�31/01/07

SDEF response to Ministerial statement on wheelchair review

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Abstract

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The Scottish Disability Equality Forum (SDEF) welcomes Scottish Executive’s response of the to the recommendations made in the report: Moving Forward: Review of the NHS Wheelchair and Seating Services in Scotland.

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SDEF is disappointed that the response falls short of setting up a single, integrated service for wheelchair provision, the key recommendation of the report. We would caution that, while the creation of a project board and advisory group with representation from service users and carers is welcome, this should not delay the implementation of the principle improvements recommended.

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There are also concerns over the financial implications relating to service provision in that improvements are expected to be made without additional resources being made available.

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SDEF is pleased to see that the Executive acknowledges that eligibility criteria should be clear and that user and carer requirements are seen as an essential part of the assessment process. Whilst resources remain a limitation here in terms of meeting individual needs, it is refreshing to see the links being made between wheelchair provision, barriers and access to wider participation in society.

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The development of Local Improvement Targets as a way of measuring service delivery and quality and is an overdue and important move forward.

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Cinderella won't be going to the ball

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Despite Andy Kerr, Minister for Health & Community Care, admitting publicly that the NHS Wheelchair Service was a Cinderella Service his response, hidden on the Executive’s website, to an Independent Steering Group’s Report given to him in March last year does not grease the wheels of Cinderella’s wheelchair carriage.

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The Report arose from a petition submitted in December 2004 to the Scottish Parliament by the late Margaret Scott, whose teenage daughter is a wheelchair user. It called for a solution to the critical problems in the Service by both an immediate increase in funding and through a review to address minimum standards, the scope of equipment provided and the delivery of services.

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In fairness, the Minister Andy Kerr, did respond by injecting �1.9M in to the Service and to the commissioning of the review by independent consultants.� He provided the funding for one year only to March 2006 without any evidence prior to the review.

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The Minister’s response does not accept the central plank of the Steering Group’s 40 recommendations for the Wheelchair Service to be run as a national service funded directly instead of through Health Boards.� Instead he wishes to maintain the position for the past 10 years that individual Health Boards be responsible for the Wheelchair Service.� They may be responsible but they are not accountable as they devolve their individual responsibilities to the five Wheelchair Centres.� The money does not follow the patient and even appeals are not heard by each Health Board but rather by the Health Board which is the host of the Wheelchair Centre.�

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The Wheelchair Service is not part of the Minister’s “Waiting Times” initiative and as such makes the Service even more unaccountable. Despite numerous Reports by NHS Quality Improvement Service on poor performance health ministers have done nothing to address the issues.

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Since 1996 Health Boards have not funded the Wheelchair Centres in line with inflation and instead have starved them.� The �1.9M did not cover the shortfall to 2005. However, the injection of the �1.9M was made direct to the Wheelchair Centres and not through the individual Health Boards ensuring that the money was targeted, used, made a difference to users and most importantly, the Centres were seen to be accountable for their spend.�

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We invite the Minister to meet the Steering Group half-way on its central plank.

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Key to resolving the issues with the Service is an Assessment of Needs which includes the carer and recognises lifestyle.� The Assessment does not appear to be fully embraced by the Minster’s response, as funding has not been made, resulting in a lack of recording of unmet need essential for strategic planning.� Assessment should not be based on what the service can provide as this continues the frustration felt by both clinicians and users as a result of the use of opaque eligibility criteria.

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We welcome the creation of a Project Board but find it difficult to know how the resource of a Service Manager can be freed for a year and when this Board will be started. Also welcomed is the establishment of an Advisory Board, reporting direct the Scottish Executive, consisting of professionals, users and carers to be tasked with creating minimum performance standards and national guidelines. We feel that its work will be coloured by the funds available to the Service and impeded by the lack of reliable Service data.

Given the current cost of running the Service of �14.2M and what is being recommended by the Independent Consultants is additional �15.8M, spread over three years, overall this is not insurmountable.�

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Recently, the Education Minister announced that nurseries and childcare centres were to benefit from new play equipment from �12.8M and earlier in the month �300M was announced for new IT for the NHS. Considering that the NHS Budget is projected at �10B, �30M for the Wheelchair Service is not significant.

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