Wheelchair provision - short-term loans: guidance

Annex B: EquipU Protocol

Protocol for the Provision of Wheelchairs

Introduction

The Wheelchair protocol has been developed in response to national work which highlighted inconsistency and gaps in the provision of basic wheelchairs for temporary, short-term loan. Further work within the partnership confirmed that historical arrangements for short term provision of standard wheelchairs have been inconsistent, unclear, reliant on the third sector, and staff are often left to problem solve this gap in provision leading to frustration and delays. There is evidence of a direct impact on delaying discharges from hospital settings, and lack of timely short term provision has an effect on both the physical and mental wellbeing for those patients who are at key stages in their illness/condition.

This protocol does not replace the obligations of regional wheelchair services but rather, addresses the gaps.

Current criteria advises that the regional Wheelchair services will, following assessment, provide standard wheelchairs for 'permanent and substantial usage'. However if the needs are short term or intermittent then the needs will not be met by the service. In terms of residents within Care Homes (residential and Nursing), it is the responsibility of the care Homes to purchase and provide standard wheelchairs for any short term/variable needs.

Section 1 - Key Roles and Responsibilities

The protocol will allow for the short-term provision of standard wheelchairs within the [Insert Partnership Name]. This will streamline the arrangements to avoid delayed discharges from hospital settings and to provide timely short term provision which will benefit the physical and mental wellbeing for those patients who are at key stages in their illness/condition e.g. end of life.

It will be the responsibility of the individual Partner organisations to identify the service settings (e.g. hospital and HSCP) via which this provision is likely to be most relevant in terms of meeting the wider service objectives and the strict criteria detailed below (see Section 2).

The equipment is accessed via the [enter local store details]. Their function is to:

• Procure, store, recycle, and maintain wheelchairs to relevant health and safety requirements.
• Deliver and uplift equipment directly to/from service users homes
• Arrange for repairs as requested.
• Arrange for the annual testing as per the arrangements for relevant equipment provided by Equipu.

Section 2 - Assessment and Provision

Wheelchairs ordered from the equipment service and paid for by Partners will be provided for the key purpose of supporting service users. Criteria are as follows:-

• Provision will up to a maximum of 6 months.
• The wheelchair provided is a standard attendant propelled wheelchair. Self-propelled can also be provided where appropriate.
• Provision will provide some additional short-term support e.g. for 'end of life stages', enabling timeous discharge from hospital, or to prevent admission to hospital at such times.
• Support those recovering from surgery, and temporarily non-weight bearing following illness, including helping avoid social isolation, and/or prevention of hospital admission.
• Assessment for the wheelchair provision will only be in the context of services already being provided; e.g. OT/Physio/nurse, already involved with the service user
• Provision may include those patients who are waiting for a permanent wheelchair from the Regional Wheelchair Service and are otherwise fit for discharge.
  • note: this will be dependent on the level of need the person has and whether the standard attendant propelled wheelchair would be suitable.
• This service will only provide the wheelchair, and no other services will be provided as this is only to address an immediate and short-term need e.g. this does not include environmental adaptations, ramps etc.
• he person must meet the requirements identified in the Assessment Checklist (see attached Appendix A)
• Assessors should only consider the use of core stock and recycled core stock wheelchairs, and will not be able to order non-stock alternatives.

As with all other equipment the principal of 'minimum intervention, maximum independence' (and the avoidance of over-prescription) shall underpin every assessment and alternative forms of managing should have been exhausted.

Section 3 - Ordering Process

The Equipu Store already stocks standard wheelchairs as a core product for order by the local authority Care Homes, and regularly uplifts wheelchairs from people's homes when returning other Equipu products. These chairs are asset managed within the Store.

• Core stock: - check website for current model under product code HWC1

Process for ordering:

• Once assessors have considered the Assessment Checklist [Appendix A] and are satisfied that the wheelchair will be appropriate for the person's needs, they will use their Equipu login to order the wheelchair from the system:
• Chairs will be found on the system by using the product code search facility
• Staff will use their normal Equipu login.
• The assessor will pick a slot in the normal way but to ensure the wheelchair is returned within the agreed timescale, they will order the Uplift immediately the order delivery is confirmed.
• Where necessary, the assessor will make a telephone call to service users the day before the uplift to ensure all arrangements are in place for the return of the wheelchair.
• All assessors must ensure that the service user and their family/carers are absolutely clear about their responsibility for the return of the equipment within the service timescale e.g. maximum of 4 weeks.

• Authorisation will be carried out by designated authorisers for each service
• Staff placing the order will also select the 'Care Group' and the 'Reason for provision'.
• Prescribers or an appropriate designated other person, are responsible for ensuring users and carers are safe to use the wheelchair as per the guidance in Appendix B

Repairs

In the event that a repair is required it can be arranged by the original assessor via the Equipu website or phoning the Equipu Store service directly.

Section 4 - Financial Arrangements

Outcome information from the pilot wheelchair service suggests that the budgetary impact to Partners will be minimal, and timely provision of short-term loan of a wheelchair will assist with addressing delayed discharges and help save significant costs in the wider system. It is expected that there will be high rates of recycling due to short use time scales.

Four weekly monitoring Equipu reports provide managers with detailed information on the expenditure against their budgets. The Equipu Activity sheets name staff who have ordered and describe the types of equipment selected. This information allows managers to monitor the appropriateness of service usage.

Section 5 - Guidance

Supporting information for assessors is available on Appendices A and B. Additional advice may be available through the Equipu Project team.

Section 6 - Communication

The Operational Development Group will support the delivery of the new service arrangements and there will be ongoing monitoring and review to support the delivery of the service. These groups are composed of key representatives from across the Partnership, Equipu Store service provider, the Equipu Project Manager.

The Equipu Project Manager will support Partners in all relevant communication around the Protocol and will actively engage with service areas on an ongoing basis to ensure effective delivery of agreed arrangements.