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AJM Healthcare gains CECOPS Corporate Accreditation for its Community Equipment and Integrated Wheelchair Services, nationwide!
AJM Healthcare has gained the highly regarded CECOPS Corporate Accreditation for its Community Equipment, Integrated Wheelchair Services and Approved Repairer Services. AJM is a growing organisation providing 20+ services nationwide.
AJM delivers a range of mobility equipment solutions to the NHS, Local Authority partners and individuals across the UK, providing good quality, outcome-led services in wheelchair and community equipment to increase independence, choice and control, whilst offering commissioners a cost effective and efficient solution.
CECOPS CIC is the leading independent standards and accreditation body for all assistive technology services, now working with over 200 services across the UK.
Uniquely, CECOPS has developed standards which not only cover the planning and commissioning of services, but also the delivery of services including the clinical and technical aspects.
CECOPS accreditation is a regular feature in service specifications for assistive technology services, and is a way of assuring commissioners that services are meeting the best outcome-based quality and performance related standards in this sector
Stephen Peck, Managing Director, AJM Healthcare, says:
“Our main aim is to deliver a good quality service on behalf of our stakeholders, service users and carers. Gaining the prestigious CECOPS Corporate Accreditation has helped us immensely in achieving our aim and it provides external validation on our commitment to continuously improving. The CECOPS assessment process was very thorough and commendable and we gained a lot from the experience.”
CECOPS CEO, Brian Donnelly, says:
“It is very encouraging to see the growing interest in our Corporate Accreditation programme and the value that it brings to services. It is great news that AJM has achieved Corporate Accreditation status for its community equipment and integrated wheelchair services contracts. Their commitment to quality and improving standards is impressive. Well done!”
If you commission or provide assistive technology services (e.g. digital health, telecare, wheelchair service, community equipment service, adaptations) and you would like to find out the CECOPS corporate accreditation programme can support you, please get in touch: firstname.lastname@example.org | 01494 863398
CECOPS is building on its widely used and respected accreditation model by introducing a new grading system for assistive technology services throughout the UK.
The new system aims to drive up quality, safety, performance and user experience, and has a continuous improvement focus.
Providers who are delivering excellent services will benefit from the new gradings system by being able to distinguish themselves and win new business. It will also be helpful for procurement and commissioning leads when evaluating and awarding contracts, and it will enable the public to see how well providers are performing.
From 2020, any provider gaining CECOPS accreditation status will be awarded one of the following grades:
The grading system applies across all assistive technology services covered by CECOPS e.g. digital health, telecare, community equipment and wheelchair services.
To date, the CECOPS accreditation model has sought to ensure organisations were compliant with the CECOPS standards, thereby meeting quality outcomes; it did not distinguish between a compliant and an excellent service.
The CECOPS grading system is centred on alignment with 10 themes, each of which are indicators of quality and performance at the heart of an organisation.
Grades will be awarded based on how well a service performs against each of the following themes:
Theme 1: Organisational Learning & Continuous Improvement
Theme 2: Compliance with CECOPS Standards
Theme 3: Customer Experience
Theme 4: Leadership
Theme 5: Governance & Risk Management
Theme 6: Quality, Safety and Performance
Theme 7: Staff Competence
Theme 8: Efficiency & Effectiveness
Theme 9: Innovation
Theme 10: Integration (where applicable)
Alignment with the themes will be determined as part of the CECOPS accreditation assessment process.
The grade will be public and will appear on an organisation’s CECOPS profile page.
The grading system will be introduced as a staged process from January 2020, with providers currently working with CECOPS being awarded a grading when their next assessment for accreditation is due.
We believe this exciting new development will help shape the future of assistive technology services by driving up service standards and enabling providers to demonstrate the quality of their service.
Assistive technology services are vital for the health, wellbeing and independence of many people, and it is important these services are provided as best as they possibly can be to ensure good quality outcomes. Our standards set the baseline for providers, and the grading system will help drive up quality and aspiration to aim to be the best. Prof Mike Bewick MB, BS, FRCP, FRCGP, MIPH, Chairman, CECOPS
We have been asked on a number of occasions by commissioners and providers if we were going to introduce a grading system. Now that we are working with over 200 organisations, we feel the time is right. Offering this unique approach in the assistive technology space demonstrates our commitment to improving the quality and performance of these services. Brian Donnelly MSc, CEO, CECOPS
If you commission or provide assistive technology services, and are interested in how the CECOPS grading system might support you, please get in touch: email@example.com or call 01494 863398
CECOPS is set to run its first assistive technology (AT) conference in June 2020 and will be working in association with the respected organisation British Healthcare Trades Association (BHTA) to deliver this exciting new venture.
