Wheelchair Services Information
An assessment in process
SHROPSHIRE WHEELCHAIR AND POSTURE SERVICE
‘The Wheelchair and Posture Service aims to meet the mobility needs of people of all ages with restricted abilities within the catchment area. This is achieved through skilled, clinical assessment resulting in the prescription of mobility equipment with associated seating and postural products; ensuring an equitable, appropriate service to all users. To assure users are fully supported, the service provides ongoing reviews and product maintenance.’
Listed below are definitions of the processes that may be involved with wheelchair provision and the levels of service available, these may serve to assist with answering initial queries. For more detailed information please contact the service on 01743 444051.
New Referrals
The service accepts new referrals from Accredited Referrers who have undertaken training from the Shropshire Wheelchair and Posture Service, enabling them to refer for a wheelchair assessment.
Re-referrals/Reviews
Users or their representatives, who are already receiving a provision from the service, are able to request a review of their circumstances directly, without having to access an Accredited Referrer.
Screening/Triage
Referrals are screened by clinicians through a triage system to ascertain appropriate action.
(N.B. Triage is a process of prioritising patients based on the severity of their condition)
Assessment Process
Wheelchair and seating assessments are carried out by an appropriately skilled service clinician. The assessment team comprises of the Wheelchair Service Manager, Wheelchair Therapists, Rehabilitation Engineers and Wheelchair Assistant Practitioner.
Direct Issue of Wheelchairs from Referral Information
The service may, where appropriate, issue equipment directly to the client without a physical assessment, if sufficient information is provided by the referrer and there are no contraindications.
Home Visits
Wheelchair assessment visits are carried out as judged appropriate to the users needs e.g. when the home environment requires assessing for access into and within the property.
Wheelchair Clinics
Wheelchair clinics are held regularly at the Shropshire Rehabilitation Centre, Shrewsbury and Special Schools in the catchment area. A suitable range of assessment wheelchairs and seating is available at the SRC Wheelchair Clinic. Equipment appropriate to the user’s clinical need is demonstrated, and the user provided with the correct knowledge and information to enable them to make an informed choice together with the wheelchair clinician undertaking the assessment. The user is fully involved in the assessment process with an opportunity for them to discuss their needs, views and perceived requirements from the service. Carers and other professionals involved with the user can attend the clinic situation provided this is agreed with the wheelchair user at the commencement of the assessment.
Medical Involvement
The need for medical confirmation of the user’s medical history or disability will be requested from their individual GP or Consultant as necessary. The service has referral access to additional examination/opinion by the Consultants in Rehabilitation Medicine at the West Midlands Regional Rehabilitation Centre with the user’s consent.
LONG TERM/PERMANENT LOANS
Manual Equipment
Manual Wheelchairs/Buggies
A range of wheelchairs, including specialist children’s equipment available to loan from the service is agreed and regularly reviewed by the clinicians in the service. This takes into account the changing needs of the population, innovations in design, versatility, reliability and cost effectiveness.
Active/Higher Performance Wheelchairs - Consideration for provision of this type of wheelchair are only available to users with no walking ability and will be subject to specific guidelines, which have been agreed with the Shropshire Wheelchair Users Group.
Lighter weight Wheelchairs for Carers - Can be supplied for a family carer who has a medical condition, which either precludes or is exacerbated by pushing or transporting a standard model of wheelchair. These will only be supplied following an assessment by a wheelchair clinician. It may be necessary in some cases, for further clarification of medical need to be sought from the carer’s GP prior to supply.
Tilt-in-Space/Postural Management Wheelchairs - considered for users with complex seating and postural management issues which cannot be addressed safely in the standard configuration of equipment. A comprehensive expert assessment and prescription is required.
Powered Equipment
Indoor Powered Wheelchairs (EPIC) - indoor powered wheelchairs to facilitate independent mobility within the user’s home and their garden.
Outdoor Powered Wheelchairs (EPOC) - attendant operated powered wheelchair for when the carer’s needs are such that they are unable to push a manual wheelchair i.e. have a disability themselves, thus seriously affecting the user’s quality of life.
Indoor/Outdoor Powered Wheelchairs (EPIOC) – users with a long term condition or a rapidly deteriorating condition, requiring a powered wheelchair indoors (around their own home) in the first instance are considered for this equipment. It is anticipated that eligible users will benefit through issue of this equipment, by an increased independence in daily life.
Tilt-in-Space/Indoor/Outdoor Powered Wheelchairs - considered for users with complex seating and postural management issues requiring increased independence in managing their own postural needs and mobility. A comprehensive expert assessment and prescription is required.
Bariatric Provision
The standard weight limit of a manual wheelchair is between 18 and 20 stones dependent on the model, the heavy duty versions are available from 25 to 30 stone, however at this weight the abilities of the user to self propel or the attendant to push needs to be taken into consideration. This is when a powered wheelchair may need to be considered, the weight limit of which reflect the manual limits, within the standard range of 25 stone.
Voucher Scheme
The option to access the Voucher Scheme is offered to all users who are eligible for a permanent loan manual or powered wheelchair. This scheme extends the user’s choice in enabling them to financially contribute to a wheelchair not supplied by the Wheelchair and Posture Service.
Pressure Relieving Cushions
These are supplied for use in wheelchairs to users who have a tissue viability concern, or postural alignment problems and are full time wheelchair users, following an assessment by a Wheelchair Therapist or a Rehabilitation Engineer.
Specialist Seating
In order to address complex postural management issues, and safety within any wheelchair, a specialist assessment carried out at a clinic appointment in Shrewsbury is necessary. Following a comprehensive assessment bespoke specialist seating ranging from a specific backrest through to a Moulded Seat Insert for wheelchairs is supplied. These are re-assessed and replaced as the users’ requirements change.
Accessories and Modifications
A range of accessories required to ensure all users’ clinical requirements are met on the wheelchair provided are available, ensuring compliance with any MHRA guidance. Modifications to equipment may be required when off-the-shelf manufactured items are not suitable. Modifications are carried out by the Wheelchair Repair Service following best practice guidelines.
WHEELCHAIR REPAIR SERVICE
A dedicated repair service is available to ensure all equipment supplied by the NHS is safe and mechanically fit for purpose. Courtesy wheelchairs are available where wheelchairs require a workshop repair. The service is available during standard office hours and can be accessed directly by the users.
A Priority Response Service is available for users who are particularly vulnerable where a major breakdown of equipment would cause immediate problems with self-care. A clinical assessment is carried out to establish a user’s need for this service. This facility is provided as an out of hour’s service.
Nursing/Residential Homes
Where residents are able to retain a level of independent mobility within the home a suitable wheelchair from the service will be loaned. This includes manual, electrically powered indoor (EPIC) wheelchairs, cushioning and seating as required, for their individual use.
SHORT TERM LOAN SERVICE
Range of equipment
This is restricted to manual wheelchairs/buggies. Limited numbers of equipment are available, from a basic buggy to a heavy duty wheelchair, ranging in sizes to try to accommodate most requirements.
Accessing the service
A new referral can only be made by an Accredited Referrer, however, once registered a user can directly request a future loan. Users are people who do not have the need for a wheelchair indoors, however require some assistance with outdoor mobility i.e. leisure trips, post-operative care, medical emergency.
It is a free, 6 week loan service, which can be renewed subject to availability.
Not all needs will be met due to the limited range and numbers of equipment and in those instances advice regarding other outlets will be given.
Supported Housing
Scheme Managers are able to access a small number of short term chairs (Community Chairs) for their residents use, enabling them to access a Short Term Loan Service on their doorstep.