Disabled 'trapped by NHS failings'

Wheelchairs can give people independence

Disabled patients are still missing out on the equipment they need - two years after a health watchdog first highlighted the problem.

The Audit Commission has found there are still a large number of shortcomings in NHS equipment services.

After its 2000 report, the government ploughed £220m into disability equipment services, but the commission said little has reached frontline services.

In its latest analysis, the Audit Commission said there had been some improvements, most notably in services for the deaf.

It is worrying that, on balance, things have worsened over the last two years

Dr Liam Fox, Shadow Health Secretary

But it added there were many areas which remained in a "parlous state".

Services are fragmented and organised according to budget rather than what patients need, it said.

Unsuitable

One in 10 people will need some sort of disability equipment, such as wheelchairs, crutches or rails around the house.

But patients can be forced to wait years for equipment which is often in poor condition or unsuitable for use.

The Audit Commission said that disability equipment is often given low priority in health service funding.

It added patients were being denied independence and safety while waiting for relatively cheap pieces of equipment.

And putting a relatively small amount of funding into the area would prevent further expense to the NHS, such as caring for people after falls or accidents, it found.

In 1999 A&E departments treated 90,000 people who had fallen as a direct result of visual impairment, at a cost of £130m.

'Radical approaches'

Since the first "Fully Equipped" report was published in March 2000, improvements in services for the deaf have included the introduction of hearing screening for newborn babies.

The tests are more effective than traditional distraction tests, carried out at six to nine months.

Progress is patchy

Health minister Jacqui Smith

More people also have access to digital hearing aids, though availability does depend on where patients live.

The government has also set targets for improvements in community equipment services, supported by a national implementation team.

The report makes a series of recommendations aimed at reorganising services into larger centres to make them more effective.

Sir Andrew Foster, controller of the Audit Commission, said he was delighted that some recommendations in the 2000 report had been adopted.

But he added: "I am very disappointed that the service, overall, has not improved since we last looked at it two years ago.

"This raises serious questions about whether we need to develop more radical approaches to the way these services are provided which may, among other options, involve the use of the public private partnerships and an extension of direct payment schemes."

Jacqui Smith, minister for Social Care, said action was being taken.

"We have set up a three year programme to improve disability services and we are not even half way through it yet.

"As the report points out, at this stage progress is patchy.

"In areas where progress has been slower than we would wish, such as wheelchairs, prosthetics and orthotics [orthopaedic devices], we are taking action."

'Ambitious agenda'

Dr Liam Fox MP, Shadow Health Secretary, said: "It is worrying that, on balance, things have worsened over the last two years.

"This is a bleak picture of Labour's performance on the organisation of equipment services."

Nigel Edwards, policy director of the NHS Confederation which represents health service managers, said: "It is a very difficult message but it will take time for improvements to be felt across the board.

"The NHS is starting from a low base given the legacy of under-funding over decades but improvements will be made in time."