The main aims of the conference are to help shape the future of AT services, and to ensure products and services are accessible, fit for purpose in the 21st century, and provided in a coherent, integrated and person-centred way, with the needs and outcomes of people requiring services being paramount. This is crucial in view of the growing elderly population, the need for people to be more independent, and for those wanting to manage their own lifestyle and care.
The conference will look holistically across all AT services e.g. digital health, telecare, community equipment and wheelchair services, communication and sensory equipment, smart homes, home adaptations and environmental controls, and across all sectors in line with the interoperability of these types of service. The conference will be strategic, pragmatic and solutions-focused, and will cover all aspects of provision including the planning, commissioning, procurement, service delivery and clinical and technical aspects, with the needs of users and carers at the heart.
This exciting AT conference will gather people from across all sectors including, for example, policy leads, commissioners, service providers, clinical and technical staff, innovators and industry.
There will be excellent and meaningful national and international speakers. Some topics will be crowd generated before the event, to ensure the conference content is directly relevant.
If you are in any way involved in the assistive technology space, this is a not to be missed event.
CECOPS CEO, Brian Donnelly, says: ‘This unique conference will consider all assistive technology services at policy, planning, commissioning and delivery levels, as well as the future design, demands and requirements of these services. Given the crisis in health and care, nationally and internationally, addressing these issues now is critical. It is exciting therefore to be running this event with our colleagues at BHTA. Their industry knowledge is second to none in the UK and will bring a lot of expertise to the table. This combined effort will help to shape the marketplace, and support organisations in the planning and delivery of assistive technology services both now and in the future.’
BHTA Director General, Andrew Stevenson, says: ‘It is an exciting time with all of the new products, technologies and innovations coming into the marketplace; however we need to ensure these are ready to be adopted and people know how to access them. Proper planning and delivery of assistive technology services is key to solving many health, care, wellbeing and accessibility issues. It is exciting to work in association with CECOPS on the delivery of this much needed conference, especially given their expertise and commitment to improving quality and outcomes in the AT space.
If you are interested in sponsoring or exhibiting at the event, please get in touch: firstname.lastname@example.org
Assistive technology providers are signing up to CECOPS’ Corporate Accreditation Programme. What is it and how does it work?
CECOPS is the independent standards and accreditation body for assistive technology (AT) services e.g. digital health, telecare, and community equipment and wheelchair services.
CECOPS has developed outcome-based quality frameworks for the procurement and provision of the various assistive technology services, and is working with approximately 200 AT services, UK-wide.
CECOPS aims not only to ensure services deliver quality outcomes, but that organisations strive to continuously improve.
When assistive technology services are being commissioned, it is often a requirement within tender specifications for providers to be accredited by CECOPS. Accreditation is gained via an assessment of services, undertaken by our independent ISO qualified team.
Many of the organisations which have become accredited under the CECOPS scheme have started out by achieving accreditation for a single service or contract, often because a commissioner has required it for their specific contract. This is also the standard approach for in-house and smaller providers.
However, for larger providers which deliver a number of services across the UK, to have CECOPS assess their services on a piecemeal basis can become time consuming and involve duplication, especially where corporate policies are in place across all an organisation’s services. For this reason, there is growing interest in the corporate programme among the large providers, with some having already opted for the programme. The corporate programme helps to enable a coherent and synergised approach to gaining CECOPS accreditation for all relevant services.
What does CECOPS Corporate Accreditation involve?
The CECOPS Corporate Accreditation Programme is designed to deliver a robust certification process which appropriately balances an adequate level of scrutiny against the ability to take assurance from the application of corporate policies and processes.
As always, quality is our main aim, so we ensure that all services covered by the corporate programme receive an on-site visit prior to accreditation being awarded. This is necessary to provide us, commissioners, providers and the people using the services with the assurance that each service we are awarding accreditation to is meeting our quality standards; it is virtually impossible to ascertain this otherwise. In our experience, local variances in how a service is commissioned and funded can result in considerable variation in how a service operates, even within an organisation with robust corporate systems in place.
