1. Community Equipment – A case study. Peter Gage Clinical Service Manager Mid & West Essex Wheelchair Services

2. 2 Wheelchair centres – 25 miles apart 2 Wheelchair centres – 25 miles apart 12,000 Wheelchair users. 12,000 Wheelchair users. Contracted out repairs & maintenance Contracted out repairs & maintenance Engineering audits & PPM audits carried out annually. Engineering audits & PPM audits carried out annually. Background

3. Different Manufacturer but this style of Attendant pushed Wheelchair

4. Relationship with Manufacturer Long standing. Long standing. Joint developments over a long period. Joint developments over a long period. Purchasing this model for 5 years before event. Purchasing this model for 5 years before event.However: Handbook recommends 6 monthly inspection. Handbook recommends 6 monthly inspection. Year 2000. Trust begins 24 monthly PPMs Year 2000. Trust begins 24 monthly PPMs Manufacturers approval of our maintenance scheduling. Manufacturers approval of our maintenance scheduling.

5. Question 1. Question 1. Was it a reasonable cost/benefit judgement to have a maintenance variation understanding with the manufacturer? Was it a reasonable cost/benefit judgement to have a maintenance variation understanding with the manufacturer? 1.Balanced – sensible use of public finance & covers reasonable risk. 2.Unsafe – dodgy, but you’ll probably get away with it. 3.Good – If the manufacturers are cooperating it must be OK. 4.Financially sound – If an accident happens, any potential payout will be less than the savings on maintenance costs. 5.Wrong & Dangerous - An accident waiting to happen.

6. The Story Chair supplied on 8 th July 2003 (PDI check) Chair supplied on 8 th July 2003 (PDI check) Delivered to client 19thJuly 2003 Delivered to client 19thJuly 2003 Failed PPM attempt Oct. 2004 Failed PPM attempt Oct. 2004 Brake adjustment Jan 2005 – No PPM done. Brake adjustment Jan 2005 – No PPM done. Dec 2005. Technical Bulletin emphasising 6 monthly PPM intervals. Dec 2005. Technical Bulletin emphasising 6 monthly PPM intervals. Feb 2006. Technical Bulletin stating upgrade castors/wheels/brakes then 60 month intervals. Feb 2006. Technical Bulletin stating upgrade castors/wheels/brakes then 60 month intervals. Advisory: Service intervals relate to client usage. Advisory: Service intervals relate to client usage.

7. Question 2. Question 2. Should the manufacturers have funded the equipment upgrades to support the 24 month servicing schedule? Should the manufacturers have funded the equipment upgrades to support the 24 month servicing schedule? 1.It would be reasonable to expect a subsidised cost for retro fitting parts. 2.No. When you purchased the equipment they recommended 6months inspections. 3.Yes. Equipment should have been recalled by the manufacturer. 4.Yes. All costs of upgrading locally should the covered by the manufacturer. 5.Because they accepted your 24 month schedule the costs should be split 50/50.

8. The Event Rear wheel falls off while being pushed. Rear wheel falls off while being pushed. Occupant OK uninjured. Occupant OK uninjured. Carer sustains knee injury supporting client. Carer sustains knee injury supporting client. Surgery fails & has to be re operated. Surgery fails & has to be re operated. 12 months off work – Injury claim/ Ongoing. 12 months off work – Injury claim/ Ongoing.

9. Question 3 Question 3 Could the wheelchair user be responsible for initiating a free service? Could the wheelchair user be responsible for initiating a free service? 1.Yes, It should be part of the Conditions of loan that the user (or the carer) telephone the contractors for a PPM at stated intervals. 2.No. You issued the chair & it is your responsibility to maintain it regularly. 3.Yes, but you will have to monitor the uptake & remind those people who forget, or are unable, or don’t bother to telephone. You are not free of responsibility. 4.Yes, but only if you fit mileage recorders or timers to remind the user when it is due. 5.Yes, but only if you transfer ownership of the equipment from the NHS to the wheelchair user. You are now free of maintenance responsibility.

10. What could we do differently ? Follow manufacturers recommendation on scheduling ? – Big cost implications Follow manufacturers recommendation on scheduling ? – Big cost implications Loopholes in Contractors follow up ? Loopholes in Contractors follow up ? Linking between repairs and annual maintenance ? Linking between repairs and annual maintenance ? Schedule PPM intervals to appropriate usage – ? how to measure usage ? Schedule PPM intervals to appropriate usage – ? how to measure usage ?

11. What changes have we made to maintenance systems ? Cost /Benefit analysis regarding the upgrades. Cost /Benefit analysis regarding the upgrades. Initiated professionally assessed scoring criteria to be completed at assessment. - ODPM Objectively Directed Preventative Maintenance. Initiated professionally assessed scoring criteria to be completed at assessment. - ODPM Objectively Directed Preventative Maintenance. Introducing a client review at the same visit. Introducing a client review at the same visit.

12. Thank you for listening. Any questions / comments ?