Health and Social Care Committee

HSC(4)-08-12 paper 4

One-day inquiry on wheelchair services in Wales – Evidence from Scope Cymru

 

 

Scope Cymru written evidence to the Health and Social Services Committee one-day inquiry on wheelchair services in Wales

 

About Us

 

Scope Cymru supports and works with disabled people and their families at every stage of their life. We believe disabled people should have the same opportunities as everyone else. We run services and campaigns with disabled people across Wales to make this happen. As a charity with expertise in complex support needs and cerebral palsy we never set limits on potential.

 

For more information on Scope Cymru’s work visit: http://www.scopecymru.org.uk/

 

We welcome the opportunity to provide both written and oral evidence to the committee as a follow up to our original evidence to the previous committee inquiry conducted by the Third Assembly’s Health Wellbeing and Local Government Committee.

 

This evidence is based on the experiences of a small number of individuals that work at or use our services. This is a small sample and should be treated with caution. However, we believe these experiences may provide the committee with a useful snapshot of the current situation with wheelchair services in Wales at present.

 

While creating our evidence we spoke to:

 

 

While we believe there has been some improvement to wheelchair services in Wales in the two years since this inquiry was conducted, these improvements are limited and elements of the service remain patchy and inconsistent, with individuals still facing long waiting times for new wheelchairs or repairs. We have spoken to those who use our services about their experiences with wheelchair services in Wales in the last two years since the previous committee inquiry.

 

As this inquiry intends to review whether the recommendations of the previous committee report have been enacted, we will attempt to match our comments to recommendations contained within this report.

 

Recommendation 11. We recommend that the Welsh Government should conduct an assessment of the long-term resource needs of the service, giving particular consideration to the resources required to sustain improved waiting times; provide regular reviews for some users; and to clear the waiting list backlog in North Wales. The Government should then make a clear statement setting out how it intends to meet these resource requirements for the current budget cycle.

 

There has been some improvement to waiting times, but it is a mixed picture. Our School in North Cardiff, Craig-y-Parc, said that there had been an improvement, with the time for initial referral to first contact by ALAS reduced significantly. It is now no longer a case of waiting six months, but instead around 4-6 weeks, sometimes even less. The School did highlight that there can sometimes be problems getting individual parts, such as harnesses and footplates and that this can take up to six months. Some individuals are able to use their chairs during this period, whereas others are not.

 

“Generally speaking, it is much approved from two years ago.”

Occupational Therapist, Craig-y-Parc School

 

These waiting times are within the target set by the National Service Framework for Children, Young People & Maternity Services of an assessment in six weeks and equipment in the following eight weeks. However, a mother of a disabled daughter told us that she had to wait for almost twelve months for her daughter to get a wheelchair. This is not a geographical issue, as she was served by the same ALAC as Craig-y-Parc school.

 

We were also contacted by an adult living in North Wales who was told that she would have to wait for an assessment for over a year. She contacted her local Assembly Member and managed to get an assessment but was then told she could not have a wheelchair until her home was made accessible. She informed them that the council had approved plans for ramps but she has been told that without ramps, she will be removed from the waiting list. The council are now installing ramps but she does not know whether they will be able to complete this work before she is removed from the waiting list.

 

“My MP received a letter from the Health Board telling him that I had been misinformed about the waiting times but as of today, it has been 11 months and still no sign of any wheels!”

Wheelchair user, Conwy

 

Recommendation 15. We recommend that, as a matter of urgency, the Welsh Government should clarify and make public the policies and arrangements for joint funding with organisations and individuals.

 

Recommendation 16. We recommend that the Welsh Government clarifies and makes public its policy and arrangements for the maintenance and repair of equipment bought by individuals.

 

There are still concerns about joint funding, or the apparent lack of it. Several people we spoke to mentioned the lack of choice of wheelchairs available on the NHS and that anything they required beyond this would have to be paid for privately. Any wheelchair paid for outside of the NHS would not be repaired by ALAS.

 

One parent we spoke to has asked the Cardiff ALAC why the chairs that she sees at trade shows are not available on the NHS and has been told that the cost of maintenance is the problem. She also highlighted that it is often not clear or widely publicized exactly what chairs are available on the NHS.

 

Recommendation 18. We recommend that the Welsh Government should review arrangements for short-term loans of wheelchairs, which are not provided by ALAS, to ensure that this service provision is adequately resourced.

 

Recommendation 19. We also recommend that the Welsh Government should ensure closer joint working between ALAS and those providing short-term loans of wheelchairs, particularly the British Red Cross.

