OUTLINE NOTES PDSICG MEETING 14/08/14
Richard from MKWUG asked wheelchair users at the meeting
DID ANYONE GET THE CHANCE TO SAY WHAT THEY HOPED THEY WOULD BE ABLE TO ACHIEVE IF THEY WERE TO HAVE A WHEELCHAIR?Anywhere else in the NHS an individual has the chance to say why they think a particular course of treatment may benefit them.
HAVE YOU RECEIVED A COPY OF YOUR ASSESSMENT/CARE PLAN AND CO SIGNED YOUR AGREEMENT THAT THAT IS WHAT WAS AGREED?
HAVE YOU RECEIVED CO SIGNED COPY OF YOUR FINANCIAL AGREEMENT EVEN IF YOU MAKE A ZERO CONTRIBUTION? (if you enter into a funding agreement or loan for a Partnership Wheelchair Voucher the CQC request that there is documentary evidence that a financial agreement has been made and will be adhered to so the NHS does not order a wheelchair which it cannot fund itself and is unique to the patient so cannot be used for another patient)
HAS ANYONE RECEIVED A POWER CHAIR VOUCHER?(These should have been made available when the trial of manual vouchers from 1996 – 2000 was successful and made a permanent part of patient choice. Only a small number of NHS Wheelchair Services have done this, because no funding from the government was in put in place for it) [Why should that be a problem, because under the independent voucher a lump sum for five year maintenance of the wheelchair is given to the end user.]
HOW MANY WITH MORE COMPLEX NEEDS, HAD FROM MK WHEELCHAIR SERVICES, A MULTI DISCIPLINARY ASSESSMENT THAT INCLUDED A CLINICAL SPECIALIST KNOWLEDGEABLE IN THEIR PARTICULAR DISABILITY?
IF YOU HAVE SPINAL DEFORMITY WAS THERE ALSO A PLASTER TECHNICIAN THERE TO TAKE A MOULD OF YOUR BACK SO YOU GOT THE RIGHT SEAT BACK? Currently Milton Keynes cannot offer this service and in fact refuses to acknowledge the evidence of clinical specialists who is an experienced professional in their field. Rather that the Wheelchair OT and her manager make the final decisions. This is all well and good but elsewhere in the NHS complicated cases are put before a panel of experts or managers and no one individual makes the decisions. These types of panels should meet at least once a month.
THIS WEEK THE BRITISH HEALTHCARE TRADES ASSOCIATION PUBLISHED THEIR CURRENT THOUGHTS ON PROVISION OF CHILDREN'S WHEELCHAIRS AND OTHER DISABILITY EQUIPMENT. TELLS US THAT THE CQC PRODUCED A REPORT IN 2012 THAT IN A NUTSHELL SAYS THE DISABILITY EQUIPMENT SERVICES, INCLUDING WHEELCHAIR WAS NOT FIT FOR PURPOSE. IT ALSO DETERMINED THAT IT WASVERY DIFFICULT TO DETERMINE EVIDENCE BECAUSE NONE WAS COLLECTED. Locally the Joint Strategic Needs Assessment is the document that forms the core of what Health and Social Services need to provide for its population. Again they have failed to ask the relevant questions of the Wheelchair Service Users as to what they need. Instead they expect hard, irrefutable evidence, before they will include it in their JSNA.Nationally there has been little evidence put forward on the benefits of wheelchair provision nor the way in which it can reduce costs elsewhere in the NHS and Social Services. The fact that no one tells the wheelchair users either what is needed also leaves the wheelchair users ill-informed and unable to challenge decisions. In fact MKWUG will go as far as to say any attempts by MKWUG under the PCT have been met with stonewalling, outright denial and refusal to co-operate especially where finance is concerned. The simple fact of finance is that because the NHS Wheelchair Service has been neglected they do not know what a good wheelchair Services should do and therefore actually have no idea how much it would cost to run. A fact borne out by the last attempt to improve the wheelchair service because there was, and for that matter still is not an NHS Tariff available at a National Level. A tariff is roughly how much it costs to Assess the needs of a prospective wheelchair user, neither is there a fixed monetary figure of allocated to each individual both for manual wheelchairs and (to use the proper term) Electrically Powered Chairs. They do however have more of an idea how much it costs to maintain wheelchairs. Neither is there an established list of both manual and electric wheelchairs that the NHS will provide. Therefore a Tariff is all the costs needed to put a person in a wheelchair and maintain it for five years.
IN 2000 THE AUDIT COMMISSION TOLD US THE SAME SERVICES WERE BARELY FIT FOR PURPOSE. IN OTHER WORDS PROVISION HAD GOT WORSE.
Both the Scottish and Welsh governments ordered inquiries into their wheelchair services. The English government to date has not.
A WHEELCHAIR USER GROUP, PROPERLY FORMED, CONSISTS OF REPRESENTATIVES OF AS MANY DISABLED PEOPLES CHARITIES AS POSSIBLE IN ORDER THAT AS MANY DISABILITIES AS POSSIBLE ARE REPRESENTED IN ORDER THAT THE INTERESTS OF THOSE PEOPLE ARE HEARD.
A WUG HELPS THE WHEELCHAIR SERVICE DETERMINE HOW THE WHEELCHAIR USER SEES THE WHEELCHAIR SERVICE AND WHERE THE SERVICE IS DEFICIENT HELPS THE SERVICE APPLY FOR MORE FUNDS TO CORRECT THOSE DEFICIENCIES.
IT ALSO CAN NOTIFY THE LOCAL OVERSIGHT COMMITTEE OF ANY PROBLEMS SO THAT THEY CAN BEGIN A PROCESS TO CORRECT THOSE PROBLEMS. OUR MP's ARE ON THAT OVERSIGHT COMMITTEE BUT TELL US THEY ARE UNABLE TO GET INVOLVED AS LOCAL HEALTHCARE AS THEY ARE NOT ALLOWED BY RULES TO INTERFERE IN HOW LOCAL HEALTHCARE IS RUN.
From 25th February 2014, NHS England began the process of putting into place the missing pieces of the NHS Wheelchair Services and bring it into the 21st century. For the first time people who actually use wheelchairs are now part of the process and could be deemed “Patient Commissioners”
In Milton Keynes, after, allegedly, the wheelchair service took four years to get the correct wheelchair. The patient had to go to an external independent assessment. The local Wheelchair service reneged on an agreement to be bound by the findings of this external process and then back down on the agreement, and, allegedly, amended documentation to match their own view of the agreement. This led to a formal complaint that was upheld and initiated a complete review and re-commissioning of the Milton Keynes NHS Wheelchair Service. This began on 1st July 2014 and the Wheelchair Service Users and public will not have any say in that process until September 2014.