Wheelchair provision - short-term loans: guidance

Statutory Responsibilities to meet need

Regional Wheelchair Services

Wheelchair and Seating Services across Scotland are based at five main rehabilitation centres:

• WestMARC (The West of Scotland Mobility and Rehabilitation Centre)
• SMART (South East Mobility and Rehabilitation Technology)
• TORT (Tayside Orthopaedic & Rehabilitation Technology)
• MARS (Mobility and Rehabilitation Service)
• Raigmore Hospital, Inverness

The wheelchair centres will, following assessment, provide standard wheelchairs for 'permanent and substantial use', which has been interpreted as being a need that will last longer than 6 months.

NHS and local authority

The National Health Service (Scotland) Act 1978 places a duty on Health Boards to:

• Promote a comprehensive and integrated health service designed to secure improvement in the physical and mental health of the people of Scotland, and the prevention, diagnosis and treatment of illness
• To provide medical, nursing and other services, whether accommodation or premises, in the home of the patient or elsewhere
• To meet all reasonable requirements, for the purposes of the prevention of illness, the care of persons suffering from illness or the after-care of such persons.

Section 12 of the Social Work (Scotland) Act 1968 places a duty on local authorities to promote social welfare by making available appropriate advice, guidance and assistance, and such facilities as they may consider suitable and adequate to anyone over 18 who need assistance.

Section 12a of the 1968 Act places a duty on local authorities to carry out an assessment of need for anyone they are under a duty to provide care or assistance to, and decide whether those needs call for the provision of any service.

Health & Social Care Integration

The Public Bodies (Joint Working) (Scotland) Act 2014 established the legal framework for the integration of health and social care in Scotland. It requires each health board and local authority to delegate some of their statutory functions, and associated budgets, to their Integration Authority (IA). The IA will be responsible for the planning and delivery of the related services using the entire delegated budget.

The Act also introduced national health and wellbeing outcomes that apply equally across health and social care services in Scotland. These outcomes aim to enable service users and carers to have a clear understanding of what they can expect in terms of improvements in their health and wellbeing.

Successful integration of health and social care services should provide for more people to be cared for and supported at home or in a homely setting. This outcome aims to ensure delivery of community based services, with a focus on prevention and anticipatory care, to mitigate against inappropriate admissions to hospital or long term care settings. It recognises that independent living is key to improving health and wellbeing.

The 2014 Act provides the statutory framework for driving forward these changes and is supported by a set of regulations that prescribe the housing-related functions that must be delegated by a Local Authority. In addition the regulations set out where Local Authority housing-related functions may be delegated subject to local agreement.

Delegated Functions

To underpin the National Outcomes functions relating to equipment and adaptations are part of a range of local authority functions that must be delegated to the Integration Authority.

A definition of equipment (aid) and adaptations which must be delegated has been set out in Regulations^[2].

"aid or adaptation" means any alteration or addition to the structure, access, layout or fixtures of accommodation, and any equipment or fittings installed or provided for use in accommodation, for the purpose of allowing a person to occupy, or continue to occupy, the accommodation as their sole or main residence."

Where equipment and adaptations are provided, these services, along with the resources which fund this support must be included in the integration arrangements.

• This guidance recommends that Health Boards, Local Authorities and Integration Authorities, along with other relevant partners, should include the short-term provision of wheelchairs within their integrated arrangements for the provision of equipment and adaptation services.