NHS SCOTLAND WHEELCHAIR AND SEATING SERVICES – CLINICAL STANDARDS CONSULTATION

GENERAL COMMENTS

i.  Capability Scotland works with disabled people of all ages and their families and carers throughout Scotland to provide a broad range of flexible, personalised care services. We are also a campaigning organisation, committed to using the influence we have to ensure disabled people achieve the same human and civil rights as the rest of society.

ii.  We welcome the opportunity to respond to the NHS Scotland Wheelchair and Seating Services Consultation on Clinical Standards. We have consulted widely amongst staff and service managers for their views.

iii.  Capability welcomes and supports these clinical standards which we believe will help to improve the wheelchair service and the health and wellbeing of wheelchair users across Scotland. The clinical standards also put into effect many of the recommendations made in Moving Forward, the 2006 review of NHS wheelchair and seating services.

Needs Based Assessment

1.  As acknowledged in point 1.1 of the standards, it is essential that assessments are person centred and anticipatory. We support this approach but believe the standards should go further to ensure that the needs of the individual are fully and thoroughly assessed. In particular, we are keen to ensure that assessment findings are in no way influenced or limited by the range and availability of NHS equipment. We are concerned that assessments are currently too prescriptive, with individuals often being assessed in terms of their suitability for NHS equipment - rather than NHS equipment being reactive to individual needs.

2.  When an assessment is carried out, the range of equipment available from the NHS should not prevent the assessor from fully identifying the specific needs of the individual and how those needs would be best met – even where the NHS is unable to meet those needs immediately.

3.  The draft standards state that “information on the range of NHS equipment available should be readily available to those undertaking assessment”. We understand the rationale for this but are concerned that assessments are already prejudiced by assessors’ knowledge of available equipment and that this can sometimes prevent him/her from identifying the full extent of a person’s requirements. Assessors should be encouraged to assess need regardless of whether there is NHS equipment available to meet that need.

4.  We acknowledge that, due to financial and practical constraints, the NHS will not immediately be able to meet all the needs identified by needs based assessments. However, such an approach would identify unmet need in the broadest sense, allowing information to be gathered on the equipment that would best the needs of wheelchair users in Scotland. This information should then be collated and used to inform the procurement process and decisions in relation to stock selection and renewal.

5.  A more needs based approach also has the potential to lead to savings for the wheelchair service. Capability has anecdotal evidence of individuals being given more expensive equipment than they require, because more suitable, cheaper options are not available from the NHS. Recording information on demand of this kind would lead to more informed and well planned procurement decisions being made.

6.  An entirely needs based assessment would also provide the individual with an accurate picture of what their equipment needs are. This would make it easier and safer for individuals to identify the correct equipment should they decide to buy their own equipment from a private supplier.

Equipment Provision and Management

1.  Recommendation 4.9 seeks to ensure that “a model of equipment renewal that responds to technological advances and changing user needs is in place”. We are keen to ensure that there is a formal procedure in place in relation to product selection and equipment renewal. This will help to ensure that there is transparency and accountability within the decision making process and that a suitable balance is struck between financial/practical constraints and the needs of users and carers. As noted above, it is essential that information on demand for products not currently supplied by the NHS is recorded and used to inform product selection decisions.

Thank you for the opportunity to comment on this consultation

Hanna McCulloch

Senior Policy Advisor

Capability Scotland

Head Office Westerlea

11 Ellersly Road

Edinburgh

EH12 6HY

0131 347 1025