The Scottish Government

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Building Capacity

Local clinics

Developing local wheelchair and seating clinics and the local expertise to support these will increase capacity as well as provide services closer to home. This model of service delivery needs to be underpinned by developing local expertise and clinical leadership for wheelchair assisted mobility and postural management and the wheelchair centres have a key role in supporting this through sharing expertise and developing others.

Developing practitioners with a special interest provides the framework in which to do this. Local service provision will be ehhanced by practitioners with agreed levels of clinical, technical and product knowledge who can directly order wheelchairs from the centres.

Building the capacity of the workforce, developing its skills and knowledge within services will offer an opportunity to develop career paths for those working in wheelchair and seating services as well as contributing towards sustainable services. Wheelchair and seating services have challenges with recruiting staff and it is crucial that career pathways are formed to support succession and sustainability.

A tiered model of service and skills progression provides an illustration of the way forward:

Supporting Definitions;

Tier 1 - Simple Cases

• basic cases
• standard issue chairs
• standard cushion
• no adaptations

Tier 2 - Moderate cases

• specialist lightweight chairs
• some degree of modification to the seat or the chair
• currently assessed by centre staff

Tier 2 - Complex Cases

• significant postural difficulties
• major seating requirements
• require assessment and treatment by centre staff
• require planned review

In order to develop the health workforce and to provide services locally within the tiered model, professional leadership will be needed. Physiotherapists and Occupational Therapists are the two principal professional groups who manage clients' mobility issues and function in environments and they form part of the Allied Health Professions grouping. Strategic professional leadership should be identified in Board areas in relation to wheelchair and associated postural management seating to support local service and professional development within the context of evidence based practice and sustainable services.

Separate wheelchair and seating clinics need to be developed locally for adults and for children, ensuring that age appropriate care is provided within suitable environments.

Staff employed to deliver clinical services to children need to be appropriately trained in child development. Clinical services provided will embrace child centred approaches through MDT working and centres will actively support transitions through school and from child to adult services by being responsive to the their individual needs. It is particularly important that service are delivered in a timely way as delays to provision for children can have disproportionate effect.

Providing local access and local clinics requires accommodation that meets the needs of service users and staff and that can be accessed with patient transport. Facilities need to include clinical space for assessment, wheelchair access and toilets, space for storing wheelchair stock. WSS centres should have this as standard to deliver their service.

Improved access for wheelchair users to centres and to local clinics needs to be underpinned by suitable transport that needs. The WSS centres and local health providers need to work in collaboration with the Scottish Ambulance Service ( SAS) and other transport providers to ensure that wheelchair users and their carers have appropriate and timely access to clinics.

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