Adults: NHS Wheelchair Services (WS)
Adults: NHS Wheelchair Services (WS)
How the NHS Wheelchair Services are organised and what they will fund varies from region to region; many have a waiting list. As a first step, however frustrating this can be, it is important to check whether you are eligible for their help and, if so, either which chair or what financial help they may give you. Your consultant, GP, OT or physio will refer you for a wheelchair assessment.
"We discovered through another SMA family that now the powered wheelchairs provided by the NHS are more robust than 5 years ago, with more functions. There is also a possibility to add functions to the powered wheelchair as you need it. The advantage of the NHS powered wheelchair is that any maintenance costs is down to them -batteries, repairs, wheels etc.”
You may need tilt-in-space (the seat-to-back angle remains the same while the whole seating system is tilted backwards) and / or seat elevation to help with your positioning and posture at home and work and to socialise with friends and family. While tilt-in-space is usually funded by wheelchair services, seat elevation is not generally considered a clinical need and is not usually available through the NHS. In England, NHS legislation permits the provision of these services but it does not require them to do so. When there is a shortage of money, local eligibility criteria can change who may and may not have different sorts of wheelchairs. In some areas it is possible to organise joint funding of a wheelchair with charitable funding paying for any necessary seat elevation or alternative functions which the NHS will not fund.
Your OT / physio should be able to advise you if you are likely to face an issue with NHS funding for any seat elevation or alternative functions you need. They can also advise how you can try to pursue the possibility of charitable funding for these.
Following your assessment, there are several possible outcomes:
This usually includes a 3 – 5 year maintenance agreement. The chair belongs to the NHS and they are responsible for insurance, maintenance and repairs.
This is likely to be due to the regional criteria and what funding has been allocated to wheelchair funding. Though it is difficult, this can be challenged under NHS legislation and Human Rights and Disability Discrimination Law. Your OT / physio should be able to advise you if this has been done in your area and support you if you wish to appeal.
If WS will not pay for seat elevation or other functions (such as powered elevating leg rests) in some areas – for those aged up to 25 years – it is possible to organise joint funding with education paying for these. This is so that you are properly able to access educational and social opportunities at college or university. Similarly, it may be possible to organise joint funding via Access to Work (see Access to Work on this page) if you are eligible for this assistance. Your OT / physio or neuromuscular care advisor should be able to advise how you can try to pursue this possibility.
Personal Wheelchair Budgets (previously wheelchair vouchers) are possible in England. You can use this towards the cost of buying any wheelchair of your choice.
With a personal wheelchair budget, you would expect to have had:
- a personalised assessment where you are supported to identify the health and well being outcomes you wish to achieve
- a care plan which captures the health and well being outcomes identified, which may be part of any wider care plans you require for your care
- care that is better integrated, meaning that different agencies work together to support your postural and mobility needs and achieve your health and well being outcomes
- information provided upfront about the amount of money available in your personal wheelchair budget and the options available to you locally to use it
- information about the repair and maintenance of wheelchairs, if the option to purchase a wheelchair outside of the NHS commissioned service is taken.
If this is the outcome, you pay the difference to an agreed supplier. The chair is the property of the NHS and you are responsible for maintenance and repairs. Not all WS will offer this option.
"We agreed to try a mid-wheel Ultra (which came to around 14k) that wheelchair services offered (unsure how they funded it but was part of the voucher scheme). It was a disaster: clunky, hard to drive, no display to see the functions being used. We argued that it was making life difficult instead of the ‘enabling’ effect it should have had.
We asked Wheelchair services to take it back and put the 14k towards a Permobil and then went on to get some funding from a couple of charities and the CCG (now the Integrated Care Board in England). The CCG needed a really clear understanding of how much having the correct chair is so important and life-enhancing – how it can affect mental health well being if you are putting up with something that is uncomfortable and not up to the standard that you need. I’d say you have to use ‘mental health’ in these arguments. Additionally, it may impede you going out and about like able-bodied people.”
WS must give a clear reason, in writing, which you can then discuss with your OT / physio or neuromuscular care advisor. If it is due to the regional criteria and what funding the Integrated Care Board (ICB) has allocated to wheelchair funding, though it is difficult, this can be challenged under NHS legislation and Human Rights and Disability Discrimination Law. Your OT / physio should be able to advise if this has been done in your area and support you if you wish to appeal.