"Clinical Need"

[K'sdad]

Hi all,
As is often the case a bit of advice, not sure if it's in the right section so sorry all if it is not!
We had our first appointment/meeting with wheelchair services yesterday, they noted that K's current chair has a riser facility then proceeded to tell us how they won't supply anything like that as it doesn't form part of a "clinical need"for her in day to day life. They said it may make things easier for her to do but they won't be fund or maintane them as wheelchairs are for getting about.I asked about the funding a couple of you have achieved (burgermans' wheelchair payment policy) and they denied it exists, just that i could have a voucher for her so she could go to an approved supplier.
They showed us the chair they recomend for everyone (I had images of Burgerman in my head when they said that!) from full grown adults to sub 12kg children all get to drive the mid wheel drive quickie salas, oh and it has to be red too as that way they only have to keep parts for it in one colour. It's a good 6-8 inches longer than K's current chair almost 2/3 of it's length will be behind her so i can't imagine that it'll be easy for her to use really.
On the plus side, they think that she's ok to drive an indoor and outdoor (two seperate criteria here it seems) chair so wouldn't need to be reassesed later.Which is nice of them given that she's been driving since she was 2.
SO what i was going to ask ids i know some of you have had to fight to get what you have, any tips on where to start? What to say and who defines a clinnical need?
cheers all

[Burgerman]

Somewhere here I described this half a dozen times.

But how can they deny "it" exists when I am looking at a cheque in the bank 18 months ago?

Surfice to say I assessed myself, showed them why they were clueless idiots multiple times and caused them a lot of embarassement.

[Burgerman]

This is the guy responsible,
Leigh Holton | Programme Manager, Transforming Care Team (NORTH EAST LINCOLNSHIRE CARE TRUST PLUS)
Directorate of Integrated Commissioning
North East Lincolnshire Care Trust Plus
1 Prince Albert Gardens, Grimsby, DN31 3HT
M: 07887 558 323
E: leigh.holton@nhs.net
W: http://www.nelctp.nhs.uk/transformingcare
Transforming Care, My Care, My Way – Individuals Shaping Services

Along with: Wheelchair services boss lady, as in runs many of them, called Jacqui Twomey (NORTH LINCOLNSHIRE PCT)

Try calling them and asking how progress is going. Havent heard a thing since I saw them a year back.

[K'sdad]

I was clearly searching wrong because I knew i had read it before but couldn't see it for lookig, thanks for posting it up again.
I'll be honest thought i said to them that the quickie/zippie was huge and they replied "it's great isn't it because the base is big enough for an adult or child".Really not sure i see it as a benefit and when i pointed out how much bigger it was they meausred it and said oh it's only 6 inches or so and most of it's behind her so it won't make much difference." It's hard to know how to start combating such levels of intellegence.
Thanks again
Dave

[Burgerman]

It's hard to know how to start combating such levels of intellegence.

Its impossible. They are *all* unbelievably ignorant of any type of understanding or ability in any way. Other than courses on seating (usually some day courses) that just teach what is available. They have no concept of even the basics.

You have to educate them. But they are usually the wrong "kind" of people to understand this stuff. Basically assess the chair they suggest and take ten pages explaining why its a joke and therefore why they couldnt asses a cheese sandwhich. Do it in front of their piers, and bosses, esp the real big bosses. Do it with facts, and clear explanation, drawings etc. Explain why a big chair with huge heavy batteries is completely wrong for a child for eg. Bullet points. Lots of them. Then explain that you have forgotten more about power chairs and your childs needs than it is possible that any of them could ever learn, and that you are in a better position to organise the best solution yourself. Then ask why I am allowed to do exactly this, and you are not? Trust me, being amenable to discussion, and wasting time with these idiots is pointless. You have to take charge, show them up for what they are and take no prisoners. You shouldnt need to do this, but it seems the NHS or Gov, will employ anyone.

[Phil Esgate]

I have been throught the whole system too K's Dad. I have written about my experiences on this board in a few places and how I've managed to deal with the subject of numpty WCS OTs and the like.
As I have been able to spend time researching and receiving advice from BM (John), I have been able to use the hierarchy of the local PCT to my advantage. Each PCT has a similar pecking order which you will need to access. Also if you have a social worker then you will be able to get him / her to help you access all areas.
First you need to get a meeting, at home, with your WCS Manager - educate him / her.
Then they refer your case to the "Exceptions Panel" with bullet point "clinical needs" and "Holistic needs" (please remember that part as it is very important).
Next you make sure the panel forwards your case to the Medical Director of the PCT for approval. The aim is for them to give you a blank cheque voucher for you to get a private OT and manufacturer's fitter, to make sure you can test everything on your short list, and be prescribed exactly what you need.
They then send the prescription to your WCS manager who will arrange for the voucher to be given to the supplier of your choice who fulfills the Holistic and Clinical needs that you have.
Hope this helps a bit - Phil

[Burgerman]

There are many ways. But this one is different to what I did.

