NHS wheelchair provision

Frances Ryan tells us all that wheelchairs aren’t available on the NHS to those who need them. Then fails to ask the correct question. So I do in the comments:

What would be interesting to know is, has there ever been a time when the NHS provided, free at the point of use and on time, the correct wheelchair for all who needed one?

That is, is this a new problem? Or an old one that has just come to your/our attention? Knowing that will aid in understanding why. For example, perhaps it is about tight money these days. But if it has always been true, then perhaps it’s about the structure of the system itself?

That something is wrong seems obvious. But we can’t fix it until we know what is wrong, can we?

49 thoughts on “NHS wheelchair provision”

  1. 8 years ago my daughter broke her femur (after a stone fireplace she climbed up collapsed on her) and we had to pay to rent a wheelchair from a private company.

  2. I once had an ankle operation which involved me being on crutches for six weeks. Except…a week later while on a training course I dislocated my shoulder too. Frimley Park A&E then suggested I should leave. It was 0100 in the morning, and the prospect of hopping on my left leg while praying I didn’t fall over on a right ankle with a screw through it or a recently dislocated shoulder didn’t appeal, so I persuaded them to let me stay until I could get a relative to pick me up.

    Needless to say, they wouldn’t give me a wheelchair. Neither would the GP at home: you had to apply for one, which took weeks. So, I got one from a local Red Cross shop for a few weeks in return for a donation.

    Our wonderful NHS….

  3. Jesus. I once took a girlfriend to hospital here – on her insistence – because she had a cold and it was a Sunday night and all the clinics were shut. I was so embarrassed, but when the nurse called her name my jaw hit the floor…. They had prepared a wheelchair for a 20 something year old girl with a cold.

    I was speechless.

  4. The NHS will provide wheelchairs for people permanently unable to walk. Vast amounts of assistive equipment ends up in spare rooms or attics and wheelchairs are expensive. Organisations like the red cross hire out wheelchairs for short term use.

  5. My own experience is that the NHS wheelchair service moves very slowly; we were warned about this a decade or so ago when it first became an issue, cut out the middleman, and didn’t try to speed the process up. Five years later, an appointment for a fitting for a manual chair came in the post.

  6. It seems to be only recently that the NHS in our part of the world gives you an address to return your crutches to. I imagine nobody will check. And I suppose it would be filthy Fatcherism if they were to ask for a deposit on crutches.

    I imagine that many people keep their crutches “just in case”.

  7. But if it has always been true, then perhaps it’s about the structure of the system itself?

    On a Sunday morning in July last year, I went to the local NHS hospital to return a pair of crutches used by The Other Half after an accident a few months previously. I made my way to the main reception desk, behind which a large woman was staring intently at a celebrity gossip magazine. I stood directly in front of her, smiling expectantly. For several seconds, almost ten, nothing happened.

    “Morning,” I said. “I’m returning these crutches. Could you tell me where I can leave them?” The receptionist’s eyes moved, very slowly, from the magazine to me, but the enquiry was met with a blank stare. I assumed the receptionist hadn’t heard me on account of the gripping contents of her magazine. Just as I started to repeat the question, the large woman mouthed one word: “Hydrotherapy.” I looked around at the maze of doors and corridors, hoping for a sign marked ‘Hydrotherapy’.

    “Sorry, can you tell me where I’ll find Hydrotherapy?” As I asked this, I sensed I was already testing the woman’s patience. Another awkward pause, followed by a vague gesture and an irritated tone of voice: “Down that corridor, on the right.” “Thanks,” I said, determined to sound civil, albeit unilaterally.

    The corridor in question was quite long with numerous right turns, none of which was marked ‘Hydrotherapy’. However, after a walk of maybe 70 metres or so, I did spy a door on the left with a sign to that effect, through which I found another long corridor and, eventually, another reception desk, where three members of staff sat chatting in a near whisper. Again, I stood right in front of them, hoping to be noticed.

    “Morning,” I said. Again, nothing happened. Evidently I was expected to stand there patiently until the chatting had reached a crescendo and the subsequent laughter had concluded. “I’m returning these crutches,” I said. “I’ve been told I should leave them here.” The second, equally blank receptionist glanced at crutches, but not at me, then said, distractedly and apparently to the room in general, “There’s no-one here to take them. Have you tried main reception?”

  8. Given the amount of junk that most people accumulate in their homes, you’d think they’d be glad to get rid of a grotty wheelchair lying around.

