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Last Updated on 11/11/2026 by Sarah Sarsby
Complaints to the Public Service Ombudsman about NHS wheelchair services rose sharply over five years, increasing from eight in 2020/21 to 110 in 2025/26.
A new report from the Ombudsman, ‘Strengthening NHS wheelchair services: commissioning with confidence’, calls for stronger national oversight, better data, and more support for commissioners.
Drawing on complaint investigations, the Ombudsman identified national and system-level barriers to effective commissioning of wheelchair services in England.
More than 80 percent of complaints received over the reporting period concerned services delivered by independent providers.
NHS England’s national wheelchair performance indicator specifies that 92 percent of people referred for a wheelchair or modification should receive it within 18 weeks of referral or re-referral. The Ombudsman says most complaints concerned waits substantially exceeding the 18-week target for new wheelchair equipment or parts.
One case in the report involved a child waiting around 90 weeks from referral to receiving a suitable wheelchair. Another involved a man assessed as needing an urgent replacement in May 2023 who did not receive suitable equipment until October 2025.
Integrated care boards (ICBs) are the NHS bodies responsible for commissioning and developing wheelchair services locally. The report examines whether they have the information, resources, and support needed to fulfil this role.
The report finds that commissioners lack reliable information about wheelchair users in their local populations. There is no accurate national picture of wheelchair user numbers, while weaknesses in the governance, scrutiny, and analysis of the national wheelchair dataset limit its usefulness.
In a 2025 Wheelchair Alliance survey cited in the report, 78 percent of responding commissioners said the dataset did not support service planning.
Existing data largely captures provision that commissioners have previously funded. It does not adequately capture unmet need, according to the report, including people who sought equipment privately or through charities because NHS provision did not meet their requirements.
National guidance expects wheelchair services to consider clinical needs alongside social, educational, employment, lifestyle, and family needs. However, the report finds a gap between these expectations and what services fund.
Local eligibility criteria can exclude equipment intended solely for education, employment, leisure, or transport.
Personal wheelchair budgets can pool NHS funding with support from local authorities, Access to Work, and other sources. However, individuals are often left to find additional funding themselves, while poor coordination between organisations limits consistent support for their wider needs.
Contractual guidance gives ICBs considerable discretion, leading to inconsistent responses and levels of investment when providers underperform. ICBs can address similar concerns separately, while unclear escalation routes and limited intelligence-sharing hinder coordinated action and learning.
Providers also described pressures associated with block contracts, where payments remain fixed while inflation and workforce costs increase.
While the MHRA regulates wheelchair devices, the Ombudsman identifies a gap in health and care regulation covering assessment, fitting, and repair services, leaving independent providers without equivalent external quality oversight to NHS trust services.
Limited provider choice leaves ICBs with few alternatives when services underperform. Commissioners can lack the capacity and flexibility to attract providers or encourage different delivery models, alongside skills gaps in managing provider sustainability, business continuity, and supply chain risks.
Organisational change, staffing reductions, and immediate operational pressures further restrict longer-term service development.
Current measures focus largely on activity, expenditure, access, and waiting times. Person-centred measures have been developed but are not routinely collected across ICBs, limiting understanding of services’ effects on health, independence, and wellbeing.
ICBs often depend on providers’ complaint responses and reporting systems, which may categorise feedback differently or lack clear processes. This limits commissioners’ ability to identify recurring problems, assess performance independently, and use people’s experiences to improve services.
The Ombudsman received a large number of complaints about waits exceeding the 18-week target for wheelchair equipment or parts from outsourced provider AJM Healthcare. Investigations identified delays linked to queue management, poor communication, and inadequate record-keeping.
The Ombudsman upheld or partly upheld the complaints investigated, recommending apologies, financial remedies, and action plans covering clinical prioritisation, queue management, procurement, supplier arrangements, communication, and records. AJM Healthcare, whose management team has since changed, accepted the findings and recommendations in full and took a proactive approach to providing remedies.
In Hertfordshire, intensive work with AJM Healthcare improved wheelchair waiting times, with the contract performance notice and remedial action plan closing in February 2026. However, the ICB said the resources required would be difficult to sustain. The Ombudsman did not uphold complaints about the relevant ICBs, but identified wider commissioning barriers.
Building on its findings, the Ombudsman directs its recommendations to the Department of Health and Social Care (DHSC) and NHS England (NHSE).
DHSC and NHSE should collect reliable national data on wheelchair user numbers and strengthen the wheelchair dataset so commissioners can understand local need, including unmet need.
The report recommends senior national accountability for scrutinising performance and driving improvement, alongside clear escalation routes, intelligence-sharing, and coordinated support where concerns about independent providers affect multiple ICBs.
The government should decide how to establish appropriate, proportionate quality oversight of wheelchair assessment, fitting, and repair services.
NHSE should ensure its Strategic Commissioning Development Programme equips and resources ICBs to commission sustainable, person-centred services, using wheelchair provision as a practical case study.
The programme should support commissioners to work together to develop provider markets and encourage sustainable, innovative delivery models. It should also strengthen their ability to manage provider performance, sustainability, business continuity, and supply chain risks.
Commissioners should coordinate funding to meet people’s wider health, educational, employment, and social needs, and learn from local authorities’ experience of commissioning in fragile provider markets.
DHSC and NHSE should develop a consistent national approach to measuring wheelchair users’ experiences and outcomes.
The national dataset should extend beyond activity and expenditure to capture the effects of services on health, independence, and wellbeing.
Forthcoming complaints regulation reforms should clarify how ICBs collect, analyse, and act on feedback to improve services, reflecting the NHS Complaint Standards.