Each local service area receives its own full assessment report which highlights findings, evidence submitted, plus any non-conformities. The comprehensive report also suggests improvements to the service or system, where relevant. In addition, a corporate report is produced which summarises themes and trends from across all operations and suggests improvements which could be made to corporate systems, processes and policies.
The service-specific reports can be shared with local commissioners (where this is a requirement of the contract); whilst the corporate report is ideal for board oversight and scrutiny.
We have been asked why we don’t just look at head office operations and take sample checks at some of the local services. While this may be applicable in some settings, we don’t believe this is appropriate with these types of services, not only because the lack of adequate scrutiny could allow poor practice to hide under the radar, but also because AT services are often provided to vulnerable people, and the risks involved demand a more serious outlook to be taken than a brief tick-box exercise. Also, commissioners often want reports for their individual service.
For the CECOPS Accreditation badge to maintain its respect and be meaningful, to commissioners, providers and citizens using services, it is important that we don’t compromise on quality.
It is heartening that some of the largest and best-known providers of AT services in the UK agree with us on this, and have embraced the CECOPS Corporate Accreditation Programme. For example, two of the largest assistive technology (AT) providers, NRS Healthcare and Medequip, became the first companies to receive corporate accreditation from CECOPS.
NRS Healthcare have gained corporate accreditation for all of its community equipment and wheelchair services contracts throughout the UK, and Medequip likewise has gained corporate accreditation for all of its community equipment services.
Jerry Benson, NRS’ CEO, says the CECOPS corporate accreditation will help it to deliver “the highest possible standard of service to its customers”. He comments: “Working to the CECOPS outcome-based quality framework across community equipment and wheelchair services, and being independently assessed against this, has helped us immensely.
Meanwhile, Marie Martinalli, head of SHEQ and governance at Medequip, says: “Working with CECOPS across all our community equipment services has assisted Medequip in developing and enhancing good practice within our organisation. It is very customer outcome-based and has enabled us to demonstrate assurance, that we deliver a safe and quality service.”
If you are a provider of assistive technology services e.g. telecare, community equipment, wheelchair services, digital health, across multiple locations, and you are interested in gaining CECOPS’ Corporate Accreditation, please get in touch.
01494 863398 or 07511667330
CECOPS has gained the prestigious CPD Certification for all of their training courses!
The CECOPS training courses cover the various assistive technology related services including digital health, telecare, electronic assistive technologies, community (disability) equipment, and wheelchair and seating services.
Uniquely, there are courses for: Planning and Commissioning; Service Provision and; Clinical and Technical aspects.
The training is outcome-focused, meaning it can apply in different settings and countries.
All training is based on CECOPS’ Codes of Practice:
National and International recognition
Our training already has widespread recognition as, for example, it was included as a requirement for staff to be trained by us in a recent national NHS Supply Chain Framework Agreement for Electronic Assistive Technology, Lone Working Devices and Telehealth.
The CECOPS framework, standards and training were also recommended in a recent World Health Organisation (WHO) Position Paper on Assistive Technology: ‘Enabling appropriate personnel skill-mix for progressive realisation of equitable access to assistive technology’.
The following CPD Certified training courses are now available:
Technology Enabled Care Services
These courses are for everyone involved in the planning, commissioning and delivery of technology enabled care services e.g. digital health, telecare, electronic assistive technology services.
COURSE 1: Planning and Commissioning
COURSE 2: Service Provision
Community Equipment Services
These courses are for everyone working in the planning, commissioning and delivery of community equipment, including clinical and technical aspects. The training covers all equipment services provided by health, social care and education. The training also applies in other settings where equipment is assessed for and provided e.g. care homes, home improvement agencies.
COURSE 3: Commissioning and Governance
COURSE 4: Service Provision
COURSE 5: Clinical and Technical Responsibilities
Wheelchair and Seating Services
These courses are for everyone working in the planning, commissioning and delivery of wheelchair and seating services, including clinical and technical aspects. The training covers all wheelchair and seating services provided by health. The training also applies in other settings where wheelchairs are assessed for and provided e.g. care homes.
COURSE 6: Commissioning and Governance
COURSE 7: Service Provision
COURSE 8: Clinical and Technical Responsibilities
CECOPS will be running training courses around the UK. Check our ‘Events and Training’ page on the CECOPS website for regular updates.
