1.1. The wheelchair service will supply a wheelchair on loan to a named individual who:

• Has a long-term (defined as 6 months or longer) mobility problem and requires a wheelchair for permanent use because they are unable to walk functionally. Shorter loan periods may be considered for individuals with a prognosis of less than 6 months’ life expectancy.
• Will use the wheelchair frequently, defined as more than 4 days per week AND for more than 4 hours per day.
• Is permanently registered with a GP in the wheelchair service catchment area, or permanently resides in the wheelchair service catchment area.
• Meets the other specific eligibility criteria set out in this document.
• Lives in an environment that is compatible with safe use of the wheelchair.
• Can demonstrate that, where their wheelchair is used in transport, Best Practice Guidelines (see Section 18) are followed.
• Agrees to the Terms and Conditions of Loan (available on request).

1.2. Individuals new to the wheelchair service must be referred by an Accredited Prescriber, GP or HCPC-registered therapist using the correct referral form. The form must be fully completed.

1.3. Existing service users can re-refer themselves directly by phone or in writing but only for replacement / review of the same category of wheelchair.

1.4. Eligible service users who require a new or replacement wheelchair or buggy may be offered a Personal Wheelchair Budget (see Section 16).

What is the wheelchair service unable to provide?

2.1 The wheelchair service does not supply wheelchairs for:

• Work use only
• Sporting activities
• Portering purposes
• Temporary use during rehabilitation
• Emergency / evacuation purposes
• Behaviour management where the service user does not meet the relevant eligibility criteria
• Transit use in care homes

2.2 The wheelchair service does not supply:

• Trikes
• Scooters
• Class 3 powered wheelchairs
• Powered wheelchairs with attendant-only controls
• Power-assist devices for manual wheelchairs
• Non-clinical accessories such as rain covers, sunshades, shopping baskets, etc.

The wheelchair service has an approved equipment list from which wheelchair service clinicians prescribe, this can be viewed on the wheelchair service website.

The Personal Wheelchair Budget option (see Section 16) may be available for eligible service users who wish to obtain a wheelchair or buggy that is not on the approved equipment list.  Please note that service users can only make use of the Personal Wheelchair Budget scheme under certain circumstances.

Attendant-propelled or transit wheelchairs are provided to service users who are unable to mobilise independently and who:

3.1 Satisfy the general eligibility criteria in 1.1.

3.2 Have a family member, carer or other individual who can safely manage the use of the chair.

A wheelchair with large (self-propelling) wheels may sometimes be provided for transit use if the service user’s environment requires it.

Self-propelled wheelchairs are supplied to service users who can mobilise independently using a wheelchair and who:

4.1 Satisfy the general eligibility criteria in 1.1.

4.2 Can functionally self-propel a manual wheelchair without this being detrimental to their development or their medical condition. GP advice regarding this may be requested.

These wheelchairs are supplied to service users who meet the criteria in Section 4 above and who:

5.1 Are full-time existing wheelchair users.

5.2 Have sufficient physical and cognitive ability to manage a wheelchair that is designed to be used in a less stable configuration.

5.3 Would achieve significantly greater independence with this type of wheelchair.

These types of wheelchairs are usually provided for service users who can transfer independently.

Buggies are supplied for those service users who are unable to mobilise independently and who:

6.1 Satisfy the general eligibility criteria in 1.1.

6.2 Have sitting dimensions that are too small for a wheelchair.

6.3 Do not require postural support but have outgrown standard commercially available buggies.

Service users who require postural support may be provided with a buggy from the wheelchair service even if they have not yet outgrown standard commercially available buggies.

Double buggies are only supplied in line with the above criteria where both siblings have long-term mobility problems.

EPIOCs are supplied for those service users who demonstrate their ability to operate a powered chair independently and who:

7.1 Satisfy the general eligibility criteria in 1.1.

7.2 Are full-time wheelchair users.

7.3 Are unable to self-propel a manual wheelchair functionally or where self-propelling is contra-indicated on medical grounds.

7.4 Live in a permanent residential environment where the wheelchair can access all relevant facilities required for daily living and with safe access to outdoors.

7.5 Can manage their wheelchair safely in a variety of outdoor environments.

7.6 Have no medical conditions (including medical treatment or medication) that affect consciousness such that they or others are put at risk.

7.7 Have no problems with visual, cognitive, visual-spatial or other higher cortical functions or other medical conditions that would put them or others at risk.

It is the responsibility of the wheelchair service to determine whether or not an individual can operate an EPIOC proficiently and safely.

EPIOCs with dual controls are only provided in exceptional circumstances.

Service users who have a suitable indoor environment and who will not use a powered chair outdoors will be considered for powered wheelchair provision.

A standard cushion will be provided for use in conjunction with the supplied wheelchair. Specialist cushions, appropriate to the service user’s needs, will be provided for any service user who:

8.1 Has specific pressure care needs when using their wheelchair.

8.2 Requires additional postural support within their wheelchair.

These cushions are supplied for use with wheelchair service loaned equipment. Service users who would be eligible for wheelchair service provision and who have their own clinically appropriate private wheelchair may be considered for issue of a specialist cushion.