 

We are aware of changes that have been made to the services provided by the British Red Cross Community Equipment Loan service. There has been an increase in the delivery charge for equipment as well as a reduction in the range of equipment that they are able to provide, although Wheelchairs are still available. There has also been an increase in the donation requested by the British Red Cross to cover the cost of a wheelchair, up from £5 a week to £1 per day, equivalent to £7 per week. They also informed us that there was an 8 week limit on a loan, compared to the 12 weeks mentioned in the last committee report.

 

While this may not seem a particularly large amount of money, if the individual is on a low income or benefits, it can be a high cost for something that is necessary to retain their independence.

 

The Red Cross state that these changes are due to ‘financial constraints’.

 

Scope Cymru also spoke to an individual who had been unable to get a loan of a powered chair when hers was in need of repair after being dropped at an airport. She was without a chair for a week and while she had a manual chair, she was not able to get around using this without assistance. As a result of this, she was unable to attend her voluntary placement that week.

 

Without a loan chair, someone who requires a wheelchair can have the independence severely affected and that this could have a particular impact on those in employment who may be unable to attend work as a result.

 

Recommendation 20. We recommend that the Welsh Government should ensure that the arrangements for maintenance and repair in Cardiff ALAC, and Wrexham ALAC be kept under review, to ensure that the service is meeting the necessary standards.

 

Those we spoke to offered both positive and negative feedback of repair services. Our school in Cardiff and our Skills Development Centre in Cwmbran both had quite positive experiences. The school has a regular appointment where someone from the ALAC will attend and carry out maintenance on any wheelchairs in need of it while they are there. Given that the vast majority of pupils at the school are wheelchair users, this means there is often work to be carried out.

 

Similarly, the Cwmbran Skills Development Centre had a similar view. While they did not have a reoccurring appointment in the same way Craig-y-Parc school does, they found that if someone attending to fix one chair, they would also fix any other problems that other service users had. Cwmbran has the same member of staff each time, allowing the individual to get to know the service users and re-occurring problems.

 

The individual conducting repairs is also able to access detail on the chairs owned by individual service users using their name and date of birth in order to make further arrangements if needed, including referrals for new parts. This process can be completed in two weeks, significantly quicker than a referral to an Occupational Therapist.

 

“If he’s here and it needs doing, he’ll fix it”

Service Manager, Cwmbran Skills Development Centre

 

However, other people we spoke to had different opinions of the service. Despite being based just down the road from our Cwmbran Skills Development Centre, our DIAL group in Cwmbran had encountered several problems.

 

One volunteer there said that the repair service was “very shortstaffed” and that when a repair is needed, the service would not send someone until they were in this area. This caused it to take a while for services to wheelchairs to be booked.

 

A service user who lives two miles from Maesteg also has to wait for repairs due to his location. He has a reoccurring problem with a footrest on his chair. He has been unable to leave his house for up to a week at a time due to needing repairs, causing him to become very frustrated and having to miss his day service.

 

A parent we spoke to in Bridgend has had to wait 4-6 weeks to get parts when repairs have been needed to her daughter’s chair. When her daughter started school it became apparent that she would need a headrest as she was using her chair more. It took 4 months for this to be fitted and only occurred after her paediatrician wrote to ALAS to ensure she received the appropriate head rest.

 

Given that those based in physical services seemed to receive more timely repairs than those who are based in the community, we believe that ALAS should look at whether arrangements can be made to enable those who have repairs that are needed to visit technicians if they are attending a particular place or service. However, this would need to be arranged so it did not detract from the service received by those in attendance at the facility, or be used as a substitute for visiting individuals in their own homes. This should be seen as supplementary service to enable people to get repairs quicker when needed.

 

Recommendation 22. We recommend that the Welsh Government should ensure that regular reviews for users are delivered, particularly for children and other users with changing conditions

 

The evidence we have seen is that this is currently not occurring. A member of our Face 2 Face group in Bridgend who have requested a review for their daughter received a letter from Cardiff ALAC stating that they have, “received a large number of referrals and unfortunately not everyone can be seen immediately”, “We are currently seeing people that were referred in October 2011” and that their daughter is now on a waiting list.

 

Their daughter is finding her chair uncomfortable as she has grown significantly since her last review.

 

An adult that volunteers in one of our services has also had negative experiences. Her chair has broken on several occasions and she believes she is in need of a review, but has not been offered a review in the previous six years. She has been told during previous repairs to her chair that she has not been put forward for a new chair due to funding constraints.

 

“Life can be difficult enough when you have a child who has special needs and the difficulties we have faced with ALAS have only added to that difficulty.”

Parent, Bridgend

 

For any additional information or if there are any questions, please contact Matt O’Grady, Senior Policy and Campaigns Officer for Wales on 02920 662406 or matthew.ogrady@scope.org.uk

 

Mae cyfieithiad Cymraeg o'r ddogfen hon ar gael ar gais.