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Referral, Assessment and Provision

Referral

Referral to the WSS centres are accepted from a variety of registered healthcare professionals including Occupational Therapists, Physiotherapists, other Allied Health Professionals, Nurses, General Practitioners and hospital medical consultants. The practice of needing approval of referral from a GP or hospital doctor will be discontinued .

Referral pathways need to be developed to include local authority Occupational Therapists in social care in keeping with MDT and multi agency approaches. Training for referrers will be developed to facilitate this. Pathways for onward referral from WSS centres to other clinical and/or social care services need to be clearly established for people who need them.

Assessment

The initial identification of need for a wheelchair is currently made by health care staff many of whom refer to the WSS centre. These practitioners carry out the screening assessment, measure the client and make decisions as to whether a more in depth assessment is required. Alternative pathways for issuing standard equipment for people who do not need a specialist assessment should be established in partnership with other local health and social care equipment providers.

Centre staff assess people who require additional or more complex technological solutions to address their mobility and associated seating needs. Accurate and clear information needs to be provided to the centres to ensure optimum outcomes for the client and reduce unnecessary delays. Any relevant additional information should also be provided where appropriate

It is essential that this process forms part of MDT assessment and care planning for those with additional and/or complex health and social care needs. The WSS contribution to the care plan in MDT settings ensures that information is provided as needed and their contribution recognised. By doing this there is increased clarity of where the duty of care lies, whether planned review is to be offered and by which service.

The assessment carried out by centre staff, needs to be standard, with goals agreed with the user, outcome focused and support decision making. The outcome of the assessment will be shared with the user and/or their carers who will receive a copy of it and a copy of the equipment that will be supplied to meet need. Summary information will be shared with other teams and agencies as needed, including any intention for review. Information will be shared within agreed data sharing frameworks.

The single shared assessment and the national minimum information standards provide a mechanism for identifying the need for carer assessment. This mechanism can capture specific issues relating to carer need that impact on their ability to care. Issues directly relating to wheelchairs should form part of this and be addressed through case management.

Provision

The outcome of the wheelchair and seating assessment will identify the type and nature of equipment required. Decisions made for product selection need to be transparent to users and their carers and based on clear assessment criteria. The provision of equipment will take into account the lifetime costs of the chair and the costs associated with not providing a suitable wheelchair to meet user/carer needs.

NHS wheelchair services are based on the principle of universal provision of a wheelchair to meet mobility needs that is free to all. The assessment is based on level of function and the focus is on self initiated mobility or self propulsion related to type, nature and extent of impairment. Statutory services that provide equipment have underpinning criteria for issuing it . These may be financial or clinical or both and aim to provide for the greatest number within available resources.

Criteria for the issue of wheelchairs will be reviewed within the context of other health and social care equipment provision and the pathway of care, in keeping with social models of disability and joint assessment of need.

Nursing and care homes should provide some health and personal care equipment for general, non-specific use such as mobile hoists and wheelchairs for occasional use, and bathlifts as a shared facility for the care group resident in the home. WSS centres could enter into service level agreements with nursing and care home providers to arrange for provision and maintenance of wheelchairs for occasional use to meet this need for their residents.

Wheelchairs are selected from the agreed range of products on the NHS national contract and this range of equipment needs to reflect the needs of users and their carers. Criteria to underpin product selection must include non financial criteria that can assist assessors in their decision making as well as providing useful information and feedback to national procurement, their suppliers and manufacturers.

Delivery

Timescales for equipment delivery will be given at the time of assessment and recipients will be informed of any unforeseen delays. On delivery of the equipment, a mechanism for checking the total order supplied and associated information for wheelchair users and their carers should be provided as routine. This should include explanation and a means of demonstration.

The written information provided to users will comply with the Scottish Accessible Information Forum ( SAIF) recommendations. This shall include as minimum:

• Manufacturer and user information for their wheelchair
• Conditions of supply
• Guidance on transporting their wheelchair on public and in private transport
• What the user should do if the wheelchair should need repair.

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