Clinical standards for National Health Service wheelchair and seating services in Scotland

Abstract

Purpose: To develop rigorous clinical standards for National Health Service (NHS) wheelchair and seating services in Scotland. Method: Clinical standards and an evaluation tool were developed by a working group using a well-established methodology. The available evidence was reviewed and a person-centre, iterative, consensus decision-making approach was employed to draft the standards. A public consultation was undertaken. The draft evaluation tool was tested during pilot visits to two wheelchair and seating centres. Results: The majority of the 34 consultation responses were supportive, recognising the need to encourage and measure improvements and for a consistent approach to service delivery. Piloting found that the standards were challenging but achievable. The finalised standards and evaluation tool have been issued to health boards in Scotland. Conclusions: Following a structured, interdisciplinary and consultative process, the first clinical standards for NHS wheelchair and seating services in the Scotland were developed. They emphasise the need for an anticipatory approach, shifting from a reactive model of service delivery to a proactive one. Although developed in the Scottish policy context and service delivery model, many aspects of the standards will be applicable to services based in other parts of the UK and beyond.

Implications for Rehabilitation

• Clinical standards should be developed and validated using established, rigorous methodology with a person-centre and consensus decision-making approach that includes public consultation and piloting.

• Wheelchair and seating service provision should be anticipatory and person-centre.

• The clinical standards and the supporting evaluation tool provide the basis for consistent, high-quality services for those individuals who require wheelchair and seating provision.

• Anticipatory care
• assistive devices
• disability
• mobility
• patient-centred care
• rehabilitation

Acknowledgements

The author would like to thank all the members of the Working Group and Reference Group for their valuable contributions and all those who responded to the public consultation, many of whom went to considerable effort to provide detailed responses and helpful comments. The author would also like to thank the staff of the two pilot sites for their work on completing the draft evaluation tool.

Declaration of Interest: The author was on secondment, between February 2010 and July 2011, to the SG as the Clinical Advisor with responsibility for leading the development of the clinical standards.