For a while now we’ve all heard snippets about changes to how you might get a wheelchair from the NHS in England, personalised wheelchair budgets have been on the agenda for several years now. So, we wanted to learn more about them, how it’s going to work and how it will differ from the current voucher system.
We asked some questions to NHS England to help you (and us) understand what personalised wheelchair budgets will mean to service users. If your question hasn’t been answered, sign in and ask us in the comments below – we’ll then take it to the NHS team on your behalf.
How does a personalised wheelchair budget differ from the voucher scheme?
Currently, wheelchair users are assessed and then offered a voucher that reflects the value of the wheelchair deemed suitable for the users needs. Some users then opt to fund additional options themselves, such as lighter wheels or different push rims.
Personalised wheelchair budgets aim to build and improve upon the voucher scheme and is designed to work with other services to enable users postural and mobility needs to be met, as part of a wider care plan. For example, it might be part of an Education, Health and Care (EHC) plan or part of an integrated plan with organisations such as Access to Work. A personalised wheelchair budget can also support users to access a wider choice of wheelchair, as well aiming to reach an outcome that should be integrated around a person and their family instead of a one size fits all approach.
So, why are personalised wheelchair budgets being introduced?
The wider aim is to give a better service, joining up with other agencies and organisations to provide a more tailored service. In 2015 the National Wheelchair Leadership Alliance produced a wheelchair charter which listed actions that needed to be undertaken to support better wheelchair services and a better quality of life for every wheelchair user.
Some of the key aims include:
- A person-centred service that works in partnership with service users and their carers and makes the user/carer voice central to any design, innovation and service change.
- Entry to service via referral from an appropriately skilled professional. The time from referral to delivery will be at least within the constitutional right of 18 weeks with further substantial improvements by 2016/17 for all people using the service.
- Innovative and flexible budgeting working with key partners to strengthen integration across health, social care, work and education, enabling the accommodation of individual needs, independence, health and wellbeing.
Let’s break that down, what does it mean for service users?
- A wheelchair user (and their family and/or carers where appropriate) will be involved at all stages of their wheelchair provision process.
- Your GP, Consultant, Physiotherapist or Social Worker will be able to refer you to wheelchair services if they believe your needs should be reassessed.
- Wheelchair services will work with other organisations, such as social services or Access to Work, to share the cost of the wheelchair when appropriate.
Can I still contribute my own money to add features that I want?
Yes – the introduction of personalised wheelchair budgets does not change the current framework.
What are my options for managing my wheelchair budget?
You’ll be able to manage your budget. There are four options when it comes to managing a Wheelchair Budget:
Notional Personal Wheelchair Budget – this is where the wheelchair user (or their representatives) chooses to use their budget within NHS services. Wheelchair services will purchase and provide the wheelchair, the wheelchair user (or other services) can also contribute for wheelchair enhancements. This was previously known as a Partnership Voucher.
Third Party Personal Wheelchair Budget – this is where the wheelchair user, or their advocate, chooses to use their wheelchair budget outside of the NHS. An independent dealer will receive the budget via invoicing the NHS. The user (or other services) can also contribute for any wheelchair enhancements. This was previously known as an independent voucher.
Traditional Third Party Personal Health Budget – this is where an organisation that is legally independent of both the NHS and the wheelchair user holds both the money and manages the budget. A good example is where a wheelchair is provided as part of a wider care package.
Direct Payment – this is where the budget holder holds the money in a bank account or equivalent account and takes responsibility for arranging the wheelchair, care and support in line with an agreed personalised care and support plan. It’s unlikely that this will be routinely available as an option at this time though.
Is repair and maintenance included in a personal wheelchair budget?
If you have a third party personal wheelchair budget and direct payment, where the money is spent outside of the NHS, then it should include a contribution towards any repair and maintenance costs.
If you choose a notional budget is then the repair and maintenance will be provided by NHS commissioned wheelchair services. However, if the budget included contributions to the cost of extra features, then the repair of these features may not be covered by NHS commissioned services.
Who owns a wheelchair provided by a personal wheelchair budget?
In short, personal wheelchair budgets mostly follow the same principles of the original voucher scheme. This is that people who took the independent voucher option (third party personal wheelchair budget) would become the owner of the equipment. Whereas, wheelchairs provided via the partnership voucher option (notional personal wheelchair budget) remained the property of the NHS. Where there are multiple funding streams involved, the ownership of the wheelchair would be decided on a case by case basis.
So, is there actually much difference between budgets and vouchers?
No. The Personalised Wheelchair Budget is built on the functionality of the voucher system. Clinical Commissioning Groups (CCGs) will also have to ensure that vouchers remain available whilst the services transition from vouchers to budgets.
Where can I get details about my what my local service offers?
All CCGs will be expected to publish details about their personal wheelchair budget offer as part of the wider personal health budget offer. You can normally find this on the CCG website. Alongside this, NHS England have a web page with some information and an FAQ.