10QI

10QI 1        

NHS have a legal obligation to provide appropriate wheelchair for people who have a need of a wheelchair. Each local wheelchair sets their own eligibility criteria.

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10QI 2   

The patients Doctor/GP make a referral to the NHS Wheel Chair Service. There are usually waiting lists for assessment for provision.

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10QI 3 

During the referral process, the user or their carer should think laterally. For example, will the wheelchair offered be suitable for both indoor and outdoor use? Some NHS wheelchair services may offer a ‘voucher’ of a set value that can be used towards the purchase price of a wheelchair from a private supplier.

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10QI 4        

Methods of propelling wheel chairs

4.1   Self Propelling

Using the rim of a large diameter wheel (24”) the user can move independently. The larger wheel makes the chair much more manoeuvrable and more readily cope with kerbs and inclines.

4.2 Transit Style

These chairs have smaller wheels and the user relies on a carer to push the chair

4.3 Electrically powered wheelchairs

Giving full independent movement, these chairs are ideal for users who do not wish to rely on a carer but do not have the ability to self propel. Most NHS wheelchair services will only supply one of these is there is a requirement for its use both indoors and outdoors (i.e if someone can walk indoors they will not fulfil NHS eligibility criteria)

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10QI 5        

Tyres. Ideally these should be puncture proof. A flat tyre on a wheel chair makes it incredibly difficult to push or control in this condition and brakes / wheel locks become ineffective. However active wheelchair users usually select pneumatic tyres as they believe them to have improved performance.

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10QI 6        

Customisation Once the model of wheel chair has been chosen, it will need to be customised to the individual needs of the user taking into account their height, weight, upper torso strength and other factors. Support cushions, pelvic support straps and tension adjustable seat backs are all considerations when making the chair fit for purpose for the individual.

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10QI 7        

Shared Use Wheel chairs should not be shared. Each person has specific requirements and long term use of a chair which has not been adapted for the individual user may have detrimental affects on their physical health and systemic function.

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10QI 8        

Regular Reviews When a person first starts to use a wheel chair it may be the consequence of a traumatic injury. The status of this injury may change as the condition improves/settles. In order that the wheel chair continues to provide effective support regular reviews are required initially on a monthly,3 – 6 monthly or annual basis. It is important that when necessary the structure of the wheel chair is adapted to meet the changing requirements of the user.

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10QI 9        

Wheel chairs and the older user As long term wheel chair users age, the affect of the aging process has a notable effect on the posture of the user. Without corrections to the seating position, a ‘C’ shaped spine and other postural deformities may develop. This is particularly noticeable in women who have passed through the menopause. Again, it is important to carry out regular reviews to ensure good posture is maintained. Good sitting posture in the wheelchair enhances functional independence.

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10QI 10      

Wheelchairs in Sport Historically, wheelchairs were cumbersome affairs and associated with infirmity. In recent years and, in particular as a consequence of rising to the challenge of providing equipment for use in the a wide range of wheelchair sport, as evidenced in the recent 2012 Paralympics, the technology, engineering design and aesthetics of wheel chairs has evolved such that they can now provide for enhanced ergonomic performance from which users can compete.

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With acknowledgments to Christine Turner for her advice and contribution to this article.  

Visit www.wheelofhealth.co.uk