Wheelchair provision has impacted the physical health of 17 percent of young wheelchair users

A new report was created to identify the value of providing the right wheelchair that meets the needs of the recipient and the NHS.

The report, titled ‘The value of a wheelchair’ was funded by the Motability Foundation as part of their efforts to improve accessible travel, amplify disabled peoples’ voices and better understand the ways access to all kinds of transport needs to change.

According to the report by the Wheelchair Alliance, there is currently a lack of up-to-date mixed methods research that considers the value of an appropriate wheelchair to the wheelchair user and society more broadly.

Previous work has provided a compelling articulation of the unevenness of NHS wheelchair service provision and the negative consequences of poor provision, the report found. Much of this evidence, however, fails to meaningfully incorporate the voices of wheelchair users or is not based on granular quantitative analysis.

The report aims to address these gaps by examining the value of appropriate wheelchair provision holistically; and adopting a mixed-methods approach, blending high-quality quantitative analysis with in-depth engagement with wheelchair users.

It models the value per user, per year that could be unlocked if there was a move from a relatively uneven standard of NHS wheelchair provision, which the report suggests is the case currently, to a universal high-quality offering that is currently delivered by some but not all NHS wheelchair services.

This has enabled the Wheelchair Alliance, which works in partnership with other organisations to influence decision makers and help ensure wheelchair users can lead independent lives, to highlight the difference in outcomes that can be expected for an individual who has access to the right equipment and associated support services versus the same individual who does not have access to the right equipment.

Evidence from the Wheelchair Alliance’s previous report, ‘An economic assessment of wheelchair provision in England’, shows that the quality of current NHS provision of wheelchair services can vary significantly over time and across different geographical areas.

Wheelchair users in some areas receive excellent service whereas users in other areas may experience significant delays, inappropriately tailored equipment, a lack of training, and/or slow response to breakdowns.

Findings reveal provision of high-quality wheelchairs can have a significant positive impact on people’s lives and also lead to meaningful financial benefits for the NHS and society.

The report’s central estimates suggest that the annual benefits of appropriate wheelchair provision for young wheelchair users, relative to poor or uneven provision, are approximately £10,700 per user, per year. The equivalent figures for working-age adults are £15,200 and for retired adults is £13,400.

For young wheelchair users in full-time education mental health impacts account for two-thirds of total benefits. Mental health impacts are followed by physical health impacts at 17 percent, impacts on carers at 12 percent and education impacts at four percent respectively.

These findings were also seconded by the qualitative interviews, with interviewees stressing the importance of feeling like they were the same as other young people in their school or university, and could enjoy the same hobbies and opportunities.

For working-age wheelchair users, the distribution is different and employment impacts are the third largest category at 14 percent, and among retirement age wheelchair users’ physical health impacts are the largest source of benefits and account for half of the total benefits.

The report states that the cost of increasing equipment spending to the average level amongst Integrated Care Boards (ICBs) that currently report below average levels of per-patient spending is approximately £22 million per year, and suggests that if the patients collectively realised, only an additional one percent of total annual benefits of high-quality wheelchair provision the societal return would be over £60 million.

If patients registered with these ICBs collectively realised an additional five percent of the total annual benefits of high-quality wheelchair provision the societal return would be approximately £315 million, according to the report.

Additionally, the report states the NHS would also experience significant cost savings as a result of improved wheelchair service provision. Wheelchair users and their carers would experience fewer health issues which would otherwise require costly treatment and unplanned secondary care.

The report goes on to make policy recommendations, including NHS England (NHSE) playing a more active role in ensuring that all ICBs prioritise wheelchair services and dedicate sufficient resources to effectively deliver the service.

For example, it is recommended that this could be done by mandating that all ICBs adopt the Quality Framework for Wheelchair Provision along with the Model Service Specification when commissioning wheelchair services. This would help to minimise inequality across different services and ensure consistent delivery of good quality service and provision.

It also recommends that the Department of Health and Social Care (DHSC) and NHS England should explore the possibility of increasing current spending on NHS wheelchair services to help ensure more benefits are realised and the NHS can unlock significant cost savings.

The report’s final recommendation is that local wheelchair services and commissioners should continue to share best practices and explore opportunities to pool budgets between wheelchair services and other local services.

It also states that NHS England should consider what support and processes are required to encourage and facilitate greater joined-up working and frictionless pooling of budgets.

In the recent ADASS Autumn Survey 2023, almost two-thirds of social care leaders say that community-based care and support is not widely available in their local area.