Access to prosthetics for amputees in England

Approximate read time: 10 minutes

On 1 May 2025 the House of Lords will debate the following question for short debate:

Lord Mackinlay of Richborough (Conservative) to ask His Majesty’s Government what steps they are taking to ensure that amputees receive appropriate prosthetics at an appropriate time.

1. Amputation and prosthetics

Amputation can be necessary for a range of reasons, including:^[1]

• severe infection in the limb, and sepsis where the immune system’s reaction to an infection damages tissue
• effects of gangrene, often as a result of peripheral arterial disease
• serious trauma (injury)
• complications from diabetes

There are also instances where a limb is amputated if it has limited movement and function.

Some people who use a prosthesis have not had an amputation; they have had a limb difference from birth.

The NHS explains that prosthetic limbs are not suitable for everyone who has had an amputation: an extensive course of physiotherapy and rehabilitation is required.

If a prosthetic limb is appropriate, the type recommended depends on:

• the type of amputation
• the muscle strength in the remaining section of the limb
• the patient’s general health
• which tasks the patient wants the prosthetic limb to perform
• whether the patient wants a limb that looks as real as possible

The NHS states: “It is possible to have a prosthetic limb that’s both physically realistic and functional, but there may have to be an element of compromise between the different types”.

2. Prosthetics from the NHS in England

As a signatory to the United Nations Convention on the Rights of Persons With Disabilities, the UK is committed to taking “effective measures to ensure personal mobility with the greatest possible independence for persons with disabilities”. Prosthetics are provided to those who need them on the NHS. There is also a Veterans’ Prosthetics Panel, through which people whose limb loss followed from their military service can access high-quality prosthetics.^[2]

In a patient survey conducted in 2018, the majority of people were happy with the care they received from NHS-commissioned prosthetics services.^[3] However, some people reported having issues including delays in the fitting process, dissatisfaction with the range of equipment offered, a high turnover of staff, and inconsistent access to psychological support.

In 2021, NHS England adopted a national framework for prosthetics equipment to end variation between what was available in different areas.^[4] Innovations in recent years mean that options can include ‘bionic’ (myoelectrical control) prosthetics, which respond to the body’s electrical signals. These have been available from the NHS since 2022.^[5]

3. Prosthetics demand and workforce

In the previous government’s ‘NHS long term workforce plan’, prosthetists are listed as one of the groups of allied health professions where more practitioners are needed. A refreshed workforce plan from the Labour government is expected in summer 2025.^[6]

Analysis of the global prosthetics market suggests that demand is rising due to an increase in conditions like diabetes and vascular diseases.^[7]

The number of patients with an amputation or congenital limb deficiency attending specialist rehabilitation service centres in the UK was estimated at 55,000 to 60,000 in 2018.^[8]

4. Concerns about NHS prosthetics provision

Lord Mackinlay has said that the prosthetics initially given to NHS patients “do not do mental health any good”.^[9] Lord Mackinlay said that the arms provided to him by the NHS after he had a quadruple amputation due to sepsis were effectively “rubber clubs with a slight hook shape”. He said the NHS had indicated that he would probably receive a multifunctional arm in year four after his amputation, which he argued is too slow. He said:

I can guarantee that because your functionality is limited, your ability to get to work is limited, your physical appearance looks extremely disabled. So for heaven’s sake, let’s get the prosthetics people need at the earliest time.

Ahead of a meeting with Health Secretary Wes Streeting, Lord Mackinlay told BBC News:

I was fortunate that when I needed to, I could afford quality limb replacements, however we must seek to do better for a whole host of reasons when it comes to what is on offer currently through our NHS.^[10]

Responding to similar points raised in an ITV interview with Lord Mackinlay, an NHS spokesperson said:

The NHS provides a comprehensive package of care and support for people who have lost limbs, including a range of prosthetics. Bionic arms have been part of the offer since 2022, and we are looking at the clinical criteria to see whether more patients could access them quicker if their care teams think they would benefit.^[11]

5. Sports and high-performance prosthetics

Some campaigners have called for more options to be available on the NHS, including sports prosthetics.^[12] A government fund set up in 2017 means any eligible child can obtain a sports prosthetic through their local NHS England limb centre.^[13] This is not available to over-18s.

Paralympian Richard Whitehead has said this causes people to give up sport, because NHS-provided prosthetics do not allow the same range of movement and can cause discomfort when running.^[14]

In answer to a written question in January 2025, the government said the NHS provides adult amputees with “primary prostheses, activity limbs, and adaptations for non-competitive sports, but does not extend this support to high-end sports-specific prosthetics necessary for competitive-level participation”.^[15] It said there were no plans to commission activity blades for over-18s. The NHS has stated that many fitness and physical activities are possible without a sports-specific prosthetic.^[16]

6. Read more

• Limbless Association, ‘Resources library’, accessed 24 April 2025
• Michael Keohan and Emily Coady-Stemp, ‘‘Bionic lord’ holds key limb loss campaign meeting’, BBC News, 6 November 2024
• Nicola Eddison et al, ‘The UK prosthetic and orthotic workforce: Current status and implications for the future’, Human Resources for Health, 8 January 2024, vol 22
• Patrick Kane, ‘Being bionic: How technology transformed my life’, Guardian, 15 November 2018

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Cover image by Lara Jameson on Unsplash.