Community equipment and housing adaptations: draft guidance

Community equipment Store service models

Since the original guidance in 2009 many Store service arrangements have been reviewed, and Integration has also proved to be a catalyst in helping partners reflect on their local models for provision.

However more could still be done to improve service pathways and remove barriers to the provision of equipment for people in our communities, particularly in relation to issues with the separate funding stream arrangements some equipment services have in place, which can create barriers and blockages.

Store services should be resourced by partners with a funding 'pot' which allows the Stores to procure equipment into the service, according to demand, throughout the year, with all equipment funded equally from this arrangement. Costs for the use of the equipment should then be charged to partners according to use by their services, rather than by type.

The Store service arrangements should be designed and resourced to effectively meet the partner objectives, ensuring that the equipment service is strategically aligned across all relevant services, with clear statements which articulate the expected benefits of timely equipment provision within the service pathways, between hospital and home, institutional settings, and community.

It is the partners' responsibility to ensure that the Store service is appropriately resourced and is provided with clear direction on the business requirements with robust governance in place. Operational and strategic managers should be clearly accountable for expenditure, and actively support the Store service managers to achieve business efficiencies, as well as ensuring they provide a responsive and effective operational service.

The partnership should have documentation which supports effective governance including a service level agreement with the Store service which clarifies the service specification, standards, and monitoring and reporting requirements. The partners should also outline their own arrangements and relationship to the Store service as 'service provider', with an agreement which confirms their obligations and roles and responsibilities.

The funding model needs to allow the Store service to seamlessly procure a wide range of standardised core equipment which should include equipment most commonly assessed for by physiotherapists, nurses and occupational therapists, and for all care groups, and ages, with an annually agreed budget which guarantees appropriate levels of funding throughout the year.

The earlier section on the 'Contribution of equipment and adaptations provision' highlighted the importance of equipment as a cost-effective service with significant benefits for people in our communities, and any decisions to adjust funding need to be properly thought through in terms of the wider impact on service pathways and outcomes.

A fit for purpose IT system should not only allow streamlined processes for the ordering, delivery, and asset management of equipment, but also ensure detailed activity information which provides performance and management reports, supporting the proactive strategic management of the service, and accountability at front line and local team level.

The refreshed Good practice guide for the provision of community equipment services and the self-assessment tool which accompanies this Guidance, should assist partnerships to review their Store service models in line with these aims.

Key Actions

• Store service arrangements should be designed and resourced to effectively meet the partner objectives, ensuring that the equipment service is strategically aligned across all relevant services to help deliver key aims related to supporting hospital discharge, and effectively maintaining people in the community.
• Store services should be resourced by partners with a funding 'pot' which allows the Service to procure equipment into the service, according to demand, throughout the year, with all equipment funded equally from this arrangement. Costs for the use of the equipment should then be charged to partners according to use by their services, rather than by type.
• Funding model should allow the store service to procure a wide range of standardised core equipment for people of all ages and needs (e.g. including equipment assessed for by all relevant Allied Health professionals (AHP's), nurses, care staff, staff working in Sensory services etc.), with an annually agreed budget which guarantees appropriate levels of funding throughout the year.
• Operational and strategic managers should be clearly accountable for overall expenditure and actively support the store service managers to achieve business efficiencies, as well as providing a responsive and effective operational service.
• Partnerships should utilise the Good practice guide for the provision of community equipment, and the new self-assessment tool attached to this Guidance, to assess current services and ensure their arrangements are in line with the aims of the national guidance.