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1. Introduction
The Executive welcomes the independent Review of the NHS Wheelchair and Seating Service, "Moving Forward - Review of NHS Wheelchair and Seating Services in Scotland: March 2006", as a comprehensive critique of existing services from the viewpoint of users and carers. It is a valuable tool in guiding the Executive in addressing the concerns of those who use the service and indicating ways in which clients believe the service should develop.
The Executive commissioned this Review as a direct result of the Petition to Parliament, PE798, in December 2004 by the late Mrs Margaret Scott, urging the Executive to "resolve the current critical problems in the provision of wheelchairs and specialist seating services within the NHSScotland through a review which, in consultation with users, addressed minimum standards, the scope of equipment provided and the delivery of services."
The Executive is aware that NHSMEL(1997)47, in responding to a review of the relevant services in 1996, highlighted improvements to the service that the Scottish Office wished implemented. This latest review endorses the need to continue to address these improvements.
Many of the proposals for change identified in 1997: increase in the number of satellite services to bring services closer to patients; improvements to patient transport arrangements; efficiency savings in the refurbishment procedures; criteria for provision of a second wheelchair; clearer definitions of the parameters of the service; and more integration with other service providers remain equally valid today.
Furthermore, the new Disability Equality duty, which came into force in December 2006, obliges public bodies, including the Executive, to be proactive in identifying and eliminating discrimination against disabled people, to promote positive attitudes to disabled people and to their participation in public life, while the United Nations International Convention on the Rights of Persons with Disabilities will come into force during 2007.
The challenge, therefore, for all stakeholders involved in addressing the issues raised, is to establish an effective mechanism whereby client-centred transformational change can be achieved realistically, while maintaining - and improving upon - existing services.
The current policy direction within the Health Department is based on Delivering for Health, published in November 2005, in response to the Kerr Report Building a Health Service Fit for the Future, May 2005 sets the framework for developing policy and delivery for health services in Scotland. . Community Health Partnerships ( CHPs) are being encouraged to find innovative ways to deliver client-centred services at local level via a joined up approach .
The independent Review of NHS Wheelchair and Seating Services identifies priority areas for improvements to the service for both users and carers, and recommends the way forward in implementing the improvements in partnership with the client group.
The outcome of the Review is the desire, expressed by both users and carers, for a move to a more integrated model of service delivery, which meets individual and social needs more effectively.
The Review Steering Group, including of a number of professional experts and representatives from service providers, and users and carers, made 40 recommendations. The Executive, NHSScotland and the wider agencies involved will work together on how best to implement the recommendations, both in the short and longer term. We are aware that there will be concerns over capacity and resource issues and we will need to discuss how these can best be managed. The priorities set by the Steering Group provide a helpful framework. However, those recommendations with significant additional financial implications require to be considered as part of the next Spending Review, due to take place in the summer of 2007.
There are, however, significant opportunities to make improvements without committing major new resources, for example, through rolling out of examples of best practice which have already been identified. NHS Boards are encouraged to consider the recommendations with this in mind.
We are extremely grateful to the members of the Steering Group, and all external stakeholders who took the time to respond to the regional, national and formal consultation process. The responses have helped to identify areas where there is most need for improvement. The challenge will be to target those areas where changes will benefit the greatest number of users and carers, within a reasonable timescale, and in ways that are cost effective to NHSScotland and its partners.
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