  9. Are we surprised at this?

    Free (at the point of consumption) service not having sufficient resources to meet needs.

    It’s the kind of resource allocation/management problem economics exists to solve. Now if only people would use economics* to solve it….

    *actual economics. Not just throwing more money at it.

  10. @ David Thompson: “…However, after a walk of maybe 70 metres or so, I did spy a door on the left with a sign to that effect…”

    I’m only amazed it didn’t say ‘Beware of the leopard.’…

  11. When we had a clear out of the garage of the house we moved into 18 years ago, we found three old-style wheelchairs. We couldn’t find anyone to take them, despite being in good working order. So they sadly went to the tip.

    Just three years ago, we were trying to dispose of some old equipment left in a cupboard of a social club for OAPs my mum used to run. Another couple of wheelchairs. These, however, were collected by a local charity!

  12. “The response in some quarters is that the NHS is a finite resource – the implication being that there’s limited money to go around…”

    *sighs* *plants another magic money tree*

  13. @Julia,

    Having visited the same hospital several times over the years, accompanying relatives, my impression of the place is that while there are friendly and efficient doctors, surgeons and nurses, the admin staff is a very mixed bag and largely unfamiliar with notions of customer service or even common civility. Competence, too, is very hit and miss, and during the recent experience, an important appointment notification was never sent, a set of records was accidentally deleted, and a set of x-rays was simply lost, never to be found. None of which was regarded by the staff as particularly unusual or embarrassing.

    Shit happens, of course. But the apparent indifference to it happening, repeatedly and in piles, suggests a systemic issue. One that often leaves the customer feeling like, at best, an inconvenience.

  14. You can be sure that nearby, a separate NHS hospital will, a) be paying for external storage to house their excess of wheelchairs and crutches, b) bemoaning the budget pressure thus caused.

  15. “But the apparent indifference to it happening, repeatedly and in piles, suggests a systemic issue.”

    Mistakes must never be acknowledged. Omerta, and all that.

    Get a group of mixed NHS workers in a room – with no “civilians” present – and they’ll happily bang on about the amazing inefficiencies and stupidities they encounter. Add civilians, and you won’t hear a peep.

  16. My dad needed a wheelchair so got given an NHS one by his hospital. Totally unsuitable for him so handed back. They did give him a voucher towards a new wheelchair so he used it and ordered one, went for a fitting, and got the chair. Still uses it now years later.

    Wife asked about a wheelchair, was told no she couldn’t have one. So from a shop across the road from the hospital she purchased one and has used it as needed since. Even attending hospital in it.
    Only needed when lots of walking required.

  17. “This is by far the most disturbing thing I have read in a long time. My instant reaction is I want to help, I understand from the article that charitable donations are not the best way forward, but is there a charity co-ordinating a lobbying attempt of MPs? ”

    Is one of the first comments.

  18. It probably works better that they aren’t involved. You can get them on eBay for about £25 used. That’s going to be less than employing wheelchair administrators running with a system built by Serco for an eyewatering sum of money.

    Just hand a bit of extra money to the poor.

  19. @Tim

    ‘The NHS aren’t always that good in letting people know how to return stuff’

    Fucking hell, the fucking country’s seriously fucking fucked.

  20. Older chap I know has to go into the John Radcliffe some time soon for some kind of heart surgery.
    (As I understand it the condition won’t kill him, but it is seriously affecting his quality of life. Been waiting months and still hasn’t got a date. But that’s by the by.)
    Half the hospital is being closed for a fucking year to remove some cladding, post-Grenfell.
    For the cost involved you could employ a dozen fire marshals 24/5/365, even assuming it’s a real issue.
    The people in charge of this country are utterly fucking barmy.

  21. Nothing to do with wheelchairs, but I have just returned from my optimistically called Medical Centre after a blood check, whilst talking to the nurse the question of the place taking on ever more patients from the new estates going up whilst retaining the same amount of nearly all part time doctors, the question of lengthening appointment times came .
    Currently running at three weeks plus and lengthening she told me me of her friend who uses the next nearest surgery who needed an appointment and was quoted twelve yes twelve weeks, have we reached peak waiting for appointment times or will the next time we phone and ask for one be asked what year would you like should you still be alive.

  22. @Interested: “The people in charge of this country are utterly fucking barmy.”

    Once upon a time, that wouldn’t matter. Because public servants were on the ball. But these days, they’re as barmy as the leaders.