If you would like training provided on any of the above courses at your premises, please get in touch. +44 (0) 1494 863398 or email: email@example.com
It is with sadness that I write this tribute to Sir Bert Massie CBE, Chairman of CECOPS, who sadly passed away on 15/10/2017.
I first approached Sir Bert in 2009 to write a Foreword for a paper I was writing on national minimum standards for disability equipment services; he was very obliging and interested in my work. I kept in close contact from that time, and in 2012 I approached Sir Bert to see if he would be interested in chairing CECOPS, the not for profit standards and certification body for assistive technology services. Bert was delighted with the CECOPS concept and agreed to help me to establish the organisation.
Sir Bert said at the time that the main reason he took on the role of CECOPS Chair was that he believed in its aims and saw it as a vehicle for helping to improve services for disabled and older people, a cause close to his heart.
Sir Bert’s role has been very instrumental in establishing CECOPS; he has been a real champion for the cause. CECOPS’ growth over recent years is largely due to Sir Bert’s wisdom, experience and passion.
Bert was a true campaigner, but he was never a complainer. He only asked for what was right and nothing more. He had a wonderful art of guiding conversations in a way that made others feel that they had made decisions themselves.
Bert’s view was that a good cause is always worth fighting for. He always maintained a cheerful and happy spirit, and had a great sense of humour.
Bert was much more than a chairman, he was also a friend. As well as wanting CECOPS to succeed, he was also genuinely interested in my wellbeing and that of my family.
Bert was a mentor, giving me a positive outlook amidst the gloom. Lastly, he was an inspiration, not just in his role within CECOPS, but more as an individual. He overcame many personal barriers in his life, and more, he worked tirelessly to remove barriers others couldn’t remove for themselves. Thank you for your selfless labour Bert, you will be greatly missed.
I was recently asked to explain the digital health marketplace in the UK and how providers are supposed to access the market. This marketplace includes, for example, telehealth, telemedicine, eHealth and mHealth products, as well as telecare.
A marketplace is formed where there is demand for a product or service, and when this demand is supplied. Of course then, markets grow and evolve over a period of time.
Within the digital health space, on the supply side there is a vast range of products and services, but the demand side is unclear. The need is there, but organisations responsible for planning and commissioning services are often unsure of how best to engage with some of the technologies available and to procure these. What works? Where do we start? Is it cost effective? How can we assess service impact?
So we could reasonably conclude that the marketplace for digital health is not well defined and has not yet matured. This is discouraging for providers, especially SMEs, and there is confusion about the best approach for accessing the market. This could even cause a provider, particularly a smaller one, to ‘give up’. This would be a shame if they had an excellent product which they were struggling to sell.
It is important for those on the demand side to be clear about what it is that they want to procure or commission, and that they are ready for adopting the technologies and services. Organisational readiness is often an area overlooked; yet this is such an important issue to address to ensure the marketplace matures and thrives.
While there are some pockets of excellent working in getting products to segments of the market e.g. acceleration programmes, processes are not the same across different geographical areas and sectors. These issues are not limited to the UK. From conversations I am having with people overseas, the situation is pretty much the same internationally.
The imbalance between the supply and demand sides of the market cannot continue.
So, what can be done?
To help shape the marketplace, CECOPS has developed the first ever International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services. This is an outcomes-focused quality framework for procurement and provision of services. It offers an end-to-end solution which addresses all aspects of the marketplace.
This new framework for the first time provides structure to the marketplace and is set to become the recognised benchmark.
Working with the Code will help to create and shape a more balanced marketplace. Following it will also help to ensure an organisation’s readiness before engaging with digital health. The Code can also act as a framework to support providers coming into the space, so that they have a clearer understanding of what might be required of them.
Using the Code within tender specifications simplifies the procurement process. As the Code is outcomes-focused, it encourages providers to be innovative. It will also help to achieve sustainable economic growth in the space; as growth for some providers is currently minimal and short-lived.
As the standards and certification body for these services, CECOPS is also able to accredit services via an external assessment.
