This paper, produced by the British Healthcare Trades Association and the Wheelchair Alliance, explains how community equipment services (CES) and wheelchair services are funded, commissioned, and delivered, highlighting key differences to improve public understanding and support informed policymaking. It focuses on public services in England and does not cover private sector provision.

While CES and wheelchair services both play an important role in supporting independence and meeting people’s health and care needs, they are distinct services with different structures, responsibilities, and routes of access.

The guidance provides an accessible overview of how each service operates in England, including who is responsible for commissioning services, how provision is organised, and how people are referred to or access support. It also considers how eligibility and individual needs are assessed, and where responsibility for clinical decision-making sits.

Another key theme is the way the two services approach personalisation, choice, and funding. The paper highlights where the models differ and why CES and wheelchair services should not be viewed as interchangeable, despite some similarities in the people and needs they support.

Bringing these themes together, the guidance offers a clear comparison of the two service models and is intended to support a better understanding among policymakers, commissioners, healthcare professionals, providers, and other stakeholders.

Download the paper in full here.

The British Healthcare Trades Association (BHTA) is calling on the UK Government to deliver fair and sustained investment in the healthcare and assistive technology sectors ahead of the Autumn Budget, due to be announced on 26 November 2025.

Support for community equipment and independent living services

The BHTA is urging government to act on the findings of the recent All-Party Parliamentary Group for Access to Disability Equipment report. The report highlights systemic failures leaving thousands without the essential equipment they need. Targeted, long-term investment from the government in community equipment services would ensure that people receive timely support, while reducing pressure on hospitals and enabling more individuals to live independently at home.

Improve wheelchair provision through allocated funding

A recent BBC article exposed widespread delays in NHS wheelchair services, leaving many people waiting months or even years for appropriate equipment. BHTA and industry partners have called for increased funding for Personal Wheelchair Budgets, to ensure individuals can get access to the right chair for their needs.

BHTA members that provide wheelchair services to the NHS are constantly battling underfunding and increased service demand, which impacts their ability to deliver timely, high-quality care. Increased government funding would not only ease this pressure but also enhance the overall efficiency and sustainability of these vital services.

Scrap defibrillator tax

The BHTA continues to lead the national call to remove VAT on public access defibrillators through its Scrap the Heart Restart Tax campaign. This is a simple, cost-effective measure that would immediately make life-saving equipment more accessible in communities across the UK.

The issue is also gaining political momentum, following a recent debate in Parliament where MPs voiced strong support for removing the tax. The association welcomes this cross-party attention and urges the government to act swiftly to implement this crucial reform.

Increase home adaptation funding

The BHTA also calls for greater funding for home adaptations. Evidence from an Age UK report highlights that delays in home adaptations are forcing older people into residential care unnecessarily, demonstrating that timely adaptations help people remain safe and independent in their homes for longer. Increasing Disabled Facilities Grant (DFG) funding would allow more people to access high-quality adaptation equipment suited to their needs – from stairlifts and homelifts to accessible bathing solutions and grab rails – reducing long-term costs for the NHS and social care systems.

David Stockdale, Chief Executive of the BHTA, commented: “We can’t build a fair and sustainable health system without investing in the organisations that make it possible.

“From ensuring access to life-saving defibrillators to funding the right wheelchair for every person in need, these aren’t luxuries – they’re essentials.

“The Autumn Budget is the government’s opportunity to show that it values ethical innovation, fair access, and the health of every individual.”

The wheelchair sector has responded to a recent BBC news report that highlights how thousands of people across the UK are experiencing long waiting times for crucial mobility equipment, as the NHS faces tighter budgets and higher demand.

In the most recent quarter (January-March 2025) in England, 77.9 percent of children and 80.8 percent of adults received an NHS wheelchair, or a modification to their wheelchair, within 18 weeks. This is below the 92 percent target set out by NHS England.

A large contributing factor to these delays is a lack of funding from the UK Government for vital NHS wheelchair services, which means providers do not have sufficient resources to deliver them effectively and timely.

The Wheelchair Alliance is a community interest company with a goal of improving wheelchair provision in England. Its vision is to transform the experience of wheelchair users in England through improved access, quality, and effectiveness of services.

Nick Goldup, CEO of the Wheelchair Alliance, said: “The Wheelchair Alliance is working hard to ensure people receive better provision of wheelchairs through the NHS, and we often hear of long waits for appointments and receipt of a wheelchair. Wheelchair users are often faced with a complex and complicated system to navigate.

“The NHS refers regularly to the use of Personal Wheelchair Budgets (PWBs) as a mechanism to help people receive the wheelchairs they need; however, these are very limited in their application as the rules often prevent wheelchair users from getting what they want.

“For example, in Ivy’s case, Ivy would benefit from a powerchair but would be prevented by the PWB rules from upgrading her manual chair to powered and, if she decided to take the PWB externally to buy a powered chair, the money offered by the NHS would come nowhere near to how much she would need. This results in an inequality.

“In short, PWBs can be good for people with money, but for those with limited funds they offer no solutions.

“The Wheelchair Alliance is lobbying government for ownership and accountability of wheelchair services at a senior, national level, to take responsibility for a broken system. We have also been working hard towards driving improved commissioning of services through developing a Quality Framework that we hope the NHS will use to make wheelchair provision more consistent and fair.

“Lastly, our research and reports have shown that much of the data around demand for wheelchair services is estimated. We need reliable data to form an accurate local and national picture, as well as improved budgets.”

BHTA member AJM Healthcare has also responded. AJM Healthcare is an NHS wheelchair services provider in the UK, specialising exclusively in wheelchair services.

Guy Eatherington, Business Development & Customer Relations Director at AJM Healthcare, commented: “AJM Healthcare is committed to supporting the ongoing national redevelopment and reform of wheelchair services.

“The data presented below highlights a concerning trend across the system: a significant number of service users are not receiving the equipment they need within appropriate timeframes. This delay in provision undermines both the quality of care and the independence of individuals relying on these essential services.

“One key metric of referrals received versus referrals completed, has shown a peak performance of 97 percent. However, the average completion rate over the past two years stands at just 90.59 percent, indicating a persistent gap in service delivery.

“More than three-quarters of wheelchair services across England are currently delivered by NHS trusts or other publicly funded or third-sector organisations. This reflects the significant role that non-private entities continue to play in the provision of the NHS wheelchair services provision nationwide.

“More critically, the national waiting list has grown substantially during this period. An additional 40,000 individuals have been added to waiting lists across the country, reflecting mounting pressure on services and a growing unmet need.

“AJM Healthcare recognises the urgency of these challenges and remains dedicated to working collaboratively with commissioners, providers, and service users to drive meaningful improvements. Our goal is to ensure that every individual receives timely access to the right equipment, enabling greater mobility, independence, and quality of life.”

David Stockdale, Chief Executive of the British Healthcare Trades Association (BHTA), added: “Stories like this are deeply concerning, and they reflect what our members tell us: demand for NHS wheelchair services is rising, but funding has not kept pace.

“Clinicians and providers work hard within tight constraints; the issue is not a lack of commitment on the frontline, but a lack of sustained, adequate investment. Without funding to meet increasing need and costs, services struggle to recruit, retain, and innovate, and people wait too long for the essential equipment that enables independence, safety, and participation in daily life.

“We urge the government to prioritise wheelchair provision by increasing budgets, setting clear national accountability for delivery, and supporting consistent commissioning so that access is fair across the country. With the right resources, the system can reduce waiting times, provide the right chair first time, and ensure that every wheelchair user receives timely, person-centred support.”