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ITEM EX11 - ANNEX 1

EXECUTIVE – 1 OCTOBER 2002

INTEGRATING COMMUNITY EQUIPMENT SERVICES

INTEGRATING COMMUNITY EQUIPMENT SERVICES

Audit Commission Reports: ‘Fully Equipped’

2000 Report:

This national report was informed by a Steering Group involving service commissioners, providers and specialists, representatives of user groups, the NHS Supplies Authority, the British Healthcare Trades Association and Department of Health officials. Nationally the Commission found that:

  • there are unacceptably low standards of service in some parts of the country;

  • users often have to wait for long periods of time for their equipment;

  • equipment is not always either of reasonable quality or suitable for the user;

  • the services support a culture of dependence rather than autonomy; and

  • many equipment services are small and fragmented and characterised by a lack of clinical leadership and senior management involvement.

2002 Report:

This national report has updated the 2000 report. It reported that nationally: -

  • Service users did not always get equipment of a reasonable quality

  • Poor clinical outcomes combined with a waste of money when services did not meet users’ needs the first time

  • Many equipment services were small and fragmented

  • Equipment services were characterised by a lack of clinical leadership and senior management involvement

  • Users continue to report long delays for equipment of dubious quality.

  • Many who could benefit from equipment services are excluded by stringent eligibility criteria.

  • Waiting times for some equipment could be up to six years – a period of time that would be unacceptable for other National Health services.

  • Very little of the £220 million ‘new’ money provided for equipment services has been spent in accordance with ‘Ministers’ stated wishes.

  • A mood of despondency is common among managers running equipment services.

  • No progress has been made in integrating mobility services, leaving the wheelchair and orthotics services marginalised.

  • Service commissioning is not integrated with wider health and social care objectives.

  • Services are often measured in terms of pieces of equipment, not people.

  • Equipment services are commissioned to match a limited budget, rather than to meet need.

  • Equipment is a vital ingredient to policies that aim to promote social inclusion and independence.

  • Better equipment services would reduce admission to, facilitate prompt and appropriate discharge from, acute hospital services which would in turn have a major impact on bed capacity.

  • Equipment services reduce morbidity at costs that are very low when compared to other forms of healthcare.

  • If the targets in the National Service Framework for Older People are to be achieved, improvement in equipment services is vital, especially to help to reduce the number of falls in the home.

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