To celebrate UK Disability History Month this year (16 November to 16 December), our Wheelchair Service team takes a look back at the history of the NHS Wheelchair service and the progress of wheelchair technology, and the critical care we provide today.
At Bromley Healthcare, our Wheelchair service provide care for people of all ages in Bromley with long term mobility needs. We currently provide care to around 2,600 people across the borough and are one of the biggest providers of wheelchair care to children.
Our focus is on providing personalised and custom care to people who need it. Wheelchairs allow people more independence and better wellbeing and quality of life that many who do not need wheelchairs might take for granted.
Origins of the NHS Wheelchair Service – Providing care to injured Veterans
Artificial Limb and Appliances Centres in England were run by the Department of Health and Social Security. The services they provided include supplying artificial limbs; providing and fitting artificial eyes; giving vehicles for the disabled; and other services for war pensioners, including surgical appliances, hearing aids, and home nursing equipment.
In 1953, these services were transferred to the Ministry of Health. At that time, it was intended to bring the artificial limb fitting service within the NHS to closely associate clinicians and surgeons responsible for investigation, assessment, treatment and management of amputees with those responsible for prosthetic care, to improve the service to the patient.
In 1984, a working party was put together to review these services, consulting clinicians, service users, manufacturers and other organisations, producing a report in 1986. The conclusion was that management of the services needed changing to integrate all the services into one service. These suggestions were accepted by the government who on 1 July 1986, set up the Disablement Services Authority as an interim measure, with the aim of integrating the service with the Health Authority’s management by 1 April 1991. The service has since developed, and now provides integrated care for those in need of a wheelchair across the NHS.
Providing personalised care to people in Bromley
Today, people who are referred to the Wheelchair service in Bromley range from those that might only need a few appointments to those needing lifelong care. Wheelchairs can be either manual or powered, and are personalised to each individual, being updated when needed to accommodate for their changing needs .
We run many different types of clinics as explained by Creena, one of our Occupational Therapists working within the service:
“Clinics which can be quite standard or quite complex like the Special Seating Clinic. We do home visits because we may need to look at the access and the environment to make sure the wheelchair is going to fit and some people are bedbound so they can’t get to us.
We do school clinics, which is quite handy as other therapists are there who know the kids well, and the parents can into the school so they are involved. We go to [residential care] homes. And we are at hospitals sometimes, but we normally wait for them to come home rather than seeing them while they’re inpatients”.
Creating custom wheelchairs
The Special Seating Clinic is for people who have complex postural needs and are unable to sit in standard wheelchairs. A thorough postural assessment is completed for people who come to get their first custom-made wheelchair which will suit their needs. People with long-term complex conditions also need to upgrade and replace old wheelchairs.
Appointment are started by checking in with the person, asking how they had been since their last appointment and if there were any comments they wanted to make. This is where their height and weight can be taken down or we can check their weight if they aren’t sure using our Wheelchair accessible scales. Arranging a home visit might then be discussed to see if the new chair would be suitable in the person’s home or if any adjustments would need to be made based on their assessment.
The next step is to review the parts of the current wheelchair that works well and what could be included in the new wheelchair design and what parts were needing improvement. Weight distribution and resting points on the chair are checked and the person is then hoisted up on to the bed for measuring and assessing their posture.
An example wheelchair might then be brought into the room to demonstrate any upgraded functions that could be added to the new chair e.g. an alternative style of controller for the powered wheelchair to enable the person to continue to use the powered wheelchair independently. The decision will be based on the person’s preference and what they think is suitable.
Moulds are often taken of the person’s legs and back (and sometimes chest, if support is required at the front) whilst they are seated in their best possible position and checks done to see if there would be any discomfort for them in the new mould, e.g. if their knees rubbing together. Lastly, checks can be carried out on the tray and the pelvic belt.
We have received great feedback from people who have used the service and their families. One mum said “Professional and very good and actually, you (service user) must have felt it because you were so relaxed on there”, which the person agreed to.
A family member of another service user said “I think the clinic today went really, really well. I felt listened to, I felt that [my family member’s] needs were listened to as I am [their] communication vessel. So yeah, I think it has been a really positive clinic experience and I am really, really pleased to see that the service are in new accommodation.”
At Bromley Healthcare, we are proud of how much our service has developed and the amazing team that support people.
There is still more to be done to make sure that people with physical disabilities needs are met, and that care focuses on what individuals need, and to help people live independently, with dignity and respect.
If you want to find out more about our Wheelchair service, please visit the Wheelchair service page.
Information pulled together and written by: Creena (Occupational Therapist, Wheelchair service), Debbie (Administrator), Hannah (Team Coordinator, Wheelchair service), Jok (Service Lead, Wheelchair service), Lizzie (Occupational Therapist, Wheelchair service), Mel (Occupational Therapist, Wheelchair Service), Sophy (Communications team), Stephanie (Occupational Therapy Assistant, Wheelchair Service).