Code of Practice for Disability Equipment, Wheelchair and Seating Services

A Quality Framework for Procurement and Provision of Services

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• Publisher: Matador
• Year: 2015
• eBook ISBN: 9781784629649

Discover everything you need to know about planning, commissioning, assessing for and providing disability equipment, wheelchair and seating services safely and effectively in this comprehensive and unique Code of Practice. To address the impending global care crisis resulting from the growing elderly population and an increase in the number of people living with long term conditions, there needs to be better deployment of the full range of disability equipment, with a clear strategy, for enabling independent living, enhancing disabled people's employment prospects and empowering individuals to take control and manage their own care. To achieve this effectively there need to be the right structures and processes in place to ensure timely and safe provision of the right equipment and associated services, thereby improving outcomes for service users. This Code provides a template for taking these actions and following it will go a long way in achieving these aims. The Code relates mainly to disability equipment, wheelchair and seating services, and applies in every setting where these services are provided. It also applies more generally to other assistive technology related services, and provides the necessary links to these services so that holistic, integrated and person-centred care can become a reality. The Code can be used for many purposes: as a general guide, for tendering services, performance and risk management, regulatory compliance, strategic and operational purposes and much more. It puts the user at the heart of services. The Code sets a national (UK), and perhaps international, benchmark against which services can be measured, as well as a realistic level of service people should expect to receive.

PART ONE

COMMISSIONING AND GOVERNANCE

CODE STANDARD 1

Service Requirements and Specifications

OUTCOME

The requirements, expectations and aims for the delivery of an equipment service are clearly specified and communicated, realistic, and easy to be interpreted and understood.

Introduction to Code Standard 1

Without the equipment provider having a clear understanding about what it is they are expected by the commissioners to do, in terms of service requirements, aims and outcomes, it is very likely that problems will arise.

Clearly specifying service expectations and standards, and having the right controls and measures in place for ensuring compliance, are key in the delivery of an all-round successful equipment service.

Where there is little data regarding activity, or where a new service is being commissioned, it is wise for the commissioner and provider to work hand in hand and to be flexible, so that activity levels and funding can be readjusted retrospectively where necessary. Otherwise problems may persist throughout the duration of the contract if activity levels prove inaccurate.

It is important for providers, service users and carers to know what the aims and principles of the service are, and what level of service they can expect to receive.

1.1	Service requirements, aims and principles have been clearly specified, in the form of a service level agreement, service specification and/or a contract, as appropriate.
1.2	A realistic expectation of activity levels, including approximate numbers for each type of activity, together with agreed tolerances, etc., have been clearly specified. The contractual agreement specifies the procedure to be taken should activity levels exceed or fall below these tolerances.
1.3	Current and future demands on services over the duration of the contract have been considered, factoring in any expected growth in demand where, for example, the number of service users rises owing to the increasing average age of the population.
1.4	Allowance has been made for any anticipated changes in equipment design, and new developments which could arise over the duration of the contract.
1.5	Prior to commencing the contract, there has been dialogue with the provider to ensure that the requirements and expectations placed upon the provider are realistic, and budget allocations have been arrived at using an appropriate calculated formula. Where there is no historic or suitable data available to form such an agreement, i.e. when a completely new service is being set up, frequent reviews are agreed with the provider to monitor and assess the level of activities.
1.6	Allowance has been made for the costs of compliance for the provider to meet all the requirements as set out in the specification and/or contract.
1.7	General or vague statements have not been used within the service specification and/or contract, etc. where ambiguity could be to the detriment of service provision. For example, requesting that the provider complies with all relevant health and safety requirements is too broad, and could be misleading. Providers should be given a comprehensive list setting out actual requirements and obligations, e.g. ‘a portable appliance test is carried out on all portable electrical appliances in accordance with the Electricity at Work Regulations 1989.’ (Note the costs of compliance with the cited legislation will also need to be considered.)
1.8	Service level agreements/service specifications and/or contracts are reviewed at fixed intervals, e.g. annually, and reviews involve suitable stakeholders and users of the services.
1.9	There is a patients’ charter, or similar information package, outlining the levels of service which users can expect to receive, and types of need that will be met, e.g. short or long-term, or occasional use.
1.10	There is a visual representation of the care pathway available, in accordance with the service model. The care pathway must reflect all key stages of the service as specified in the service description and ensure maximum response times for each stage of the pathway are set. This is communicated to all interested and relevant parties, e.g. service user, General Practitioners.
1.11	There is a list of the equipment types that are provided under statutory provision; this includes both simple and complex equipment. Any approved third-party providers or suppliers also have access to this list.
1.12	Roles, responsibilities and accountabilities of the commissioners, providers and any third-party providers or suppliers, are clearly specified.
1.13	Where different parts of the service are provided by different providers, e.g. routine and complex equipment, and maintenance, this is clearly specified in corresponding contracts and/or agreements.
1.14	There is a requirement for service providers to submit proper clinical audit and clinical effectiveness reviews. Particular attention should be paid to service user satisfaction, with an emphasis on needs being met.
1.15	Providers are actively encouraged to suggest and use innovative ways to deliver the service, taking advantage of the range of technology available.

CODE STANDARD 2

Partnerships and Joint Working Arrangements

OUTCOME

Sector-wide integrated commissioning and joint working is in place, together with joint funding arrangements (where appropriate) with all relevant agencies, to ensure duplication and inefficiency are minimised, and to make sure all the needs of the service user can be met in a coordinated and timely manner.

Introduction to Code Standard 2

There are many statutory organisations funding delivery of similar equipment-related services, e.g. health, local authority (housing, education and social care).

In view of the scope for duplication, time delays and inefficiencies when providing entirely separate services for the same service user, efforts have been made over recent years to improve integration and joint working between relevant organisations.

Commissioning arrangements should include plans for multi-agency and joined-up working to ensure the totality of users’ needs are met as seamlessly and effortlessly as possible. This will require liaison arrangements with, for example, the housing service for adaptations, the education department for special needs, and other equipment-related services, including prosthetics, orthotics, telecare and community equipment services.

Simply including in service specifications that providers, including clinical staff, should work in a joined-up and integrated manner, is not sufficient to ensure this actually happens in practice. These ambitions need to be firstly established and agreed at a commissioning level, for them to be effective.

There are many voluntary and private sector organisations, and wider support services, such as housing agencies, providing equipment-related functions. As yet the benefits of these organisations and sectors fully engaging in joint working for achieving seamless, timely and cost effective equipment supply have not been fully explored and realised. We are living in an era when these opportunities should be embraced.

2.1	There are formal agreements in place for funding integrated commissioning and joint delivery of services between relevant agencies responsible for arranging equipment services locally.
2.2	Interdependencies with relevant organisations, services and departments are listed, and formal link...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• Forewords
• Preface
• Acknowledgements
• Overview of the Code of Practice
• Introduction
• Part 1: Commissioning and Governance
• Part 2: Service Provision
• Part 3: Clinical and Professional Responsibilities
• Part 4: Peripheral Issues and Specialist Areas
• Appendices