Dear Dr Dash, Dear NWL ICB,

This is an official FOI request, related to the information in your response to my Feb/April 2024 complaints C23-0921 & C23-1984 dated 25.07.2024 and 08.08.2024.

Please release the following information:

1. On 08.08.2024, the NWL CNO sent me the NHS wheelchair service eligibility criteria extracted from the last NHS contract with AJM Healthcare, showing no discriminatory care home exclusion clause (this document will be sent to Dr Dash by email). On 19.08.2024, the NWL CNO wrote to the effect that: “The ICB is committed to ensuring that all eligible individuals, regardless of their residence, have equitable to wheelchair provision.“ However, on 27.09.2024, AJM Healthcare published eligibility criteria containing an unfair, unjust and discriminatory care home exclusion clause: “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 Specialist Wheelchair Service.”
https://northwestlondon.wheelchair.servi...
Please release any document showing who decided, and on which basis, to authorise AJM to publish the above unfair, unjust and discriminatory care home exclusion clause, which is currently in force. AJM claims that all the relevant information on their website was agreed with the NWL ICB.

2. Who is the current programme delivery manager, supervising NWL NHS WCS?

3. Please provide their email address.

4. Which employee of NWL ICB ensures that contractual NHS providers respect the agreed eligibility/exclusion criteria, visible in the NHS contract, and who at NWL ICB checks if the eligibility/exclusion criteria published on the NHS provider’s website are the same as those agreed in the NHS contract and commissioned by NWL ICB?

5. Please provide the definition of: “wheelchair for transit purposes only” as used by the contractual NHS provider, AJM Healthcare, on their website and which was apparently agreed with employees of NWL ICB.

6. Please disclose the reason(s) why people living in their own homes are entitled to receive a properly assessed and measured NHS transit wheelchair, but people relocating to care homes become ineligible and are obliged to return their NHS wheelchair to AJM Healthcare (NWL NHS WCS).

7. Please disclose the measures in place ensuring that all NHS wheelchairs returned to NWL NHS WCS are duly inventoried and accounted for, remain the property of NWL ICB and are not erroneously or accidentally redeployed by AJM to another ICB area where they also operate, or improperly accounted for by AJM as AJM Healthcare property.

8. Please disclose how many NHS wheelchairs are returned annually to the NWL NHS WCS due to the demise of the service user, changing needs of the SU, relocation of the SU to a care home, etc. I would like to received the breakdown of how many NHS wheelchairs are returned annually to AJM Healthcare running NWL NHS WCSs, and how many to the NHS Trust(s) running NWL NHS WCS.

9. Was my email to Dr Penelope Dash dated 21.11.2024 read, and will it be acted on, or just archived?

10. Please, release the full contractual annual amount that the NWL ICB will be paying to AJM Healthcare and to the NHS Trust, for running of the NWL NHS WCSs, starting from 01.04.2024. Please break this figure down to separate private contractors (AJM Healthcare) from NHS contractors (NHS Trust).

Please, provide a response in PDF format, on the WhatDoTheyKnow website (link below), within the statutory timeframe.

Many thanks in advance.

Yours faithfully,
Marc Jordan

Dear NWL ICB, Dear Dr Dash,

As stated in my FOI request dated 26.11.24, on 08.08.2024, the NWL CNO sent me the NWL NHS Wheelchair Service eligibility criteria, extracted from the last NHS contract between NWL ICB and AJM Healthcare, showing no discriminatory care home exclusion clause (new NHS contract starting on 01.04.2024).

For sake of clarity and transparency, I would like to share the relevant content of the above-mentioned contract on the WhatDoTheyKnow platform (see below). Inexplicably, on the AJM Healthcare website there is an unfair and discriminatory care homes exclusion clause, published by AJM on 27.09.24, which does not appear in the NHS contract that started nearly six (6) months earlier. The said unfair and non-contractual care homes exclusion clause hampers access to legal rights (PWB etc.) but maximises AJM’s profits.

Extracts from the new NHS contract between NWL ICB and AJM Healthcare, commencing on 01.04.2024

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 Provider 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.

Yours faithfully,
Marc Jordan

Dear NWL ICB, Dear Dr Dash,

This is a request for clarification of your reply dated 24.12.2024.

My FOI request was related to recorded information linked to the following NWL NHS WCS exclusion criteria applicable to persons residing or moving into care homes, but which in a discriminatory manner does not apply to persons residing in their own homes:

“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”
https://northwestlondon.wheelchair.servi...

My request and the criteria published on the AJM Healthcare website are related to transit wheelchairs, but inexplicably the NWL ICB used another unrelated term “porting wheelchairs” in its response dated 24.12.2024.

What is the meaning of the term “porting wheelchairs” and what is the recorded source of this terminology. It seems that the term “porting wheelchairs” does not appear once, neither in the NHS contract, nor in the NWL WCS eligibility criteria?

Is this a typo? Was the NWL ICB referring to portering wheelchairs which also do not appear once, neither in the NHS contract, nor in the NWL WCS eligibility criteria?

According to MHRA, wheelchairs used for portering purposes inside a hospital are very different from transit wheelchairs, which are designed to be collapsible and can easily be transported in the boot of a car, thereby providing mobility and access to community life for disabled persons unable to self-propel.

Portering wheelchairs are not Class I medical devices. By contrast, transit wheelchairs are deemed Class I medical devices by MHRA, and by major wheelchair manufacturers.

Many thanks in advance for rapid clarification.

Yours sincerely,
Marc Jordan