My Lords, integrated care boards are responsible for the commissioning of local wheelchair services based on the needs of the local population. NHS England has developed policy guidance and legislation to support ICBs to commission effective, efficient and personalised services. This includes a Wheelchair Quality Framework, published in April, which is designed to assist ICBs and NHS wheelchair service providers in delivering high-quality provision that improves access, outcomes and experience.
My Lords, I am grateful to my noble friend, but does she recognise that the work by the Wheelchair Alliance and the All-Party Group for Wheelchairs Users would suggest that, if you leave this to local health bodies and local authorities, they simply will not improve the current inadequate and patchy service? The All-Party Group for Access to Disability Equipment has reported that
“63% of carers and 55% of equipment users said that services are getting worse”.
Given what my noble friend said about the quality framework, which I very much welcome, does she accept that nothing will change unless this is enforced from the centre, with strong performance management?
I accept the observations that my noble friend has made; I know he has been a voice on this for many years. I share with him the impatience for change and welcome the work of the APPG and the Wheelchair Alliance. The NHS Medium Term Planning Framework, which was published just in October, requires that, from 2026-27, all ICBs and community health services must actively manage and reduce the proportion of waits across all community health services over 18 weeks and develop a plan to eliminate all 52-week waits. I expect that wheelchair provision and services will improve through this as well as other means.
Can the Minister comment on whether we keep any statistics in relation to people who have to stay in hospital who avoid discharge because of the length of time taken to get wheelchairs?
I will be pleased to write to the noble Baroness about the specific data that is available, but we know that, because of issues to do with aids and adaptations, sometimes people’s leaving hospital is not as timely as it should be. That is not in their interests. We certainly expect local authorities, for example, which have a statutory duty, to make arrangements to do so and also for ICBs to make the provision so there are not the hold-ups that the noble Baroness refers to.
My Lords, as the Minister said, the NHS provides the funding for wheelchair access, but the wheelchairs are mostly necessary in community settings and in the home, and there is a gap between social services and the NHS using different criteria to assess the health needs of the patient. What are the Government going to do to address this so that people get the service that they need?
The provision of the right type of wheelchair is crucial, but we also need to expand care options to boost independent living at home. We have done that in part through an additional £172 million for the disabled facilities grant, which goes hand in hand with people being able to live at home. This could enable around 15,600 extra home adaptations. Introducing care technology standards for those who are using wheelchairs and those who are not will also enable proper care standards and independent living.
My Lords, I declare an interest as the conference chair of the National Association of Equipment Providers. As a teenager, I pushed my mother everywhere in a wheelchair; we had to buy it second hand through the Liverpool Echo. Wheelchair provisions have improved greatly since then, but how can the Government work with the Wheelchair Alliance and with trade associations to ensure that retailers have skilled clinical staff who are trained to undertake assessments and prescribe appropriate wheelchairs and other forms of assistive technology?
The points that the noble Lord has raised are crucial—not least that, as I alluded to earlier, one type of wheelchair does not suit everybody. That is why I am keen to see the results of the Wheelchair Quality Framework, which, as I mentioned to my noble friend, was published in April. That sets out quality standards and statutory requirements, including offering personalised wheelchair budgets, which would assist in the circumstances that the noble Lord describes.
My Lords, I declare an interest as a frequent wheelchair user and as a member of the all-party group. Some concerns have been expressed that the competition for contracts for wheelchairs is very limited and that a number of wheelchair providers are not even submitting their names to be considered for those contracts because they feel that it is not worth their while. What action are the Government taking to ensure that there is sufficient choice within the NHS and that the market is large enough to ensure that companies will actually bid for those contracts?
This is a very important point, not just for the supply chain but also for the technology, particularly if we are thinking about those with more complex needs; the wheelchair has to support and meet those complex needs. We know that there is a lack of investment in new models and that there has been disruption in the supply chain. While I do not seek to blame, that was a particular issue arising out of the pandemic. We are indeed working on better technology in terms of wheelchairs and other aids and adaptations and seeking to iron out difficulties in people making bids for contracts. If the noble Lord has examples, I would be very pleased to hear about them.
My Lords, can my noble friend comment on the problem, which carers often report, of being unable to return the wheelchair to its source when it is no longer needed?
My noble friend raises a point that applies not just to wheelchairs but to other aids and adaptations. There is indeed a very considerable issue. That is a matter for local services, but it is absolutely something that we will work with them on as part of how we improve services, because it also includes the safe and timely return.
My Lords, as well as the concerns raised by the noble Lord, Lord Hunt, about NHS wheelchair services, we know that, in addition, there are over 1 million wheelchair users of different types in the UK, and we know that people still face considerable difficulties in accessing health and social care buildings. Of course we understand that some buildings are old and will have to be retrofitted, but what specific conversations is the department having with charities, expert groups, owners of buildings and developers to raise awareness of the need and how to improve access, particularly for those older buildings?