Fred Holtkamp, Ron Schiedon, Jessica Hohenshon

1 Fontys_University_of_Allied_Health_Professions, Eindhoven
2 Schiedon Orthopedie, Consultant Orthopaedic Footwear, Amstelveen
3 Jessica Hohenschon, Fußorthopädie Hohenschon, Bedburg, Germany / Jess I Care Healthcare Innovation consulting

*Corresponding Author: f.holtkamp@fontys.nl, tel. +31 6 51942732

While orthopaedic Work and Safety Footwear (WSF) can produce great added value in relation to labour participation and reduced work absenteeism, it often remains insufficiently substantiated due to non-standardized processes and knowledge base. Stakeholders and users often have limited knowledge of relevant safety laws and regulations, and deficient insight into the medical, technical, and financial implications of selected WSF interventions. Part 2 of the UNIVERS project ‘a uniform provision of orthopaedic work and safety footwear (WSF)’ therefore focusses on both Users of WSF and Stakeholders in the WSF market.

Objective and Scope
The provision of WSF operates at the intersection of healthcare, labour, and legal regulations. Different interpretations result in inconsistencies and limited transparency. The UNIVERS project aims to create uniformity by gaining insight into stakeholders, processes, and bottlenecks. 
This subproject maps stakeholders in the current provision process, including their roles, responsibilities, and ambiguities among them. Medical criteria, technical standards, and cost-effectiveness are outside the scope and will be addressed in the remaining subprojects of UNIVERS.

Method and Results
For the Dutch WSF market an extensive desk research was conducted based on a stakeholder analysis. Market figures are indicative and based on stakeholder input assumptions, compiled in 2025. The analysis identified six key stakeholders: users; prescribers (medical specialists, general practitioners, occupational physicians); fitters and designers; pedorthists and orthopaedic footwear companies; suppliers; commissioning parties (e.g. employers, employee insurance agency, selfinsurers, private individuals). The Dutch population is estimated at 18 million (CBS, 2025). Approximately 1.44 million people (8%) use insoles or orthotic inserts, and about 1.08 million (6%) use work and safety footwear. The number of individuals requiring orthopaedic footwear is estimated at 90,000–100,000, with an annual provision volume of around 60,000. The WSF market is estimated at 10,000 pairs annually, with an average price of €2,200, resulting in a market value of €22 million. Insoles for WSF account for about 86,400 pairs annually at €300 per pair, totalling €25.9 million. Beyond direct costs, orthopaedic WSF offers societal benefits, including reduced absenteeism, improved productivity, and enhanced worker functionality. From a societal return on investment (SROI) perspective, WSF contributes to labour market reintegration, increased community participation, reduced dependency on social systems, and improved quality of life. Thus, WSF should be seen as a strategic investment in economic and societal value. To realise this value this study recommends to 1) establish a uniform and legally secured provision framework and 2) to develop a central, accessible toolbox for WSF stakeholders and users. 

Conclusion
Despite the increasing importance of labour participation, the Netherlands lacks a uniform, transparent, and legally secured provision process for WSF. Stakeholders have overlapping roles and differing interpretations. This leads to variations in quality, uncertainty among stakeholders, and inefficient use of resources. At the same time, the societal and economic relevance is significant. These findings highlight the need for a uniform, verifiable working method and provide a strong foundation for the next phases of the UNIVERS project, in particular with respect to legal and medical indications.