We think this will be a really important one for wheelchair users and the Wheelchair Alliance (the Alliance).
In the first issue of 2024, we will inform you about the latest research report we commissioned, which was launched on 3rd December 2023, International Day for People with Disabilities. We will also look back on 2023, highlight a stop press about Lithium batteries and then look ahead to what we hope will be a year of change.
Follow our progress and help strengthen our voice on our website or social channel.
Our value of a wheelchair report highlights the true value of increased investment in wheelchair provision
INCREASING spending on wheelchair services by £22 million each year could unlock benefits to society worth more than £60 million, according to a new report commissioned by The Wheelchair Alliance.
The Wheelchair Alliance (the Alliance) commissioned a research report to identify the real value of providing the right wheelchair that genuinely meets the users’ needs to enable them to live the lives they choose. The Value of a Wheelchair research was undertaken by two independent research organisations, Frontier Economics and Revealing Reality. It was grant-funded by the Motability Foundation and published in December 2023.
The Value of a Wheelchair report considered quantitative data and in-depth interviews with wheelchair users across England. It unambiguously shows that the provision of a high-quality wheelchair does not only have a significant beneficial impact on people’s lives but also leads to financial benefits for the NHS and society.
It highlights that, using conservative assumptions, investment in wheelchair services could result in a significant positive economic impact at a ratio of approximately £3 benefit across society for every £1 invested.
The report stated that an annual increase of £22 million pounds across wheelchair services, with wheelchair users provided with the right high-quality wheelchair and realising a conservative annual total of 1% benefit, would result in a societal return of excess of £60 million. Should the annual total benefit be 5%, the same investment would realise benefits to society, including savings to the NHS, of in excess of £315 million pounds.
The report highlights three key issues;
Local variation: there are clear advantages to locally led provision of NHS wheelchair services. In particular commissioners can provide a service which is tailored to local needs. However, this has led to variation in the standard of care provided and service user experience. This variation has been highlighted in previous studies and our in-depth engagement with wheelchair users re-emphasises this inequality. Service users reported that they were often left to navigate the system themselves and had to rely on their own experience and knowledge to access support.
Funding: analysis shows that a relatively modest increase in wheelchair service equipment spend could make a meaningful impact on the budgets of those Integrated Care Boards (ICBs) who are currently reporting below average per patient spend on equipment budgets. This increase in spend would deliver significant cost benefits.
Integration of service budgets: there is a need to ensure that current budgets are used in the most effective way possible. This includes the sharing of best practice between commissioners and realising the advantages of joined up working and pooled budgets by statutory bodies for the benefit of wheelchair users, their families and carers.
The report has been very well received and the BBC ‘Access All’ podcast hosted by Nikki Fox highlighted it as the lead item on 4th December.
The report has also been highlighted in some trade magazines such as THIIS and AT magazine, shared by numerous organisations such as Motability Foundation and Posture and Mobility Group on their websites and social media channels. It was also handed to the Department of Work and Pensions, who expressed interest and we will be chasing that avenue up as soon as possible. Along with an advertorial in Disability Review Magazine, which reaches around 3.5 million people with a disability, the report is ‘getting out there!’
We thought we would share a few quotes with you:
“Access to the right wheelchair at the right time isn’t just the right thing to do but it also has huge benefit to the wheelchair user and society. The Wheelchair Alliance report highlights that the right chair will increase independence, autonomy and integration in to the community for an individual, resulting in a better quality of life, mental health and physical health, not to mention the improvement to employment and education opportunities. This is all achievable by reducing the variation seen across England by focusing on quality and service improvement and investment into wheelchair services. A modest additional budget of £22m will unlock benefit to the society and the individual of £60m. This report must be a catalyst to change.”
