Equipment for older and disabled people: an analysis of the market potx

Equipment for older and
disabled people:
an analysis of the market


Contents
About Consumer Focus

3

Executive summary

4

1.

8

Introduction

2. Why these products matter

11

3. Market sizes and supply channels

13

4.

Funding and provision – an overview

16

5.

Mobility equipment

21

6.

Community equipment

27

7.

Ortheses and prostheses

31

8.

Areas of consumer concern

33

Annex 1: NHS Supply Chain

41

Annex 2: Fair Access to Care Services

42

Organisations contacted

45

This scoping study was prepared for Consumer Focus
by George and Linda Lennard Associates.
The work was undertaken in Spring 2010
www.georgeandlennard.org.uk
Equipment for older and disabled people: an analysis of the market

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About Consumer Focus
Consumer Focus is the statutory consumer champion for England, Wales, Scotland and
(for postal consumers) Northern Ireland.
We operate across the whole of the economy, persuading businesses, public services
and policy makers to put consumers at the heart of what they do.
Consumer Focus tackles the issues that matter to consumers, and aims to give people a
stronger voice. We don’t just draw attention to problems – we work with consumers and
with a range of organisations to champion creative solutions that make a difference to
consumers’ lives.
We have a duty to represent the interests of vulnerable consumers. People who use
equipment like mobility scooters, wheelchairs and ‘simple aids to everyday living’
(SADLs) are among the most vulnerable in our society. They might be making purchases

of goods they are inexperienced with, they might be afflicted by discomfort or pain, they
might have difficulties in accessing transport and using the internet. Local authorities and
Primary Care Trusts (PCTs) provide advice, assessments and equipment to people who
meet local eligibility criteria but the availability of this help varies from area to area. Often
people have to wait for long periods before they can see staff to assess their needs and
determine if they qualify for support.
We commissioned this research to better understand how the market is working for
customers. It is a time of change in these markets: the availability of direct provision of
such equipment from local authorities and PCTs is increasingly under pressure, plus the
Department of Health is promoting the use of vouchers or prescriptions in certain types of
equipment to enable consumers to have greater choice. The amount of money available
to local government and the health service is likely to decline over the next few years.
This report highlights some of the problems in this market, many of which arise from lack
of public money and shortages in the numbers of trained staff. Consumer Focus has
powers to investigate and refer markets that are not operating satisfactorily for
consumers to the regulators and the Office of Fair Trading. We are interested in seeing
further analysis of the issues by the OFT.

Equipment for older and disabled people: an analysis of the market

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Executive summary
The market
This report is an exploratory study looking at the market for equipment and services
designed primarily to enable independence for older people and disabled people in
particular. The market comprises a number of sectors covering a very wide range of
equipment and products. This study covers the purchasing and provision of mobility
equipment (such as scooters and wheelchairs) and other types of equipment that are aids

to daily living, as well as devices that are known as ortheses and prostheses – see the
box below for brief descriptions.
A variety of terms are commonly employed to describe these types of products and
equipment. In this report, ‘community equipment’ is used as a general overarching term;
in some cases, we use more specific terms in order to describe particular types of
products where necessary.
Some decisions to obtain these products are made by people who may be in vulnerable
circumstances, sometimes in times of crisis, for instance after an accident, or because of
the onset of illness or disability. Purchasing decisions are also made indirectly by
relatives or carers. There is a strong public services involvement especially by
occupational therapists and other professionals who can assess need and provide
advice, and by NHS bodies and local authorities who may purchase and provide products
to people who qualify for such help. In addition, ortheses, prostheses and cosmeses are
usually provided by NHS-based services but there are also privately-run centres that offer
these services.
Community equipment refers to a wide range of products that are primarily
intended to help disabled people and older people with everyday living. Examples
include bath seats, can openers, hoists and standing frames but there are many
other products that are available. The term can also include mobility equipment such
as wheelchairs, scooters and walking frames.
Ortheses are orthopaedic products that are externally applied and offer physical
support, such as braces, sole inserts and limb support.
Prostheses can be described as ‘replacement parts’ such as artificial limbs, hip
replacements, and breast reconstruction.
Cosmeses are designed to help preserve, restore or enhance physical appearance.

Why these products matter
The products covered in this study are of vital importance for the health, safety and wellbeing of several million people. They are also potentially useful for many more people
who may not regard themselves as disabled. Increasingly many of these products are
being seen as consumer products rather than medical items, although some undoubtedly

are of a specialist nature. These products can play a significant role in enabling people to
live more independently and to have a good quality of life.

