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ESS: What we learnt about wheelchair provision

mary mcdonagh and simon hall ess CROP

One of the industry’s most specific events, the European Seating Symposium (ESS), took place last week which saw more than 1,000 delegates, speakers from 27 different countries and leading manufacturers descend on Dublin to engage in discussion and debate. A schedule packed with talks and workshops running alongside a mobility equipment exhibition attracted clinicians, buyers and sellers in the industry as professionals sought out the latest trends and products in the market.        

The main focus of the event, says co-director Simon Hall, is education. The conference is designed to give professionals specialist insight into different wheelchair services and best practice from around the world.

“Education is the biggest aspect of ESS and we want to make sure that anyone attending and speaking here has something to contribute to the conference; it’s not just about pumping out some stats. We collaborated a lot and we’ve got 27 countries represented so we’re not looking at just a NHS system, we’re looking at practise around the world from different perspectives. You’re seeing for example the US model where services go through insurance companies and in the UK how it goes through private companies.”

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Hall points out that often, the structure of services that are contracted out to private companies means they are usually about value for money rather than just clinical application. To this end, he says that collaboration is all the more important and so ESS aims to bring people from all corners of the industry together including manufacturers. He adds that the more service providers and clinicians can collaborate with manufacturers, the better they can design what is most suitable for end-users.

Hall stresses that it is becoming ever more important that suppliers get involved in the sorts of discussions had at ESS. “You could get a wheelchair online for £39 but what’s the outcome? The wrong type of wheelchair is like the wrong type of shoes. Our focus is education. We also have the commercial element that pays for the education. It gives manufacturers the opportunity to show their products and gives delegates the opportunity to see what’s coming out of the market.”

“You could get a wheelchair online for £39 but what’s the outcome? The wrong type of wheelchair is like the wrong type of shoes. Our focus is education”

In addition to being one of the organisers of ESS, Hall is manager of assistive technology and specialised seating department at Central Remedial Clinic and has a good insight into the seating market. Aware of the demographic changes the market must adapt to, Hall says that people are now surviving where they otherwise would not have and so there are clients with more complex needs.

“We can do an awful lot for clients through surgical and medical intervention but we also need physical intervention to back that up. So if someone has spinal surgery we need to be able to give them the proper support systems and equipment otherwise they’ll go back to the same situation again. Investment in education and services is very important. Disability has been an area that has been funded by charities for a long time and it was only in the 90s that it started to change. Now it’s about being able to provide services in a difficult current climate.”

With fewer resources available it is becoming more important for people on all ends of services and the supply chain to be innovative and collaborate. Hall and fellow ESS co-director Mary McDonagh aim for the show to encourage networking between manufacturers and their international customers. Delegates from different countries attract suppliers eager to break into new markets and as a result Hall says ESS has seen an “influx of equipment that [the market] would never have had access to”.

He comments: “Now there are agents on the ground who as a result of ESS are taking on equipment from countries across Europe, America and Scandinavia. That’s been the biggest breakthrough for them. It also gives the opportunity for very small companies who don’t know how to multiply to get into new markets. They’ve got an opportunity over three days to meet with over 1,000 people and these are good quality people.”

Acting as a European gateway for global manufacturers, ESS has a history of helping companies to break into Ireland, the UK and beyond. Hall cites on firm that came to the show some years ago that had no penetration in the Irish market but now turns over “a couple of million” in the Irish market alone.

‘Money is biggest obstacle to improving wheelchair services’ 

It is widely agreed that funding is one of the most significant challenges to driving quality and efficient wheelchair and equipment services. Services that are contracted out are driven “solely upon money”, believes Simon Hall, co-director for ESS. He says many people claim contracts are dished out based on quality and standards but he is sceptical of this view, stating that the “scandals” seen in some services would suggest they are driven by cost-savings.

Hall says: “Any contract or framework that’s brought out is brought out to save money, not to spend money or to ensure resources are put in the right areas. It’s a race to the bottom and it’s bottom feeding with regards to equipment.”

There are sure to be companies, likely service providers, in the market who would disagree with this but Hall believes contracted-out services have a lot of room for improvement. He points out strongly: “In the UK 23 services have been abandoned in the last four or five years and all given to commercial companies. Contracts are normally based on 50% of costs so that gives you an idea of what governments want; they want to reduce the cost. We’re trying to educate people on how to best spend those resources.”

How do wheelchair provision trends in the UK compare to other countries?

A survey on Croatian wheelchair provision by a team from the University Vienna and presented at ESS by Siniša Štefanac, found that:

  • The main reasons for wheelchair disuse are poor wheelchairs, matching failures and difficulty for the end-user to obtain a chair
  • 60% of respondents had injured themselves using a wheelchair
  • Wheelchair assessments were mostly done by sellers rather than therapists
  • Less than 15 minutes of education makes wheelchair users feel safer
  • 80% had to have repairs done to their equipment
  • Less than 10% were followed up by services regarding their wheelchair
  • 50% of people didn’t know where to go for a wheelchair

A study on wheelchair services in the US by a team from the University of Pittsburgh and presented by Mary Goldberg, found:

  • Only 46% of people feel the end-user has an active role in deciding what equipment they get but providers think that end-users do have a large role
  • End-users tended to agree with providers about the equipment they are recommended
  • Most providers do not think end-users get long-term maintenance support
  • Only 10% of 1bn people have access to assistive technology around the world

Tags : ESSeuropean seating symposiumWheelchairwheelchair provisionwheelchair service
Joe Peskett

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