But this way requires you to trust / find other "experts" and other manufacturers engineers.

Wouldnt you rather just recieve a cheque, be able to run, maintain, or use ebay chairs, local metalworkers, buy what you want as and when it suits you? At advantagous prices and be able to keep backup chair/spares etc? Although both ways are better than their standard answer...

[Phil Esgate]

I also get full back up and support from WCS ontop of being able to choose whatever I want (need) - I've gone for the Quantum Rehab Lightning, fully loaded with what I need, including R-Net controller instead of the Q-Logic thing, Euro2 seating instead of the Tru Balnce thing, Electric Leg risers as I have some weird edema issues and because I have a urostomy I'm not allowed to have diuretics. Also as I'm dual ostomy (a colostomy too) and I'm paraplegic, I need a tilt in space plus recline so I can have my bags dealt with by one of my 3 carers ( lucky boy ;0 ) - It has Group 24 batteries 70ah, Jay2 equiv Gel cushioning, good build quality, pneumatic grey tyres as my carers are fed up of cleaning the bathroom floor from black tyre marks. I have full access to the programming suite with dongle on laptop. We are getting 5 mph on the 4 pole motors and are having the seat moved back on it's mounts to give 70% rear 30% front weight distribution. LED lighting so I can go out at night. Delivery is going to be at least Christmas time (thank you Santa)

BUT

I'm keeping my F55S and going to strip it totally and spend some months (maybe longer) and making a BM2 at least. I will have my cake and eat it

[Burgerman]

http://www.pride-mobility.co.uk/docs/Li ... cation.pdf

I thought all were 4mph in UK?
And R-Net is 80 amp?

Another thing that might worry me a little, is the 6 degree angle. 9 degree max capable. The ramp in my local pub is 14.5 degrees for eg. Theres many ramps about that exceed 6 degrees. Even some of the ramps at the edge of street junctions are worse than this. Did you test one?

[Phil Esgate]

I'm going American spec haha - Don't tell anyone - I'm having 5mph motors and yes it's the colour 9 button display controller and this one is Group 3, but I won't bother with a rear view mirror

[Phil Esgate]

Oh and that bit that tells you the angles and degrees is complete bollox - It zips up my drive which is as steep as your pub ramp. - I've got some pics and a video of me testing it all out but it's on my facebook account. - :/

[Burgerman]

Make sure its the 120 amp Rnet, they all use the same handset, but the 120 is actually a 100 amp module with a short 20 amp boost for a few secs. Make sure also that you get OEM not end user dumbed down or dealer access programmer. Your drive is 14.4 degrees? If it is I would be amazed that any car will sensibly go up it and sit on a hand brake!

[Lord Chatterley]

Hi all,
As is often the case a bit of advice, not sure if it's in the right section so sorry all if it is not!
We had our first appointment/meeting with wheelchair services yesterday, they noted that K's current chair has a riser facility then proceeded to tell us how they won't supply anything like that as it doesn't form part of a "clinical need"for her in day to day life. They said it may make things easier for her to do but they won't be fund or maintane them as wheelchairs are for getting about.I asked about the funding a couple of you have achieved (burgermans' wheelchair payment policy) and they denied it exists, just that i could have a voucher for her so she could go to an approved supplier.
They showed us the chair they recomend for everyone (I had images of Burgerman in my head when they said that!) from full grown adults to sub 12kg children all get to drive the mid wheel drive quickie salas, oh and it has to be red too as that way they only have to keep parts for it in one colour. It's a good 6-8 inches longer than K's current chair almost 2/3 of it's length will be behind her so i can't imagine that it'll be easy for her to use really.
On the plus side, they think that she's ok to drive an indoor and outdoor (two seperate criteria here it seems) chair so wouldn't need to be reassesed later.Which is nice of them given that she's been driving since she was 2.
SO what i was going to ask ids i know some of you have had to fight to get what you have, any tips on where to start? What to say and who defines a clinnical need?
cheers all

Suppose you enter a lift as everyone steps out - the doors shut behind YOU and you are now on your own but you can't reach the buttons?

LC

[Phil Esgate]

I'm going to get an angle app on my Mrs' phone, so I can properly check my drive's degrees / percentage. It's one thing to measure so many feet along and then a foot up, but it's another thing to get it measured accurately. I'll let you know and then video the flamin' powerchairs going up and down it. haha