Since December 2019, people who access NHS wheelchair services in England now have a legal right to a personal wheelchair budget (PWB). A PWB is a resource available to support your choice of wheelchair, whether accessed within the NHS wheelchair service or utilising the funding they provide in the private sector. PWBs enable postural and mobility needs to be included in wider care planning and can support you to access a wider choice of wheelchair or accessories.
PWBs have replaced NHS wheelchair voucher scheme. They build on progress to offer personal health budgets (PHBs) to more groups of people and ensure people receive care that is right for them.
PWBs have been developed by NHS England’s Personalised Care Group to empower people and their families to have far greater control over their own care and break down barriers between health and social care.
‘It’s like my mum picking my clothes for me’
Wheelchair services tend each to have their own criteria to be met to supply a person’s basic mobility needs. Thus, a chair that can get you around on level pavements and in your home may be what you are offered but may not give you full access to the lifestyle you seek.
The aim of PWBs is to give the option to be able to upgrade your basic mobility option to one with extras that meet your broader needs. The PWB will have the value of the basic chair as a starting point, and this can be supplemented from your PHB, from your social services personal budget, from educational funds, from charity funds, and/or from your own personal funds.
As one client observed: “The wheelchair service option on its own was like my mum picking my clothes for me, whereas the PWB process treated me as an individual. It helped me feel more independent.”
The NHS England website has various blogs on it showing different benefits that different clients have gained from the extra options that their PWB has offered. These have included seat-raiser options to help the client get up to eye level with standing people, electric powered leg-lifters to handle swelling of the feet, lighter weight chairs than on the basic offer, better quality cushions or other accessories, etc.
Can I get my chosen solution outside the NHS?
In many parts of England, you can take your PWB to a manufacturer or retailer and get the solution you need. This does have an element of postcode lottery to it, as the details depend on where you live and your local wheelchair service’s policies.
A note of caution, though: The wheelchair services often have contracts with manufacturers where the price is lower than on the high street, but the choice will be limited to what is on the contract. Also, your local service may wish to offer a refurbished chair that has been returned from another client. If what the service offers meets your need, that’s great, but if it does not you can go to the private sector to supplement what the wheelchair service has to offer or for the complete solution.
You would be advised to go to a company that is a BHTA member. The BHTA is the first trade body within the healthcare industry to have a code of practice overseen by the Chartered Trading Standards Institute (CTSI). All BHTA members adhere to the Code of Practice ensuring you get appropriate advice and guidance about products that you may need to maintain independent living.
The NHS England website is also an excellent resource to give you more information, including answers to frequently asked questions. A number of these have been condensed into this article:
What can I expect with my PWB?
With a personal wheelchair budget, you should expect to have:
- A personalised assessment where you are supported to identify the health and wellbeing outcomes you wish to achieve.
- A care plan which captures the health and wellbeing outcomes identified, which may be part of any wider care plans you require for your care, for example, an education, health and care (EHC) plan.
- Care that is better integrated, meaning that different agencies work together to support your postural and mobility needs and achieve your health and wellbeing outcomes.
- Information provided upfront about the amount of money available in your personal wheelchair budget and the options available locally to you to use it.
- Information about the repair and maintenance of wheelchairs, if the option to purchase a wheelchair outside of the NHS commissioned service is taken.
Who can get a PWB?
The PWB model is for people who have been referred to, and meet the eligibility criteria of, their local NHS wheelchair service and receive a face-to-face assessment with a clinician. People who are already registered with the wheelchair service are eligible when they require a new wheelchair, either through a change in clinical needs or in the condition of their current chair.
Note: Local eligibility criteria for wheelchair prescription vary, and these variations still apply.
How much money will I get in my PWB?
The amount will be based upon what it would cost the NHS to meet your assessed postural and mobility needs via your wheelchair service. (Note: The amount varies from service to service.)