Some of the many benefits of this new approach include:
- Marketplace development and maturity
- Brokering improved relationships in the marketplace
- Accelerating organisations to a state of readiness
- Achieving sustainable economic growth for the sector
- Simplifying procurement, commissioning and contract management processes
- Better chance of realising benefits from providers’ products and services
- Saving time and cost (by providing a ready-made framework)
- Improved quality and performance
- Local, regional, national and international benchmark and platform for sharing good practice and having a community building approach
- Improved clinical, wellbeing and financial outcomes
Copies of the International Code are available from here. The Code is free to organisations registered with CECOPS.
To find out more about CECOPS accreditation scheme or the Code, please get in touch.
Brian Donnelly MSc, CEO, CECOPS CIC
E: firstname.lastname@example.org | +44 (0) 7511 667 330 | T: +44 (0) 1494 863398 | www.cecops.org.uk
Technology Enabled Care Services: Overcoming barriers and organisational readiness – by Ruth Agbakoba
Understanding the landscape of the readiness to adopt technology enabled care services in practice is a key factor in ascertaining the likelihood for successful service transformation.
There is renewed pressure to act on the opportunities that digital technologies present with the publication of government documents such as ‘Personalised Health and care 2020’ and ‘Make or Break: The UK’s Digital Future’. Emphasis is focused on the ability for organisations to proactively adapt their products, services and operations in order to embrace transformative change. Many organisations that embark on projects incorporating TECS fail at this point as they underestimate the significance of evaluation.
Organisations need to be able to assess their own readiness in order to address barriers to adoption. Barriers impeding progress include but are not limited to a lack of stakeholder engagement, insufficient strategic planning, under-developed IT infrastructure and resource limitations.
How do you know if your organisation is ready to maximise the full potential of technology?
CECOPS can help your organisation to address this transformational gap by working closely with you to identify barriers early on before there is a significant investment in time, resources and finances. We provide you with our accredited CECOPS readiness framework and iCOPS evaluation tool for continuous improvement.
We will work with you to ensure that your organisation understands its current position whilst equally accelerating it’s state of readiness to enable successful uptake, fidelity and sustainability of TECS. We also provide added value in providing a platform sharing best practice for large scale innovation.
Our work in the TECS space is based on the International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services.
Get in touch today to find out how we can support you.
T: +44 (0) 1494 863398 | E: email@example.com
Ruth Agbakoba, Digital Health Consultant, CECOPS CIC. View Ruth’s profile HERE
The first ever Code of Practice and support tools covering all aspects of planning, commissioning and providing technology enabled care services (e.g. telehealth, telecare, eHealth, digital health) have been developed by CECOPS, the independent standards body in the UK for assistive technology services.
Uniquely, this new Code, which sets out standards covering every aspect of services, offers an end-to-end and whole-system approach, ranging from the early planning stages through to post-implementation of services. It can be looked at as a value-chain solution that interlinks those responsible for planning and commissioning services with service users, through the activities of clinicians and providers.
‘…this is more than a Code of Practice; it is a map, a guide and a chaperone. It is thought provoking and a source of inspiration.’
Roy Lilley, leading expert and analyst in healthcare
The Code is complemented by a unique and powerful self-evaluation and continuous improvement tool iCOPS®, which helps organisations to self-evaluate services, assess readiness before engaging with TECS and drive their own quality and performance agenda.
It is anticipated the Code and support tools will encourage wider adoption of TECS and set the benchmark and framework for all organisations in the sector to work to.
Following the Code enables the longstanding barriers to adopting TECS more widely to be overcome, ensuring projects and initiatives are delivered with the best possible outcomes, with the ability to measure their success and embed sustainability.
These latest developments offer a quality framework for the procurement and provision of services, with the ability to assess, influence and improve outcomes, as well as streamlining the whole contract management process.
The introduction of this Code means that CECOPS can now extend its accreditation scheme across all assistive technology related services (e.g. telecare, telehealth, wheelchairs, electronic assistive technology, disability equipment), nationally (UK) and internationally.
