointment with them to facilitate this but instead a phone call to them to request they refer you to us will be suffice.
We accept referrals from the following health boards;
NHS Greater Glasgow and Clyde, NHS Lanarkshire, NHS North of Scotland, NHS Dumfries and Galloway, NHS Forth Valley and NHS Ayrshire and Arran.
MACS website – Support for Microphthalmia, Anophthalmia and Coloboma. Here you will find a very helpful section on prosthetic eyes for children found under “resources”
