NHS Wheelchair Service - A Guide - Focus on Disability

Focus on Disability - For Disabled People, the Elderly and their Carers in the UK

A guide to obtaining a wheelchair through the NHS Wheelchair Service if you have mobility problems. Referrals, assessments and types of wheelchair provided.

Overview

If you have difficulty in walking you could qualify for a wheelchair, you should discuss this with your Doctor, District Nurse, Occupational Therapist or Physiotherapist. An Occupational Therapist will assess your needs at your local N.H.S. Wheelchair Service Clinic.

The Wheelchair Service provides appropriate mobility equipment for people of all ages with a long term disability ( i.e. likely to be in excess of 6 months ) who have difficulty in walking.
They will help you choose a wheelchair that meets your needs, including extras like cushions, arm rests or trays. There is usually provision for short term loan wheelchairs (i.e. less than 6 months).

NHS Wheelchair Services are run by local health authorities and NHS Trusts. They are responsible for allocating funds to the Wheelchair Service and Primary Care Trusts who are responsible for providing the service itself. This sometimes includes contracting the running of the service to an outside company.

It’s important to note that the way services are organised and provided varies between locations. This includes the ‘eligibility criteria’ used to decide what type of wheelchair – if any – to provide, the timescales in which to provide equipment, and the way in which wheelchairs are funded. The basic process is as follows:

you are referred to a local NHS Wheelchair Service
an assessment of your needs takes place
timescales and funding options are discussed
the wheelchair, and training in its use, is provided
a maintenance and repair plan(s) is arranged

Wheelchairs can be manual or powered and may be provided with accessories such as cushions, armrests and trays. They are resourced from a limited list of suppliers/manufacturers.

Steel framed wheelchairs are generally provided as standard unless there is a compelling clinical reason as to why a different wheelchair is required.

The NHS Voucher Scheme

Voucher schemes

Voucher schemes are designed to increase the choice of wheelchairs available to you. Services decide locally whether to have a scheme and how that scheme is applied.

In services that operate a scheme, when you attend a clinic for an assessment of a wheelchair you may find there are three options:

Standard option

You are provided with a wheelchair that will be supplied, repaired and maintained free of charge.

Partnership option

You choose an alternative to the type of wheelchair you are assessed as needing. This lets you to buy a wheelchair of a higher standard than that which the NHS Wheelchair Service supplies. The voucher reflects the value of the wheelchair originally recommended and you then pay the difference in cost.

The wheelchair will be repaired and maintained free of charge.

You have to choose a wheelchair from an ‘approved supplier’ who has to meet certain standards including quality of service.

Independent option

This is similar to the partnership option but you own the wheelchair and are responsible for its repair and maintenance. However, the voucher you receive will include an amount towards the anticipated costs of repair and maintenance.

Other things you need to know

The voucher period is generally five years and you will not normally be entitled to a new voucher until this period has expired. However, if your needs change – making the wheelchair you have bought unsuitable – you will be eligible for a reassessment of your needs.

You cannot exchange the voucher for cash. Also, if you buy a wheelchair privately from a commercial company or individual, you cannot ‘claim back’ the money from the NHS Wheelchair Service.

The voucher is non-taxable so it does not affect any disability benefits you are receiving.

Usually Wheelchair Service’s do not provide:

Adult wheelchairs for outside use only – this includes manually propelled and electrically powered wheelchairs

Wheelchairs in the place of a suitable static seat

Transit wheelchairs to residents of Residential Care or Nursing Homes

Powered packs or powered wheels that are retro fitted to manual wheelchairs

Wheelchairs supplied by The Wheelchair Service are for the exclusive use of the person they are provided for. If a wheelchair is no longer required by the user, the approved repairer must be contacted to arrange for collection.

Referrals and Assessments

Referrals

You will be referred to a service by a hospital, doctor, consultant or occupational therapist or the service may operate a self-referral system.

Each service will have its own eligibility criteria and the details of your referral will be reviewed to work out its priority. This will include the nature and level of your disability and/or medical condition, your lifestyle and needs, where and when you will use the wheelchair and your ability to use any particular type of wheelchair.

