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There are wheels within wheels

A Clinical Commissioning Lead at NHS Hull CCG reveals how a Personal Wheelchair Budget has transformed one young man’s life as well as saving on care costs:

Many young people have recently started university for the first time.

This year it was a particularly special time for me as I’ve been working closely with a young man called Dylan before he, too, started university in Leeds.

Dylan is 19 and lives with cerebral palsy. He had a plan to go to university and like every other student he wanted to do this on his own; he didn’t want to rely on personal assistants to achieve his goals.

For Dylan this meant he needed a new wheelchair. He wanted a chair to enable him to be independent and live without carers.

Before the introduction of personal wheelchair budgets, if Dylan had wanted something other than a standard wheelchair, which met his postural and mobility needs, he would have been offered a voucher and then had to find additional resources to buy a chair outside of NHS services. Alternatively, Dylan could have accepted the standard chair and continued with support from carers to meet his wider needs.

Now, a Personal Wheelchair Budget (PWB) can offer more flexibility.

To meet his outcomes through a PWB, Dylan needed to be reassessed by the wheelchair service. Being a therapist by background, I couldn’t resist being part of this assessment and I’m really pleased I went along and was able to better understand his needs first hand.

This personalised assessment expanded the way we looked at Dylan’s wider health and wellbeing needs and, from that, we were able to identified how many of his social care needs could be met by adding key accessories to his powered wheelchair.

One of the biggest challenges for Dylan has always been removing his wheelchair footplates, which he needed help to do. A powered footplate meant that Dylan could lower it to the floor, stand on the footplate and therefore transfer independently.  The fact that a simple and easy change can make such a dramatic difference on Dylan’s life cannot be understated.

Another problem experienced by Dylan was that he couldn’t charge his wheelchair independently because of the position of the charging point. When I spoke with various wheelchair providers their response was the same – they hadn’t had a demand for an alternative charging point because generally people who use powered wheelchairs have carers! This seemed quite ridiculous to me.

The second stage of the process was a Social Care Assessment. Dylan was already in receipt of a personal budget which he used to pay for his social care. But he wanted to use this direct payment money to pay for the additions to his wheelchair rather than pay for help. He was very clear, if he had to go to university with carers he would defer until he was in a position to do it on his own.

My mother always told me it was vulgar to talk about money, however, in this instance I think it is really important to do so. Dylan’s new wheelchair in total, cost in the region of £5,000, the wheelchair he would have been issued by the wheelchair service had a value of £3,000, which obviously leaves a deficit of £2,000.

Our request was that our Social Care partners pay £2,000 towards the new chair rather than continuing to give Dylan his direct payment to cover the ongoing cost of carers. This would result in system savings of around £13,000 over the next three years.

The request went to the joint funding panel and the new Personal Wheelchair Budget was approved immediately. Everyone could see the benefits of this personalised approach.

Dylan is now able to transfer independently, raise himself up to the same level as everyone else and put the charging plug into the chair himself. He also tested out the lights and hazards which he advised us would be an essential safety component when traveling back from the pub!

The experience of seeing the difference a Personal Wheelchair Budget can make to someone has had a huge impact on everyone involved. The clinicians within the wheelchair service have had their eyes opened to the opportunities available to them. Other members of the Multi-Disciplinary Team are excited about being given the autonomy to improve the outcomes for the people of the city of Hull.

For me, as a commissioner, Dylan’s experience really does demonstrate the opportunities personalisation can create.

But most importantly, Dylan has achieved his goal of going away to University on his own. I think mum was allowed to travel with him, check out his flat and then had to leave!

He is now doing what really matters to him – starting university with his new found independence.

See Dylan test-driving his new wheelchair in this short film:

Patience Young

Patience Young is a Clinical Commissioning Lead at NHS Hull CCG and originally qualified as an Occupational Therapist 25 years ago.

During those 25 years she has worked in both health and social care, most recently within an acute hospital before she moved into commissioning.

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