Nick Goldup, Chair of Alliance
“Reading this gives me a better understanding of when people buy expensive cars as they can feel the difference in value; the same happens when it comes to wheelchairs. You should get what you pay for, whether comfort or additional features to enhance your independence. The NHS really need to look into this; as mentioned in this report, wheelchairs are something that has a big effect on thousands of people daily, and that’s beyond disabilities. In them, improving is helping society as a whole. As I say, future-proofing makes the world accessible to all, valuing and understanding that everybody is unique and deserves the best.”
Isaac Harvey
“The Value of a Wheelchair Report articulates well the compelling evidence that the provision of high-quality, tailored wheelchairs not only significantly enhances the lives of individuals but also leads to substantial financial benefits for both the NHS and society at large.
Furthermore, the findings demonstrate the potential for substantial cost savings within the NHS, as an integrated improved wheelchair service reduces the incidence of physical and mental health issues among users and their caregivers. This can mitigate the need for expensive treatments and unplanned secondary care.
While the policy recommendations concentrates on three pivotal areas—simplifying NHS provision, securing adequate wheelchair funding, and fostering flexibility in funding— there should be focus on the service delivery side emphasizing the need for monitoring and evaluation and education and training. Specifically, incorporating real time patient-reported outcome measures, establishing a competency framework, and providing comprehensive training for wheelchair providers should be considered. These measures aim to ensure national consistency and uphold the quality of wheelchair services.”
Alex Kamadu, Exec Director of the International Society of Wheelchair Professionals
“NHS Wheelchair Service providers have always known the qualitative benefits to service users of appropriate wheelchair provision, and instinctively the cost benefits to the health and social care economy and with this valuable research we now have the evidence.”
Krys Jarvis , Service Manager, Shropshire Wheelchair and Posture Services
“It’s kind of depressing that you have to prove that the right wheelchair is a good thing.”
Dan McAleavy, Alliance board member
What people are saying on LinkedIn
“Like all the previous reports on wheelchair services over the decades I would not argue with a single word of this report. To me, there are 2 key issues and until these are addressed nothing will change. Firstly, we need a well-researched cost utility analysis for wheelchairs. My hypothesis is that such research would clearly show the true value of wheelchair provision and finally allow NHS funders to compare wheelchair services to other services. Secondly, and more importantly, there needs to be a national strategic body with real power to oversee wheelchair services. Until these issues are addressed I fear nothing will change.”
Simon Fielden, Director at Rahana Life
“I’m looking forward to reading this. The challenge however is that historically these reports have ended up gathering dust on a shelf, with no drive, impetus and more importantly money to drive serious service improvements for wheelchair users.”
PD
What action will the Alliance be taking?
The Value of a Wheelchair report highlights three policy changes that would enable a significant difference to be made. Under each policy area, the Alliance has indicated the action it will take.
Policy Recommendation #1
NHS England to play a more active role in ensuring that all ICBs prioritise wheelchair services and dedicate sufficient resources to effectively deliver the service. For example, this could be done by mandating that all ICBs adopt the Quality Framework for Wheelchair Provision along with the Model Service Specification when commissioning wheelchair services. This would help to minimise inequality across different services and ensure consistent delivery of a good quality service and provision.
Action One: We will ensure the voices of wheelchair users are represented during the development of the Quality Framework for Wheelchair Provision.
Action Two: We will act as a co-producer of the Quality Framework, only signing off the content when it is approved by both the Alliance Board and its Wheelchair User Engagement Group members.
Action Three: We will lobby the Chief Executive of the NHS to raise awareness and importance of the Quality Framework and expect urgent delivery of an early sign off.
Action Four: We will ensure the Alliance Wheelchair Charter reflects the expectations of the Quality Framework and provide a wheelchair user friendly guide to the Quality Framework.
Action Five: We will enable commissioners to provide the best wheelchair services by ensuring the Model Service Specification for Wheelchair and Specialist Seating is brought up to date and ratified.