Your referral should be acknowledged by the service within a week or so. The service will let the person that referred you know the approximate timescales for you to receive your wheelchair. The time between referral and assessment is usually between two to four weeks.

Assessments

Assessments are normally carried out at NHS Wheelchair Services centres or clinics. Ask your local social services if you need help with transport. The person doing the assessment will be a professional qualified in wheelchair assessments – for example, an occupational therapist.

Occasionally, a hospital consultant or doctor may prescribe a wheelchair.

The process may involve a rehabilitation engineer responsible for how the wheelchair works – its dimensions, functionality and any adjustments, features or fixtures it needs. This includes special postural seating.

Where necessary, a specialist team can provide assessments for equipment for people with severe physical disabilities who cannot use standard wheelchairs and/or controls.

The assessment may include other professionals across health, education and social services. This is especially important if the wheelchair is for a child who will have development needs. All the situations in which a wheelchair may be used – like at school, using transport and social activities – will be part of the assessment. Parents and carers should also be part of the process and their opinions and views considered.

Re-assessment of your needs

When a person’s needs change, the Wheelchair Service may conduct a review. This may include, for example, changing from a manual to a powered wheelchair.

Receiving your wheelchair, maintenance and repair

Timescales in which your wheelchair will be delivered can vary depending on the type of wheelchair provided and local resources. It may be from ‘standard stock’, ordered from a supplier, or ‘bespoke’ (made to measure). For a bespoke wheelchair, you may have to wait several months.

When ready, there is a formal handover of the wheelchair which could either be at the Wheelchair Service centre or clinic or at your home (or where you are living). This should involve:

showing you how to use the wheelchair including safety issues
providing you with relevant documents and a point of contact for future enquiries
information about insurance and arranging repairs/maintenance – and who is responsible for this

If you move location

If you move to a different area, the wheelchair should go with you. Depending on what type of agreement you have, the new Wheelchair Service may take over the future maintenance of equipment. Minor repairs can often be done at your home.

Wheelchairs for children

Typically children approaching school age will normally be provided with an age appropriate wheelchair. For those children under 36 months of age wher e the child cannot sit unsupported or has the potential to develop a postural deformity, a special list piece of equipment will be provided. This will either be a commercially availabl e item or a custom built system. Children under three years will be considered for an electrically powered wheelchair on an individual basis.

Postural support in wheelchairs for special needs

Clients referred to The Wheelchair Service who have problems maintaining their position when seated in a wheelchair will be assessed and may be supplied with a range of equipment with the express purpose of maintaining posture to aid mobility.
This may include contoured cushions, belts or harnesses, back supports, bespoke seating or the provision of a tilt in space system.
This service is available to all age groups, and all must be wheelchair dependant. It must also be assessed that the client will benefit from increased independence offered by the postural support, prevention of deformity or medical management.
The home environment and transport must be suitable for the larger postural solutions and the client and carer must be aware of the issues involved with provision of postural support solutions. If appropriate the client must be able to continue with transfers.

Types of powered wheelchair provided

Indoor and/or outdoor powered wheelchairs are for use by disabled people who cannot propel a manual wheelchair. There are criteria for using some types of electric wheelchair.

The Wheelchair Service are unable to fund outdoor use only powered wheelchairs and attendant controlled powered wheelchairs. These wheelchairs are usually self funded or charitably funded.

Types of wheelchair available:

Electrically Powered Indoor Chair ( EPIC )
EPIOC – Electrically Powered Indoor/Outdoor Chair – small enough to use indoors but capable of going outside as well. Often meets most power chair user needs.
EPOIC Electrically Powered Outdoor/Indoor Chair – this latter category is often not mentioned because the wheelchair may be too large to fit into the patients home. Justification of need required e.g. Lives in home outside village/Town. needs to travel distance to work/shops & no other transport available.

Highway regulations group outdoor powered wheelchairs into two categories, Class 2 and Class 3:

Class 2 wheelchairs must have a maximum speed of 4mph (6.4kph) and are for pavement use only
Class 3 wheelchairs must have a maximum speed of 8mph (12.8kph) and can be used on roads

NHS Wheelchair Service – A Guide