For those who have additional health and social care needs, the PWB could be pooled with funding from other statutory services, such as your PHB, your social care personal budget or your education support. (This needs to be agreed by all services involved as meeting the person’s assessed needs and is cost effective.)
Can I add additional funds to the money I get from my PWB?
Yes. You can contribute to the cost of your wheelchair. You can also choose to access non-statutory funding that may be available via voluntary support or charitable organisations, both nationally and locally.
What are my options for managing a PWB?
A PWB can be managed in the following ways:
- Notional personal wheelchair budget: This is where you choose to use your PWB within the wheelchair service and the service purchases and provides the chair. This also offers the option for contributions to the PWB to enhance the wheelchair you can access.
- Third-party personal wheelchair budget: This is where you choose to use your PWB outside of the wheelchair service, e.g. from a retailer or the manufacturer.
- Traditional third-party personal health budget: where an organisation legally independent of both the NHS and the person holds the money and manages the budget. This could include provision of a wheelchair as part of a package of support.
- Direct payment: This is where the budget holder holds the money in a bank account or an equivalent account, and takes responsibility for arranging the care and support, in line with the agreed personalised care and support plan. (Direct payments are currently not routinely available as an option for managing a standalone PWB.)
Note: Your local wheelchair service may have limitations on various of these options, such as requiring you to use service-approved third-party providers.
Will PWBs be available to everyone who has an assessment via their wheelchair service?
PWBs will not be right for everyone. Once you have been found to be eligible for a wheelchair, your healthcare professional will discuss with you the options for how this can be provided. Everyone should have an assessment focused on the health and wellbeing outcomes and goals they wish to achieve and have the opportunity to have their wider needs considered.
Note: It may not be clinically appropriate for someone with rapidly changing, or very complex needs, to use their PWB outside the wheelchair service as regular adaptations and changes may be required which would be likely to require close monitoring and adjustment. They could, however, be offered a notional budget. Such decisions will be made on a case-by-case basis, rather than using set criteria that restrict people who have certain conditions or diagnoses from accessing the full range of options.
If my wheelchair is purchased outside of the NHS wheelchair service, how is quality and safety checked?
As part of the care and support planning process, the PWB will need to be agreed by the responsible clinician involved in your care and that the wheelchair chosen is the correct specification to meet your assessed clinical needs.
BHTA independent supplier members sign up to a Code of Practice that gives a level of accreditation to give you confidence that you are dealing with people able to make appropriate decisions about meeting the aims of your assessment.
Does a PWB include the cost of assessing my needs?
No, in that PWBs do not change the duty on statutory services to assess a person’s needs for a wheelchair. A PWB is for the equipment only.
Is repair and maintenance included in a PWB?
Yes. A third-party PWB and direct payment (where the money is spent outside the NHS) should include a contribution towards the repair and maintenance costs. If a notional budget is taken, repair and maintenance will be provided via the wheelchair service. If the notional budget includes contributions to the cost of extra features, such as a seat riser, then repair or replacement of these features may not be covered by the wheelchair service.
Who owns the wheelchair provided by a PWB?
People who take a third-party PWB become the owner of the equipment, whereas wheelchairs accessed via a notional PWB remain the property of the NHS. Where there are multiple funding streams involved, the ownership of the wheelchair needs to be agreed locally on a case-by-case basis.
Does a PWB cover items such as seating cushions, accessories and harnesses/ belts?
If you choose to use your PWB outside of the wheelchair service and your assessment indicates the clinical need for accessories (this could for example include specialist seating or pressure-relieving cushions), then the NHS has a duty to provide these either as part of the PWB, or via the wheelchair service.
How do I access NHS wheelchair provision?
NHS wheelchair service provision is accessed via a referral from a healthcare professional. This could be obtained through consultation with your GP or issued via a therapist that you work with.
Sarah joined BHTA in April 2018.
After graduating with a Masters in English Language from De Montfort University, Sarah works across all BHTA publications (including AT Today and THIIS).