The new Code and iCOPS® tool incorporate the following subject areas:
PART ONE: PLANNING AND COMMISSIONING
- Strategic Planning and Preliminary Considerations
- Involvement of Stakeholders, Users and Carers
- Partnerships, Joint Working and Integration
- Governance, Ethics and Risk Management
- Business Case Development
- Investment and Funding
- Service Requirements and Specifications
- Contractual Arrangements
- Eligibility Criteria and Self-funding
- Legal & Regulatory Obligations and Standards
- Information Technology and Information Management
- Marketing and Promotion
- Performance Management and Continuous Improvement
- Measuring and Evaluating Service Impact
PART TWO: SERVICE PROVISION
- Governance, Risk and Ethics
- Legal & Regulatory Obligations and Compliance with Standards
- Managing Referrals and Assessments
- Procuring Technologies, Equipment and Services
- Implementation of New Technologies and Services
- Trialling, Assembling, Installing and Demonstrating Technologies and Equipment
- Involving Patients/Service Users and Carers in Decision Making
- Management of Medical Devices/Technologies
- Management of Assets and Inventory
- Monitoring and Alerts
- Quality Management Systems
- Health and Safety Management
- Staff Competence
- Information Technology, Management and Governance
- Collaborative Working
- Third Party Contractors
- Marketing and Promotion
- Contract and Performance Management, and Continuous Improvement
- Measuring and Demonstrating Service Impact
The new Code is currently available to organisations working with the CECOPS scheme.
A published hard copy and eBook version of the Code will be available to purchase in the coming weeks.
The iCOPS® tool is available for purchase now. A FREE 30 day trial is available.
If you are interested in purchasing a copy of the Code, becoming CECOPS accredited or trying out the iCOPS® tool, please get in touch.
T: 01494 863398
M: 07511 667 330
Note to editors:
CECOPS CIC is a UK-based independent, not-for-profit, standards body for assistive technology services. CECOPS is widely supported by regulators and professional organisations. CECOPS is often cited as a requirement in tender specifications, and, although relatively new, is already working with approximately 80 organisations in the UK, with growing international interest.
NHS England recently announced that to give people more choice and control about the care they receive, personal health budgets will be extended to cover wheelchairs from April 2017.
This move is intended to support the government’s target of enabling 100,000 people to benefit from greater control via personal health budgets by 2020/21.
It is proposed that Personal Health Budgets (PHBs) will replace the current wheelchair voucher scheme as part of efforts to improve services for over 1.2 million people that currently use wheelchairs.
NHS England claims the new personal health budget scheme will offer more choice over what wheelchair can be acquired, and will include a detailed care plan to help users make informed decisions about their wheelchair. They claim care plans will not only cover purchasing the chair, but will also include guidance on future maintenance, repair and replacement needs. Without a business case or impact assessment or relevant evidence, it is difficult to assess at this stage exactly how the model will work in practice.
NHS England has been reviewing wheelchair provision over the past 2.5 years, and introducing PHBs would appear to be in response to the findings of that review; however we sincerely hope that issuing PHBs for wheelchair users is not the only outcome of that review, as PHBs cannot possibly be a solution to the numerous problems associated with these services.
As the independent standards body in the UK for wheelchair services, CECOPS welcomes the move to extend personal health budgets to these services, and we have in fact already included the use of PHBs in our Code of Practice. The use of PHBs for wheelchairs will be an area which our assessment processes will cover, for organisations seeking accreditation with us.
Notwithstanding our support of measures to improve wheelchair services and user experience, we do have some concerns which we hope will be addressed before the introduction of PHBs for wheelchairs in April 2017.
We feel that if the areas of concern below are not sufficiently addressed, the roll-out of PHBs for wheelchairs will not achieve its well-intended aims. At this point it is unclear how PHBs will work better than the existing voucher scheme, and this is something we would like to hear more about from NHS England Personal Health Budget team.
Could PHBs exacerbate current difficulties associated with disjointed services?
Disabled people often require a range of assistive technology (AT) related services e.g. communication aids, posture equipment, adaptations. As the different AT services generally operate independently of each other, people usually undergo several different assessments to cover their various and holistic equipment needs.
The current model is costly and is far from being person-centred. Offering a PHB exclusively for one type of assistive technology (i.e. wheelchair) could potentially exacerbate the problem, and would appear to go against the direction of offering more holistic, personalised and person-centred care.
The following quote from a service user clearly demonstrates current difficulties, and why offering PHBs exclusively for wheelchairs won’t help with wider issues:
“It was great that I eventually got an indoor/outdoor wheelchair, but I couldn’t get in or out of my home because the adaptation hadn’t been done. I was given a communication aid but no-one would agree to mount it to my wheelchair.”
Will PHBs address long waiting times?
