Wheelchair provision - short-term loans: guidance

Models of provision

Integrated Community Equipment Service

Where integrated Community Equipment services offer the logistics and infrastructure to provide a range of community equipment, they are well placed to offer short-term loan of standard wheelchairs as a responsive service in line with any other equipment provision and service intervention. This can help provide an important context for the provision of the wheelchair alongside other intervention e.g. ongoing rehabilitation, where there will be a need to balance issues related to fatigue, with the opportunity to maximise functional ability and strength. This approach is also cost-effective, and offers the inbuilt governance associated with the existing Equipment service e.g. professional review of equipment, maintenance, procurement efficiencies, reporting and financial monitoring.

In the West of Scotland, under the auspices of the Equipu Partnership, NHS Greater Glasgow & Clyde in partnership with Glasgow City, East Dunbartonshire, West Dunbartonshire , Renfrewshire, East Renfrewshire, and South Lanarkshire have developed a joint protocol for the provision of wheelchairs for short-term use through the community equipment store. Clear assessment criteria were agreed, with a focus on reducing delayed discharges and supporting end of life stages. A copy of the protocol is available at Annex B.

Let's not always look at things from the health point of view. Let's allow someone to have some independence and quality of life.
Physiotherapist

The Duty Occupational Therapist received a call from a Physiotherapist who was trying to prevent an admission to hospital. The duty OT immediately processed an order via the Equipu joint store for a wheelchair and this was delivered the next day. Quick provision of the wheelchair meant that the client was not admitted to hospital, and instead cared for in their own home.

The Duty OT stated "It is great to have the option of Equipu, previously we were reliant on either the British Red Cross or a private hire company in such instances, but this is so much quicker and straightforward"

Commissioning from the Third Sector

Alternatively, this service could be commissioned from a third sector organisation, like the Red Cross. The Red Cross is the biggest national provider of short-term wheelchair loans. Operating from around 250 sites across the UK. In 2017 the charity provided 87,500 mobility aids across the UK, including 58,000 wheelchairs.

The Red Cross is currently providing short-term loans of wheelchairs that help:

• Avoid delayed discharges from hospital, as the patient awaits provision of a permanent chair, or requires a chair for a short-period to aid recovery.
• Aid rehabilitation; people are being referred to the Red Cross by OTs and physiotherapists who are unable to provide chairs for short-term use.

In a few areas, teams are based directly in hospitals and medical centres, where they work closely with medical staff in identifying who needs help.

Many areas are already working with the Red Cross through their Assessment at Home and Home from Hospital Services. This makes the Red Cross already well placed to also provide short-term wheelchair loans, where the infrastructure may not be in place to easily accommodate this provision via the local Community Equipment Store service.

Janis is 65 years old and is retired. She broke her ankle after a fall and had to undergo minor surgery and was in plaster for 6 months.

At the hospital Janice and her husband picked up a leaflet about wheelchair services, but none were close enough to their home in the countryside. However, one of the hospital staff mentioned that the Red Cross might provide a wheelchair loan.

Janis was discharged with a walking frame and crutches. Her husband felt that the wheelchair allowed his wife to return home earlier, avoiding an extra day or two in hospital.

The wheelchair helped Janis get around the house more easily than relying on crutches which hurt her knee and ankle. She could wheel herself to the kitchen, garden and toilet, and do day-to-day tasks by herself.

"It enabled having a bit more capability and independence…. Reduced feelings of isolation for both of us for over four weeks and even longer, so there's more freedom for both of us. Without it we would have been really stuck."

After ten days Janis was able to use the walking frame to get to the car, but still appreciated having the chair.

Her husband thinks that without the chair they may well have had to attend A&E, as Janis had stumbled a couple of times with the crutches. He feels strongly that the wheelchair had a significant and positive impact on maintaining his wife's emotional wellbeing and quality of life.