  23. @wiggiaatlarge: “… whilst talking to the nurse the question of the place taking on ever more patients from the new estates going up whilst retaining the same amount of nearly all part time doctors…”

    Ah, yes, the ‘housing crisis’which means we need to build more and more homes.

    And not increase the capacity of the infrastructure, because everyone skipped that tutorial level on ‘Sim City’….

  24. JuliaM,

    “Once upon a time, that wouldn’t matter. Because public servants were on the ball. But these days, they’re as barmy as the leaders.”

    They’ve always been shit here and everywhere.

  25. When new housing estates (some the size of small towns) are built near us, practically nothing extra is spent on the roads. Because – roll of drums – the inhabitants will all travel by bike!

  26. “It probably works better that they aren’t involved. You can get them on eBay for about £25 used. That’s going to be less than employing wheelchair administrators running with a system built by Serco for an eyewatering sum of money.”

    This x 1000.

    I don’t really shop myself, but am involved in international ecommerce. We take for granted just how smooth and powerful platforms such as Amazon and ebay are. Moving wheelchairs around a single country is nothing.

  27. My impression was they didn’t want them back because then they would have to check they were in perfect working order before issuing them to someone else. They would be liable if a wheel fell off. Easier to buy new.

  28. Dominic Lawson in the Daily Mail, 12.9.16:

    “Piles of crutches, zimmer frames and even wheelchairs are mounting in dumps across the country…One, a Mrs White, of Doncaster, said: ‘I had a knee replacement and came home with a zimmer frame, two crutches and a walking stick.
    ‘After I’d been home a month, I contacted the local hospital to have the equipment returned. I was surprised to learn they did not re-use it and disposal was down to me!’
    Those items are not cheap, but they are much less expensive than wheelchairs: we had great difficulty in getting the NHS to take delivery of one which my younger daughter had been given after she broke her leg badly. It was a wonderful, brand-new red one, amazingly easy to lift and fold, which I suspect had cost thousands.
    Yet, after my daughter had (to her great relief) no further use for it, it was impossible to find anyone at the local NHS hospital to take an interest in its return.
    Nevertheless, we put it in the back of our car and delivered it ourselves.
    No one at the hospital had any record of its existence — forget about stock control — and no one wanted to take responsibility for its return to the orthopaedic department.
    So we just left it in a corridor and drove home.
    I hope someone found it useful.

  29. mike fowle,

    It’s perfect “little platoon” stuff. Semi-retired bloke with time on his hands gets a little unit. People like me throw him the odd tenner to keep it going. Pick up crutches/wheelchairs you need, and here’s a little donation box.

  30. Hydrotherapy is an odd place to have to return crutches to.

    Heh. Quite. I didn’t ask why the crutches had to be returned there, a department we’d never visited before and which was located roughly 340 miles from where we’d parked. Rather than, say, some clearly indicated drop-off point near the main entrance. After almost half an hour of wandering up and down corridors and trying to engage bored and surly staff, I was just happy to get the hell out of there.

  31. All of this sounds horribly familiar. My father is blind and bed bound, cared for at home privately at his own (vast) expense. He’s entitled to various bits of NHS kit to make caring for him easier and safer. Getting them is the most ludicrously inefficient system imaginable. He’s currently waiting for a side frame for his bed. The district nurse filled in a form authorising him to be issued one. Week or more later a chap turns up with a kit, but its the wrong one. Nurse has forgotten to put on the form that he had a hospital bed (provided by the NHS) not a divan, so wrong kit was issued. No-one thought to contact the customer to check which was needed when the form didn’t specify, even though they should have the record of the bed being provided, as it came through them. The whole process now has to be gone through again, with another visit by the Nurse just to fill in another form, another trip for the installer. Approx 3-4 people will have been involved in all this so far and zero has been achieved. It will have taken a month for one simple piece of equipment to travel from a storage depot a few miles away to his house. No-one will of course consider that this is a) unacceptable, or b) requiring those involved to be disciplined for utter failure to achieve anything approaching a reasonable standard of service.

    All of this utter fuckwittery will naturally be solved by shed loads more money being spent on the NHS…………

  32. Dominic Lawson in the Daily Mail

    Every Guardian reader in the land would have immediately dismissed everything that followed, and still believed it was a resourcing (money) issue.

  33. Jim: “No-one thought to contact the customer…”

    Ah, Jim, you’ve made the classic mistake of thinking your father is the customer!

