Personal Wheelchar Budget Case Study

Mrs X sustained a traumatic brain injury during a fall which has left her with life-altering injuries; she is paraplegic with no independent feeling or movement from the waist down. In addition, Mrs X has a rare form of degenerative arthritis affecting her major joints, shoulders, hands, knees and hips causing her to experience pain and a significantly reduced range of movement.

Following her discharge from a local rehabilitation unit, Mrs X was referred in to her local NRS Healthcare wheelchair service and was prescribed with an attendant propelled wheelchair (definition: An attendant-propelled wheelchair is generally similar to a self-propelled manual wheelchair, but with small diameter wheels at both front and rear. The chair is maneuvered and controlled by a person standing at the rear and pushing on handles incorporated into the frame.) With ongoing community rehabilitation Mrs X could self-propel (definition – able to power her wheelchair herself) and we exchanged her chair for a light weight self-propelling version.

Six months later Mrs X was re-referred to our service as she was experiencing difficulties moving herself around her home all the time as her arthritis has got worse.

During her assessment our OT identified that Mrs X met the criteria for a funded indoor/outdoor powered wheelchair.

Through our holistic assessment approach our OT considered not just Mrs X’s clinical requirements but also her social and mental health needs. They identified that a powered chair would fulfil Mrs X’s mobility needs and that she was eligible for this through funding. We also highlighted that additional features such as a riser unit (definition: a riser unit helps a client with reduced mobility to get out of their wheelchair) would maximise Mrs X’s independence in her home and the wider community.

With the introduction of WatchAD, the national wheelchair outcome measure tool we could identify the areas important to Mrs X. not only from a mobility perspective, which is the wheelchair services focus, but also in the wider context. The provision of a wheelchair with a riser function allowed Mrs X to fully engage in all meaningful activities of daily life – addressing her social and mental health needs.

Personal Wheelchair Budgets offer the flexibility to consider all areas of a clients needs and work with our social care colleagues. We could access additional funding to pay for Mrs X’s riser unit which is not available through wheelchair services. This joined up approach allows our wheelchair service to ensure the wheelchair prescribed to the client fully meets their needs and ensures the best use of available funding. Previously this client may have had to explore the possibility of an assessment from social care for home adaptions, however a riser unit means the chair can promote independence rather than altering Mrs X’s environment.

Service develop and innovations within Wheelchair services

Personal Wheelchair Budgets are offered as part of NRS’s ongoing commitment to service development. Working closely with the local CCG’s to develop information leaflets and drive the uptake of the offering, we support the CCG’s to run public open days to promote service users understanding of Personal Wheelchair Budgets and how this can potentially transform the lives of service users.

All staff are trained to provide a comprehensive holistic assessment which explores the wider context for the individual; ensuring the best outcomes are achieved. We can support and sign-post service users so they can be better informed to make the right choices for themselves.

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