Queen Elizabeth Hospital, Birmingham

The Queen Elizabeth Hospital Birmingham boasts the largest maxillofacial prosthetics centre of its kind in the UK, catering to a population of 1.8 million. It has trained half of all maxillofacial prosthetists across the country. The team of six maxillofacial prosthetists (excluding those in training) are an integral part of the extended surgical team.

The pay banding for the prosthetists ranges from 6 for trainees to 8 for lead specialists, 8b for the consultant deputy manager and band 9 for the consultant head of department. As part of modernising scientific careers, maxillofacial prosthetics was incorporated into healthcare science in 2008 and it is one of the few healthcare scientist roles that involve direct patient contact. They are regulated by the General Dental Council.

Responsible for taking impressions, making and fitting prostheses, among others the unit works with patients who have congenital, traumatic and cancer acquired facial deformities. Many patients travel from outside the region to access the highly specialised services provided here, explains Steve Worrollo, Consultant Maxillofacial Prosthetist and Healthcare Sciences Manager.

‘It’s a great team’, says Deputy Manager and Consultant Maxillofacial Prosthetist, Stefan Edmondson, with surgical registrars always in and out of the lab. The prosthetists attend the maxillofacial, plastics and ear, nose and throat multidisciplinary team meetings and advise in theatre, guiding the surgeons with positioning of implants and in the surgical reconstruction to obtain optimum aesthetic results. ‘Our knowledge of surgery is very comprehensive’, says Steve Worrollo. He explains: ‘We go into theatre with multiple surgical disciplines, which gives us a great understanding in jointly perfecting and developing improved techniques and outcomes.’

They have their own stand-alone clinic, where they take impressions and see patients independently to fit prosthesis and appliances. Some patient relationships can last a lifetime, with patients returning to the clinic over years for new fittings and adjustments.

This case study can be found on page 65 of the Question of Balance report