  34. I guess we all had a similar experience. Break leg and forced to beg for supplies to maintain your Ilizarov apparatus and entry points in decent condition (to avoid infection). Then told to throw away crutches and leg boot when no longer needed as they’re surplus to requirement.

  35. Bloke in Costa Rica

    When I did all the ligaments in my ankle on a Friday in 1995, I had to wait till Monday to see the consultant orthopod (this was Bradford Royal Infirmary). I got a cast I could walk on about five minutes after he’d said, “yup, it’s buggered,” but they issued me with crutches over the weekend and dire imprecations to return them. I toddled up to the nurses’ station on Monday, said I was there to see the boss, where did they want the crutches? Handed them over, they made a note on an inventory form, sorted. It’s hard to believe that things have degenerated that much in 20 years.

    My mother had to buy her own wheelchair. It’s a nice lightweight one. Cost about £500. The through-floor lift didn’t get any subsidy (except the normal zero VAT for medical equipment) and that was the thick end of seven grand. It’s not immediately obvious why wheelchairs should be dished out like aspirins. If they’re loaners then take a nice big deposit, for God’s sake.

  36. “The people in charge of this country are utterly fucking barmy.”

    No. It’s the people of the country.
    That the administrators will run things for the benefit of administrators is a given. Northcote Parkinson tells us so. But people are complicit by allowing them to. A few administrators being kicked to death in their offices would concentrate minds remarkably.

  37. “Hydrotherapy is an odd place to have to return crutches to.”

    Maybe they plan to clean them by chucking them in the pool.

  38. Whilst in my last home (a flat within a block thereof) I found a wheelchair marked as property of the local hospital in the bin store one day. Being a somewhat sensible soul I stuck it in the car, took it up to the hospital and took it in to reception. The lady manning the desk was rather surprised someone had returned it.

  39. “The people in charge of this country are utterly fucking barmy.”

    But why are they ‘barmy’?

    Because so many of them are semi-educated and sub-literate people from dire comprehensive schools and mickey mouse ‘universities’ where they never learned to think critically or creatively. Taught to the test, they are ill equipped to solve any problem in the real world.

    Add to this that the state and its many bureaucracies are so large that no management team – of, say, an NHS trust – could ever comprehend all the management information necessary to manage the organisation efficiently. Markets do this sort of thing much more efficiently.

  40. Bloke in North Dorset

    I know, in passing, a guy who manages a charity warehouse were they teach the homeless and ex offenders to renovate furniture collected from recycling centres and direct donations. If I remember I’ll suggest they add wheelchairs and other NHS equipment to their list.

    There’s no reason recycling centres can’t become collection centres.

  41. A large part of the problem is demarcation of roles. One hospital I worked at, the equipment stores was refusing to accept returned crutches because they had dozens of returns that the physio department wasn’t prepared to send someone over to collect.

  42. During her last years, my mother suffered from Arthritis such that her mobility was very restricted. She had a stairlift installed and paid for by the local council and was also issued with a zimmer frame, wheelchair, and other mobility aids by the local hospital.When she eventually died I had the job as her executor of clearing everything out. It was a nightmare finding where to return the NHS stuff and. I was amazed that the council did not want to reuse the stairlift and told me to dispose of it as I wished. It just so happened that the Solicitor handling the probate wanted one for his mother so I sold it to him.
    Councils and the NHS, who cares its only the public’s money.

  43. “Because so many of them are semi-educated and sub-literate people from dire comprehensive schools and mickey mouse ‘universities’ where they never learned to think critically or creatively. Taught to the test, they are ill equipped to solve any problem in the real world.”

    OT, but a case in point:

    http://www.bbc.co.uk/news/uk-40821915

    Guy suggests replacing the concrete weights that are fitted to washing machines to damp the vibrations with plastic containers that are only filled with water once the machine is installed. Thus creating a massive weight saving, reducing transport costs, CO2 emissions etc, all very green. He can’t see why this has never been done before.

    It doesn’t seem to have occurred to him that having a reservoir of vibrating water on top of an 240V electrical device might just prove to be a bit of health and safety hazard. The worst that happens if the concrete breaks is there’s a big clunk from inside, and the drum stops going round. If the water tank springs a leak its ending up in the electrics, potentially causing a fatal electrocution.

  44. Jim, I think it was you who commented on much of life becoming a “black box” to many people on the other thread (something to do with collapsing ceilings, I think).

    Seems to be a good example of the same thing. My suspicion is that increasing the specialisation delivered by the education system also decreases the knowledge of the existence of unknown knowns.

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