Functional Electrical Stimulation (FES) for foot drop

Threshold

Norfolk and Waveney Integrated Care Board (ICB) will only fund functional electrical stimulation for foot drop if the patient meets ALL the following criteria:

• Patient is aged over 16 years of age and has been assessed by a specialist in the management of foot drop which must be of central neurological origin (e.g Stroke, MS, spinal injury)
• There is evidence that foot drop has caused trips, falls or gait issues
• The patient can walk a minimum of 10 metres independently (+/- aids)
• Patients will have undergone a period of conservative management, to include physiotherapy, exercises and different types of splints/orthotics.
• The patient’s cognitive ability is such that they can manage a FES independently if they live alone and do not have carer assistance
• The patient does not have any of the accepted clinical contraindications as per the manufacturer

Clear FES treatment goals and expectations must be outlined to the patient and the clinician must undertake 6, 18, 44- and 72-week reviews to ensure FES remains the optimum treatment. Then reviewed annually for as long as they continue to use the device.

Cases for Individual Funding Consideration ( Patients who do not meet the policy criteria)

On a case to case basis, patients might be eligible for funding, in consideration of their exceptionality. The requesting clinician must provide information to support the case for being considered an exception, by submitting an individual funding request.

Continuation of Treatment

For patients already being treated with FES, who require on-going funding for the maintenance and support of the equipment, IFR approval funding will need to be obtained. The patient will be:

• Consistently using FES
• Have objectively demonstrated (using validated assessment) that the use of FES is still clinically appropriate such as sustained improvement in improved walking ability and achieving key functional outcomes and that this cannot be attained using alternatives such as ankle foot orthoses.

Implanted or wireless FES devices are not commissioned.