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Information Compliance Team 

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From: Marc Jordan <[FOI #1210513 email]>
Sent: Friday, December 6, 2024 2:50 PM
To: HL FOI & Information Compliance <[email address]>
Subject: Freedom of Information request - Does HM Government intend to put
into place robust assessment and inspection of all NHS WCSs, to ensure
equal standards, quality and accountability?

Dear House of Lords,

On 19.12.2023, Lord Hunt posed a question related to the NHS wheelchair
services (NHS WCS): “To ask His Majesty's Government what assessment they
have made of the quality of locally led provision of NHS wheelchair
services throughout the country.”
https://questions-statements.parliament....

Below is an official complaint I sent to the NW London NHS ICB, related to
the quality of eligibility/exclusion information about access to the NWL
NHS ICB wheelchair services. If indeed HM Government conducted quality
assessments of the diverse NHS WCSs across the country, there would not be
such a disparity of information and arbitrary exclusion of certain
vulnerable members of society.

Currently, the Labour Party is empowered to make decisions about the
Government's assessment of the quality of locally led provision of NHS
wheelchair services throughout the country.

Lobbying and fundraising groups like Wheelchair Alliance CIC are currently
demanding that the Government raises funding for NHS WCSs by £22m p.a.

Without any consistent quality assessment, this would be like putting
money down the drain, tantamount to giving millions of pounds of public
funds to the private equity backers of NHS subcontractors like AJM
Healthcare, who are prominent members of Wheelchair Alliance CIC.

Does HM Government intend to put into place robust assessment and
inspection of all NHS WCSs, to ensure equal standards, quality and
accountability?

Many thanks in advance.

Yours faithfully,
Marc Jordan

Extract from my complaint to the NWL ICB
---------------------------------
Dear NWL ICB, Dear Dr Dash, Dear All,

Re: official complaint about the poor collaborative work between NWL ICB
and the NWL NHS WCS, subcontracted to AJM Healthcare - wilfully unclear
exclusion/eligibility information in the current eligibility criteria for
Brent • Ealing • Hammersmith & Fulham • Harrow • Hillingdon • Kensington &
Chelsea • Westminster

This complaint is related to the following wilfully unclear statement
visible in the current FINAL November 2024 exclusion/eligibility
information for Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon,
Kensington & Chelsea and Westminster: “Standard attendant propelled
wheelchairs for transit purposes only will not be provided to people
living in a residential or nursing home; if an existing service user is
relocating into a nursing home, a wheelchair previously issued for transit
purposes only must be returned to the wheelchair service.” (see link
below)
[2]https://northwestlondon.wheelchair.servi...

According to official information published by DHSC: “Integrated care
boards (ICBs) are responsible for the provision and commissioning of local
wheelchair services and the development of their local wheelchair service
eligibility criteria based on the needs of their local population.” (see
link below)
https://questions-statements.parliament....

According to Guy Eatherinton, Business Development & Customer Relations
Director at AJM Healthcare, all eligibility / exclusion information
currently published on the AJM website was agreed by relevant staff at NWL
ICB.

A wheelchair for “transit purposes” is an unclear, misleading and finally
meaningless term.

According to MHRA, and to diverse wheelchair manufacturers, “for transit
purposes” means a wheelchair adapted to be used occupied, during transport
in a motor vehicle e.g. to drive a disabled person to a family outing,
social event
or medical appointment without the person having to leave their wheelchair
during transportation (i.e. hospital visit for dialysis, NHS re-education,
physiotherapy, dentist, GP, X-ray etc). Used in this manner a wheelchair
is a Class I medical device (see attached MHRA documents 4 & 5).
“The IFU should clarify:
• how to secure both the wheelchair and the seated passenger in position
whilst in transit (note that lap belts and postural aids supplied with a
wheelchair are not intended for this purpose). This includes guidance on
the correct vehicle anchorage points for both tie-downs and occupant
restraint” (see link below)
https://assets.publishing.service.gov.uk...
“Lap straps are not suitable for transit purposes, approved occupant
restraint systems must be used.” (see p.10 link below)
[3]https://www.sunrisemedical.com/getattach...
Semi-professional wheelchair dealers, on the web, use another definition
for the term “transit wheelchairs”: “We offer cheap transit wheelchairs
for users who need only a temporary solution following operation or
injury.”
[4]https://www.wheelchaircompany.co.uk/whee...
The two (2) above definitions are completely contradictory so it is
unprofessional and misleading for NWL ICB to agree to the publishing of
such an unclear and incomplete document by AJM, without giving their
definition of what they mean by “a wheelchair for transit purposes”.

It is also unprofessional of NWL ICB to have allowed AJM to maintain
out-of-date exclusion/eligibility information on their website for nearly
nine (9) months, and since February 2024 have done nothing to ensure that
AJM Healthcare acting as NWL NHS WCS provide clear and complete
information. I believe that this action is wilful and serves only to
maximise AJM’s profits and reduce their costs.

By contrast another NHS WCS provider, Ross Care, has worked effectively
with the relevant ICB and produced clear and complete information about
NHS wheelchair provision in care homes (see link below, p.2 Eligibility
flow diagram).
[5]https://cdn.shopify.com/s/files/1/0403/2...

Care home residents in West Hampshire, Southampton and Isle of Wight are
entitled to receive an NHS wheelchair if: “Resident has postural support
needs AND has family, friends or advocates who visit regularly and want to
take them off-site more than four times a week.”

The NWL NHS WCS eligibility criteria fail to specify in which cases care
home residents are entitled to an NHS wheelchair.

This is another example of a current postcode lottery, unfairly consuming
public funds and using unclear and misleading terms. This is not
acceptable because it raises a barrier to access to NHS services.

Outcome: the NWL ICB to rapidly review and improve the quality of
information about NHS WCS, explaining access to NHS wheelchairs in care
homes. NWL ICB to ensure that their subcontractor AJM clearly defines what
they mean by “a wheelchair for transit purposes”.
NWL ICB to look into why the program delivery manager responsible for
supervision of outsourced NHS WCS did nothing since the matter of AJM’s
use of unclear and misleading terms was drawn to their attention in
February 2024. This resembles gross negligence or biased collusion.

Many thanks in advance for a rapid acknowledgment and appropriate action.
----------------

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