NHS England’s role

Wheelchair services are commissioned by clinical commissioning groups (CCGs). NHS England aims to support CCGs in improving wheelchair services through four specific pieces of work. These are:

Each of these is described in more detail below.

Improvement support programme

NHS England will work with eleven CCGs based in two localities to improve services for wheelchair users. We have commissioned NHS Improving Quality (NHS IQ) to support the communities. The work will help support their service improvement ambitions and will also create guidance, evidence and material which can then be shared with other organisations and communities.

The work is in response to the Charter launched recently by the Wheelchair Leadership Alliance which sets out 10 aims to transform the quality and effectiveness of wheelchair services across England.

The eleven CCGs are:

  • North Yorkshire (NHS Harrogate and Rural District CCG; NHS Hambleton, Richmondshire and Whitby CCG; NHS Scarborough and Ryedale CCG; and NHS Vale of York CCG)
  • North West London (NHS West London CCG, NHS Hounslow CCG, NHS Ealing CCG, NHS Central London CCG, NHS Hammersmith and Fulham CCG, NHS Barnet CCG, and NHS Brent CCG)

The work will be tailored to local needs and priorities and will be made up of bespoke support, lean methodology, intelligent use of data and learning networks. While it will focus on support for commissioners, each project will involve partnership working with local providers, service users, the Academic Health Science Networks (AHSNs) and other key stakeholders.

Work will begin with the sites in September 2015 and will run until March 2016.

Establishing a new dataset

NHS England is introducing a new national wheelchair dataset.  There is no central information on the volume, expenditure, access to, or patient experience about wheelchair services to enable transparency and benchmarking. NHS England is therefore establishing a national data collection to enable the gathering and dissemination of data that can be used for benchmarking and improving the commissioning of wheelchair services and outcomes for wheelchair users. There is virtually no area of service delivery in health care which has been improved without there being first this data.

Until waiting times for surgery were collected, there was no comprehensive improvement in waiting times. Until data was collected on the number of hospital acquired infections, there was no comprehensive improvement in infection control. So the importance of establishing – for the first time – a mandatory data collection is not to be underestimated.

The data collection questions have been developed through significant discussion and feedback from wheelchair service providers, wheelchair users, the National Wheelchair Managers Forum, CCGs, the November wheelchair summit, the Yorkshire and Humber Academic Health Science Network and others.

Data is being collected quarterly from CCGs from July 2015 onwards and will enable use of transparent data to drive improvements..

Developing a new national tariff

NHS England is piloting a tariff for wheelchairs. This is intended to allow commissioners the flexibility to move away from simple contracts. It will support more advanced commissioning by increasing transparency, driving service improvement, increasing efficiency and better aligning resources to service user needs. The Department of Health started work to develop a tariff that could be used by the NHS to commission non-complex wheelchair services and NHS England is now working with both providers and commissioners to test the proposed currency model through a pilot data collection. Activity and costing data is being collected from 10 wheelchair service providers for six months. Subject to the outcomes of the pilot, the intention is to roll out the currency in 2016/17.

Supporting commissioners

NHS England is working with clinical commissioning groups to support them in improving their commissioning of wheelchair services.  Work underway includes:

CCG wheelchair champions network

A network of CCG leaders who are acting as champions for the work programme – creating momentum for change, sharing good practice and driving learning and improvement.

Model service specification

A sample service specification to support commissioners when commissioning wheelchair services for people of all ages. It is being co-produced with service users and colleagues from across the health and social care system and draws upon the best examples in the field to ensure that wheelchair services are the best they can be and are truly service user focused. This will be a non-mandatory resource for commissioners to use if they wish.

A case for change

A high level document which will set out the case for change – clinically, financially and socially – of improving wheelchair services in England. It will help commissioners present the business case for investing in wheelchair services to their local decision making bodies.

Top tips for commissioners

A short ‘top tips’ document for commissioners who would like to understand more about the service they are commissioning. It is based on valuable learning from those CCG champions who had re-procured or reviewed their local wheelchair services.

Sharing learning through case studies

A suite of written and video case studies to showcase current good practice in wheelchair services across England. These will help to share learning across commissioners, providers, manufacturers and other stakeholders and are being published on the pinboard on the NHS England Learning Environment website.

Rosamond Roughton, Director of NHS Commissioning, is the champion for wheelchair services within NHS England.