One of the main problems associated with many wheelchair services is the waiting times. It is not uncommon for people to wait 18 months for a wheelchair.
PHBs won’t address waiting times, as they are not set up for that purpose. In fact, PHBs could even increase waiting times, for reasons explained below.
The main reason currently for long waiting times is lack of funds. PHBs won’t introduce any new money, and purchasing a wheelchair at retail price under a PHB rather than at bulk contract price will be more expensive. In addition, wheelchairs bought under a PHB belong to the user and will never come back into the wheelchair service to be reissued to another user. This could add significant pressure to current overstretched budgets and increase waiting times for all wheelchairs, whether under a PHB or not.
Will PHBs help people who need equipment urgently?
People with rapidly progressive conditions, such as motor neurone disease or some types of multiple sclerosis, require access to equipment urgently. Sadly, fast-tracking of services for these people is not generally in place.
Providing people with PHBs is not likely to address this serious problem. Presumably there will be a waiting list for accessing PHBs just as there is for loaned equipment, as without new money there will still be funding issues. We feel strongly that this area should be looked at as a priority; it is disgraceful that some people die whilst waiting to receive vital equipment.
One solution could be that the PHB scheme includes a fast-tracking arrangement so that eligible people have access to funds immediately to buy everything they need quickly. Obviously there would need to be clinical professionals involved to facilitate and advise.
Could PHBs for wheelchairs actually be more costly?
As previously mentioned most wheelchairs are purchased by the NHS or out-sourced provider under a bulk contract or framework, in some cases at significantly discounted prices. With PHBs, people will purchase equipment outside of these agreements from retailers at high street prices, which are very likely to be much higher than the prices currently paid by the NHS for wheelchairs. PHBs will have to be of sufficient value to cover the retail price of a wheelchair, otherwise people will not take them up! As this cost is likely to be higher than is currently paid by the wheelchair service, this could strain wheelchair budgets.
In addition, there are significant savings and cost avoidances under the current model where wheelchairs are reissued by wheelchair services. For example, a wheelchair costing £2000 issued 3 times over its life results in a cost avoidance of £4000; whereas 3 of the same wheelchairs purchased using PHBs will cost £6000. Equipment purchased using a PHB will not be recycled within the wheelchair service, and is in effect a sunk cost.
If PHBs for wheelchairs are widely taken up it could have a drastic effect on wheelchair service budgets.
Could wheelchair users be exploited?
There will need to be proper support and safeguards in place to ensure people using their PHBs to buy wheelchairs are not exploited by retailers i.e. being sold something they don’t actually need, or charged an excessive amount. It is recognised that people are consumers in other aspects of their lives, and should be able to make their own choices; however some buyers will be in a vulnerable position, making a large purchase in an unfamiliar market, which could leave them open to exploitation without appropriate guidance, safeguards or support.
When the Department of Health introduced the retail model several years ago for aids to daily living, there were cases reported of people being exploited by retailers, so this is a real concern.
Could using a PHB compromise clinical needs being met?
A PHB for a wheelchair will only be for a limited amount, although it is currently unclear how this will be set. Wheelchair users will be able to top up from personal funds if they want a higher specification wheelchair. There is a risk that wheelchair users acquire an item which does not meet their clinically assessed needs.
This is a high risk area and it is vital that users get the right wheelchair to avoid problems associated with postural care and pressure, for example. It is difficult to see how it can be ensured that retailers are competent to advise on these matters, some of which require specialist clinical input.
Failure to address the above issue could mean people end up with equipment that doesn’t meet their clinical needs, resulting in further health problems such as a pressure ulcer.
PHBs and Training
As yet no guidance has been made available from NHS England Personal Health Budgets team on training for frontline staff with regards to PHBs for wheelchairs e.g. what training is needed, who needs to be trained, who would carry out the training and who pays for it. It could be a costly and timely exercise for local areas to formulate their own guidance on this, and deliver their own training, which could potentially be a barrier for wider adoption.
CECOPS hopes the above issues will be sufficiently addressed before commencement of this initiative in April 2017; we would be willing to work with the NHS Personal Health Budget team to work through possible solutions.
Many of the areas of concern can be addressed by following our Code of Practice and working with our accreditation framework, which is now formally approved by Care Quality Commission and being adopted by many wheelchair services across the country.
Brian Donnelly, CEO, CECOPS