Using person-centred approaches to support people to get the most out of their wheelchairs

06 May 2017

In this blog, Jo talks about the work she is doing with wheelchair users in Gloucestershire and Hertfordshire to make sure that the support they are getting from the NHS reflects what really matters to them.

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Around a year ago, NHS England announced that they would be working with a number of sites to develop a Personal Health Budget (PHB) model for the provision of wheelchairs.

NHS England say that “the aim of ‘personal wheelchair budgets’ is to increase choice and control for people who access wheelchair services by offering holistic assessments, supporting people to identify their own health and wellbeing outcomes, integration of services around individuals, and increasing the availability of information about the choices available to people locally.” They go on to say that “personal wheelchair budgets will support increased flexibility and enable people to access the right wheelchair to meet their health and wellbeing needs, as well as any specific requirements that they identify as most important to them.”

These aims are strongly aligned with the work we do at Helen Sanderson Associates, and we were delighted to be chosen as part of the team to deliver this exciting new way of working. The programme is being led by Kate Buffery at NHS England and I have been working with Kate on this, as well as on a number of pieces of related work. Now we’re starting to see results, and I wanted to share an update with you all here.

The story so far

The work was originally piloted in two sites, Gloucestershire and Hertfordshire. I ran a workshop with each site to look at how they can use person-centred tools as part of their assessment conversation, to ensure that they develop a more holistic and individualised perspective on what a person wants to do in their life – and, crucially, how their wheelchair can help them with that. Person-centred thinking tools are ideally-placed to support this type of exploration.

The challenge was that this was not intended to become part of a “full on” care and support planning session, and instead it would need to be part of a standard wheelchair assessment process. I had to think carefully about which person-centred tools would really help frame the conversation, making it more personalised but without massively increasing the time needed in appointments. I introduced the concept of important to/for and then used tools such as good day/bad day, working/not working and developing person centred-outcomes to gather information. You can click on the link to the video below to see how one site has got on with the work.

 

What we're seeing

Introducing new ways of working is often met with some resistance and questioning, and it can take some time for people to really see the difference. However, we’re starting to see positive results emerge.

For some of the clinicians it was hard to see how asking these questions would make a difference, either because they felt they were already doing this, or because they felt it would raise expectations. But, of course, the real difference starts to be reflected through individual stories.

Kate shared a great story with me about a young boy who had recently received a new wheelchair. At the first review he was asked how he was getting on. He said he didn’t like the wheelchair as the arms were too high and stopped him from playing on his X-Box. Clinically it was fine for the arms to be lowered, and it was decided that it would cause him no problems at all – but he hadn’t been through our person-centred assessment. If somebody had asked at the point of assessment what made a good day for him, his answer would have undoubtedly included him playing on the Xbox and the right arm height to facilitate this would have been agreed from the outset. This is just a small example of how asking a simple person-centred question could have an impact of the provision of the wheelchair.

What next?

It is expected that there will be a much wider roll out of personal wheelchair budgets over the coming year so it will be interesting to see how this work progresses. In the meantime, I’m really looking forward to hearing more stories of how the new approach to assessment is changing people’s lives with just a few carefully-chosen questions and conversations. It just goes to show that a little extra thinking can go a long way.

If you’d like to know more about the work Jo is doing around personal wheelchair budgets or Personal Health Budgets in general, please email jo@helensandersonassociates.co.uk.

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