Policy Recommendation #2
The Department of Health and Social Care (DHSC) and NHS England should explore the possibility of increasing current spending on NHS wheelchair services to help ensure more benefits are realised and the NHS can unlock significant cost savings.
Action Six: We will lobby at Governmental level, demanding a review of current investment levels into wheelchair services which have not altered in decades and have been severely impacted by both austerity measures and the cost-of-living challenges.
Action Seven: We will work in collaboration with NHS England, ICBs, other statutory bodies, charitable organisations, manufacturers, providers and wheelchair users to demonstrate the benefits of providing high quality wheelchair services and a choice of wheelchairs to suit a persons identified lifestyle needs. This will be through our APPG for Wheelchair Provision and via an innovation group.
Policy Recommendation #3
Local wheelchair services and commissioners should continue to share best practice and explore opportunities to pool budgets between wheelchair services and other local services. NHS England should consider what support and processes are required to encourage and facilitate greater joined up working and frictionless pooling of budgets.
Action Eight: We will promote best practice examples through case studies published in our newsletter and on our website.
Action Nine: We will identify funding opportunities to conduct research to demonstrate the human benefits of shared funding mechanisms as identified by wheelchair users, their families and carers.
Action Ten: We will continue to monitor the provision of wheelchairs and, should there continue to be inequity of provision and choice across England, have high level discussions exploring the benefits of a national wheelchair service provision funded through health, social care and education contribution.
2023 in nutshell!
Alliance, post first research report in May 2022, actively influences wheelchair service tenders, acknowledged in best practice standards. Ongoing efforts focus on improving oversight, data, and equitable provision, with the second report reinforcing advocacy.
NHS England collaborates with the Alliance to develop a Quality Framework, incorporating expert input from the Alliance Board and Wheelchair User Engagement Group. This framework addresses the devolved responsibility for wheelchair provision to enhance equitable access across the country.
The Wheelchair User Engagement Group, now over 145,000 strong, aims to expand into a National Advisory Board, with strategic representation on the Alliance Board and Quality Framework group.
Alliance’s extensive outreach includes quarterly newsletters, ‘A View from a Chair’ articles, LinkedIn posts, and features in Thumbprint magazine, effectively reaching those affected by MND. Seeking support for financial sponsorship, partnership, new Board members, and an Advocate.
Website development continues with added FAQs derived from recurring user questions. A second grant from the Motability Foundation supports a new research project published on December 3, 2023.
Active participation in events such as Disability Expo and PMG, along with the creation of awareness leaflets.
Initiatives include discussions for an All-Party Parliamentary Group (APPG) for Wheelchair Provision, led by the Alliance and supported by Whizz-Kidz. Challenges of innovation in NHS provision addressed through an upcoming Innovation Special Interest Group meeting in 2024.
The Wheelchair User Engagement Group’s growth includes a member representing rare neurological conditions, contributing to strategy and Quality Framework development.
Managing 82 contact form submissions (as of 11/12/23) with FAQs addressing common problems. Collaboration with influencers on LinkedIn raises awareness.
Ongoing meetings with NHS England, especially during Quality Framework collaboration. Expanded network connections with organizations representing wheelchair users through newsletters and website links.
And what for 2024?
These are the five key areas that the Alliance will focus on as we head into the year ahead:
To build our National Wheelchair User Advisory Body
To Increase awareness of the Alliance to ensure all wheelchair users and their families know we are here to help get their voice heard.
To make action happen following our latest research report (see the 10 point action plan above)
To have the first Innovation Special Interest Group meeting
Launch our revised sponsorship and partnership offer to secure income which will ensure we can continue strengthening the voice of wheelchair users and drive change
STOP PRESS!
Some concerns have been raised about the safety of Lithium batteries (Li Batt) which are used in powered wheelchairs and mobility scooters and the British Healthcare Trades Association has developed guidance for businesses to share with consumers/customers (B2C). It says that a number of areas should be highlighted, especially as not all Li Batts are the same, such as:
