Dear NWL ICB, Dear Dr Dash,

This is an official FOI request.

On 05.02.2025 the ICB stated, somewhat vaguely:

“Our policy regarding transit wheelchairs in care homes is based on clear service specifications: If a service user only needs a chair for short transfers (transit/portering) (e.g., bed to outside), this should be provided by the care home If a service user has a long-term mobility need that would make them eligible in their own home, they would remain eligible in a care home”
https://www.whatdotheyknow.com/request/w...

Item.1 Please provide the full and dated document from which the above mentioned “clear service specifications” were extracted (without removing pages, title of the document or the date at which this document/information was created).

Item.2 If the above service specifications are accurate, please provide information giving the reasons why disabled people with long-term needs (more than 6 months) and in possession of an NHS wheelchair are obliged, by the NWL ICB and AJM Healthcare, to return their NHS transit (attendant-propelled) wheelchair to AJM Healthcare when they leave their own home and are admitted in a care home?
Comment: The current NWL ICB NHS WCS wheelchair criteria dated January 2025 confusingly states: “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”
https://northwestlondon.wheelchair.servi...

However, according to a previous NWL ICB FOI response dated 10.09.2024, no such care home clause exists in the new contract between the NWL ICB and AJM Healthcare, starting on 01.04.2024 and covering seven (7) service areas (including Harrow & Hillingdon):

“5.2 Acceptance and exclusion criteria and thresholds
5.2.1 Eligibility
The service will be provided to adults and children, including transition years who require
long term (longer than 6 months) wheelchair provision. Users’ mobility impairment must
affect their ability to walk or they must have a medical condition that means that walking
could adversely affect their health including
conditions including but not limited to:
• Musculoskeletal (including peripheral joints, spinal injuries and arthritis)
• Trauma
• Birth trauma
• Head injuries
• Congenital conditions (e.g. Spinal Bifida)
• Neurological conditions (e.g. Cerebral Palsy, MS, Parkinson’s, Stroke and MND)
• Learning Disabilities
• Age related conditions.
5.2.2 Supporting Service Users with Progressive Disorders
The Provider must offer a five-day fast track service for Service Users with a progressive
neurological disorder. If a specialist wheelchair is required which cannot be sourced within
five Operational Days, the provider will provide a temporary wheelchair that best meets the
needs of the Service User. This is to be undertaken only after consultation with wheelchair
therapists and other clinicians responsible for the care of the Service User to ensure that
clinical needs are not compromised and are safe.
5.2.3 Supporting Service Users with Terminal Illness / End of Life
For Service Users with a terminal illness a 24-hour fast track service will be offered. If a
bespoke or specialist wheelchair is required which cannot be sourced within 24 hours, the
Provider will provide a temporary wheelchair which best meets the needs of the Service
User. This is to be undertaken only after consultation with wheelchair therapists and other
clinicians responsible for the care of the Service User to ensure that clinical needs are not
compromised.
5.2.4 Supporting Children Under 36 Months Old
The Provider will accept referrals for children under 3 years if they have postural support
needs or functional wheelchair support needs which cannot be accommodated in a normal
commercially available buggy that a parent would normally be expected to fund.
The Provider will issue a simple buggy where a child is developmentally delayed and is not
able to walk distances. However, if the child has complex postural or medical needs (as
identified through the assessment process), the Provider must assess whether a specialist
buggy will be given on an individual basis. In all cases, the buggy will be age appropriate for
the child.
The Provide will provide seat belts and harnesses for postural support in the buggy and for
those children with behaviour needs who require equipment to support safe outdoor
mobility. They will not be issued for solely as a means of controlling a child’s behaviour.
5.2.5 Exclusion criteria
• Wheelchairs / buggies will not be provided as a restraint or as a stationary chair e.g.
armchair
• Equipment will not be supplied to meet specific requirements – i.e. a specific chair
for sporting requirements, rather than for regular use
• Cushions will not be issued for armchairs and other seating
• Persons who are able to walk, but for various reasons prefer not to
• Powered wheelchairs will not be provided for sole use outdoors or for use only in a
place of work or education in such cases where the service user is able to
reasonably self-propel in the same places.”

Source: https://www.whatdotheyknow.com/request/c...
https://www.whatdotheyknow.com/request/c...

The above information was also confirmed by the NWL ICB CNO in July 2024, and by another NWL ICB employee.

Item.3 Please, provide the full contract between NWL ICB and AJM Healthcare, including schedules, annexes and conditions, starting on 01.04.2024 and covering provision of NHS wheelchairs in Brent, Ealing, Hammersmith & Fulham, Harrow & Hillingdon, Kensington & Chelsea and Westminster. Please do not remove any financial information to be found therein.

Item.4 Please, provide the full contract between NWL ICB and AJM Healthcare, including schedules, annexes and conditions, commencing January 2025 and covering provision of NHS wheelchairs in Brent, Ealing, Hammersmith & Fulham, Harrow & Hillingdon, Kensington & Chelsea and Westminster. Please do not remove any financial information to be found therein.

Please, provide a full response on the WhatDoTheyKnow website.

Many thanks in advance.

Yours faithfully,
Marc Jordan

Dear NW London ICB, Dear Dr Dash,

Thank you for your FOI response dated 26.03.25.

I am not yet requesting an internal review of the said response, but rather providing clarification for the public interest test you are currently conducting.

I believe that it is very important for the public to know the “expected tariffs” AJM Healthcare charges the NWL ICB for processing, handling and acting on referrals and re-referrals.

In numerous cases, AJM Healthcare has supplied wrong equipment or equipment with missing parts and carried out incomplete handovers, due to their own errors.

When family carers send AJM Healthcare Admin an email informing them of the error and seeking a date when the missing parts are expected to arrive, AJM staff unfairly open a re-referral which is charged to the NWL ICB at a rate that the ICB refuses to disclose for the moment. Thus public funds are wastefully handed over to AJM for AJM errors, and shoddy and unprofessional AJM work.

Similarly, AJM frequently provides wrong replacement parts. When a family carer detects this error and requests an intervention to rectify the AJM error, AJM once again unfairly opens a re-referral and charges this to the NWL ICB.

Given also that for many years AJM failed to publish clear, unambiguous and up-to-date eligibility criteria, many referrals and re-referrals led to no provision of equipment or accessories, but were nonetheless charged to the NWL ICB.

Therefore it is definitely in the public interest to know the tariffs charged by AJM Healthcare to the NWL ICB for referrals and re-referrals. This information belongs in the public domain for the purposes of transparency and accountability. The tariffs will also be useful for the purposes of comparison with other ICBs across England.

Many thanks in advance.

Best regards,
Marc Jordan