Wheelchair provision - short-term loans: guidance

Assessment and Provision

Assessment for a wheelchair on short-term loan should form part of the wider assessment of on-going needs by appropriately trained staff (e.g. Physiotherapist, Occupational Therapist or nurse).

Mrs B was a palliative patient in end of life stage. Her best-friend from primary school travelled from Australia to spend some time with her revisiting old school haunts. The loan of a wheelchair from the Health & Social Care Joint Equipment Store allowed Mrs B to spend time with her friend and travel to different locations without her over-tiring.

She would have been unable to do this without the timeous loan of the wheelchair. This reduced her social isolation and improved her quality of life and well-being at a crucial stage in her illness.

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

It is good practice to encourage service users to walk whenever it is practical and safe to do so, particularly where this is part of a Rehabilitation/reablement programme. However, a wheelchair can be used when the service user has been assessed as having limited exercise tolerance, is prohibitively slow or in pain when walking, the environment could be dangerous to them, or walking is contra-indicated for medical reasons.

When to provide

It is recommended that, as a minimum, wheelchairs are provided for short-term loan in the following circumstances:

• To support those recovering from surgery, and are temporarily non-weight bearing following illness.
• To reduce social isolation.
• To provide improved quality of end of life care.
• To support service users awaiting a permanent wheelchair who are otherwise fit for discharge from hospital. (This will be dependent on the complexity of need, and whether a standard (attendant or self-propelled) wheelchair would be suitable).

When not to provide

• People resident in care homes – it is the responsibility of care homes to meet the short-term/temporary needs of their residents.
• People requiring the long-term provision of a specialist wheelchair. It is likely that their needs would not be adequately met with a standard wheelchair, and they should be referred to wheelchair specialist services to address their immediate and long-term needs.
• Where the home environment is not suitable for wheelchair access (unless the chair is required for outdoor use only).
• People with fluctuating long term conditions may be better supported by the provision of a permanent wheelchair as part of the self-management of their condition, rather than seeking a short-term loan in an emergency.