Specialist seating systems are supplied for those service users who:

9.1 Satisfy the general eligibility criteria in 1.1.

9.2 Have complex postural needs that cannot be met without the addition of customised or complex modular seating systems to their wheelchair service loaned equipment.

9.3 Can use the specialist seating effectively and safely or have carers who can take responsibility for doing so.

Tilt-in-space wheelchairs or wheelbases are supplied for those service users who:

10.1 Satisfy the general eligibility criteria in 1.1.

10.2 Have postural needs that cannot be met without the use of variable tilt-in-space.

10.3 Can use the tilt-in-space wheelchair effectively and safely or have carers who can take responsibility for doing so.

Tilt-in-space wheelbases are often provided in combination with specialist seating systems.

Referrals for wheelchair or buggy accessories or modifications to wheelchair service equipment will only be accepted when they are required to meet a mobility need or a postural need within wheelchair service loaned equipment.

Providing and fitting accessories or modifications carries some risk which must be assessed before proceeding.

11.1 Where possible, compatible accessories from the original wheelchair or buggy manufacturer should be used.

11.2 Service users or their cares must be able to use the accessories or modified parts effectively and safely.

11.3 Service users must not fit their own accessories or carry out modifications to the loaned wheelchair or buggy without following the process approved by the wheelchair service (available on request).

Headrests will be fitted to wheelchairs or buggies only where head support is an essential part of a service user’s postural management in a wheelchair or buggy.

If a wheelchair or buggy is used as a vehicle seat, a suitable head restraint should be used during travel. Wheelchair or buggy head supports are not classified as head restraints and it is the responsibility of the transport provider to ensure that appropriate restraints are provided when service users travel in their wheelchairs in a motor vehicle. Best Practice Guidelines (see Section 18) should be consulted for those with complex postural needs.

Hub or disc brakes are not supplied on manual wheelchairs except where there are safety or environmental concerns in everyday use.

More than one wheelchair may be supplied to a service user but only in specific circumstances, for example:

14.1 If the service user’s primary provision is a powered wheelchair

14.2 If a service user lives in a 2-storey home with no lift and the property is not suitable for lift installation

If approval for provision of a second wheelchair has been granted, the second wheelchair will usually be a standard / basic manual wheelchair for occasional use only.

The wheelchair service will provide mobility equipment to service users who are permanent residents of Nursing or Care Homes and who meet the eligibility criteria for provision of self-propelling or powered wheelchairs only.

The wheelchair service will not provide attendant-propelled or transit wheelchairs to Nursing or Care home residents except in the following circumstances:

15.1 If residents have postural issues and are taken out into the community on at least 4 days per week. They must be referred by an Accredited Prescriber, GP or HCPC registered therapist using the correct referral form which must be fully completed. An additional section of the referral form must be completed by the carer or family member who will be taking the service user out regularly into the community.

Service users who meet the eligibility criteria and who have been identified as needing a new or replacement wheelchair may be eligible for a PWB. A leaflet explaining this scheme fully can be viewed on the wheelchair service website and is available on request.

When service users are assessed by a wheelchair service clinician for a new or replacement wheelchair, their wider health and wellbeing needs will be considered. A Care and Support Plan will be completed to determine which of these needs can be met by wheelchair service provision and the most suitable equipment from the wheelchair service’s approved range will be offered (the Notional NHS provision). Service users will be advised of the value of this wheelchair or buggy and will then have a number of choices:

16.1 Accept this Notional NHS provision

16.2 Choose a Top-Up PWB and pay for additional accessories or features to be fitted to the wheelchair or buggy offered from the wheelchair service approved range. Some examples include:

• Trays for feeding
• Headrests for transport
• Sun canopies
• Rain covers
• Spoke guards
• Powered elevating legrests
• Powered recline
• Powered seat riser

16.3 They can choose an Alternative PWB, paying the difference in value between the offered wheelchair and an alternative one from the wheelchair service approved range.

16.4 They can request a Third Party PWB, using the value of their offered wheelchair towards a different wheelchair supplied by a third party.

PWBs will only be issued towards equipment that is considered suitable for a service user’s clinical needs and is from reliable and reputable suppliers.

PWBs are not available retrospectively for privately purchased wheelchairs or charitably funded wheelchairs.

PWBs will not be provided for Wheelchair Cushions or Special Seating.

In the event that a service user wishes to challenge the interpretation of these eligibility criteria, they should contact NHS Surrey Heartlands Clinical Commissioning Group:

• Email: syheartlandsccg.contactus@nhs.net
• Telephone: 0300 561 1555
• SMS: 07917 087 560
• Website: http://surreyheartlandsccg.nhs.uk/

“International Best Practice Guidelines: BPG1, Transportation of People Seated in Wheelchairs”

Published by the Posture & Mobility Group as “PMG BPG1 First Revision v2.2” in April 2020.

This document was available as of August 2020 from the following link: https://www.pmguk.co.uk/resources/best-practice-guidelines/bpg1-2019-revision