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Markets
There is a lack of comprehensive, reliable and up-to-date information in the public domain
on the sizes of the various market sectors, and on the numbers of users of such
equipment whether through private purchasing or public provision. Another dimension of
difficulty is that much of the purchasing of such equipment is carried out on behalf of
consumers by statutory services such as local authorities and NHS bodies – information
is not normally available on suppliers and contract terms. However, public purchasing in
England is carried out locally on a fragmented basis and therefore mainly lacks market
power.
Published estimates of market sizes vary significantly. Where statistics are available,
definitions of the sectors may differ and it is not necessarily clear what types of
equipment are included.
According to the British Healthcare Trades Association (BHTA), annual UK sales values
are estimated as follows:
Mobility products:

£200 million

Community equipment:

£270 million

Pressure area care products 1:

£105 million

Ortheses:

£90 million

Prostheses:

£55 million

These figures differ considerably from those provided in some commercial market
reports, for example by Plimsoll Publishing which estimated the UK market for ‘disabled
equipment’ at around £1.67 billion and the UK market for powered wheelchairs and
scooters alone at around £800 million. Another commercial market report by Keynote Ltd
put the UK market for mobility equipment at £501 million.
It is also extremely difficult to secure firm information on the numbers of users of these
products because of the inadequacies of published data and the wide range of products.
The Department of Health has estimated that there are at least seven million people who
would benefit from community equipment of which three million equipment service users
are supported by the State, leaving potentially at least four million people who, in theory,
could be self-funding. But these are estimates.
For such an important product area, it is remarkable that firmer figures on the value of the
sectors, and numbers of people purchasing and using such equipment are not available
in a comprehensive and robust form.

Key market features
Reliable information on market shares and on the main market players is difficult to
obtain. From interviews for this study, it appears that there are a small number of global

companies – mostly based outside the UK – which are especially prominent, as well as
smaller, sometimes specialist, companies. There is also reportedly a significant amount
of takeover activity by the larger players. Some of the larger companies provide a very
wide range of products to public purchasers as well as to private consumers.

1

Includes equipment to relieve physical pressures when sleeping or sitting for example

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This makes it especially difficult to arrive at a meaningful or useful estimate of market
shares in particular sectors. In some equipment areas, for example prostheses and
ortheses, conventional market mechanisms are not very applicable in terms of consumer
choice.
A related feature of this market is the difficulty of obtaining reliable and detailed data on
costs and price issues. This exploratory study identified concerns among some
interviewees that the price levels of some products, particularly wheelchairs and scooters,
appear higher than warranted. Further investigation of this issue is required to ensure that
consumers are getting a fair deal.
Retailing in this sector has traditionally been carried out by specialist private shops, some
of which are chains. However, consumers can also purchase some equipment by mail
order and online, as well as from some charities. Recently a number of generalist
retailers have begun to offer fairly restricted ranges of these types of products.

Provision of equipment
There is a mixture of public and private channels for consumers to obtain this type of

equipment. First, people can buy directly from suppliers/retailers using their own funds or
by obtaining help from a specialist charity towards the purchase. Some charities also
provide equipment directly to consumers or on a loan basis.
In terms of public provision, once people have had their needs assessed and if they meet
local eligibility criteria, they may be given equipment on loan by NHS bodies and local
authorities via community equipment stores and services. Or, as is the case with
wheelchair provision in an increasing number of areas in England, they may be offered
vouchers to obtain wheelchairs from approved private suppliers.
As far as other types of equipment are concerned, this is available on loan from NHS
bodies or local authorities (once people’s needs have been assessed and they meet the
eligibility criteria). However, in a number of areas in England which have adopted the
Department of Health ‘Retail Model’, public provision of what are termed ‘simple aids to
daily living’ (SADLs) is now being carried out by offering people prescriptions instead.
The prescriptions can be redeemed at accredited retailers. Under the Retail Model
prescription system and also the wheelchair voucher scheme, the products may belong to
the consumer rather than being on loan, and people can also choose to top up to obtain a
functionally similar model.

Consumers’ needs
Consumers’ individual circumstances are an important factor that need to be taken into
account. In many situations, consumers may be buying equipment as ‘distress
purchases’. Some are in vulnerable situations and unable to get out to shop around.
Purchasing from generalist retailers or via mail order, or on the internet where people
have access, may be feasible for some products. But many consumers may need expert
advice and independent assessment of their needs. They may also need to try out
equipment, or have a home visit to ensure that the product meets their requirements.
Purchases are frequently made on someone’s behalf by friends and carers who may not
be sufficiently informed about product suitability. At the same time, many of these
products are potentially of benefit to a wider range of people who may not regard
themselves as disabled.

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Areas of potential consumer detriment
a) Prices: concerns were raised by some of the people we interviewed about the retail
prices of some of the equipment covered here such as wheelchairs and scooters.
However, the lack of publicly-available data is a barrier to further investigation, and there
are also difficulties in making price comparisons between what are often individuallytailored products. Some public purchasing is carried out centrally through the NHS but
mostly it appears to be done on a local basis with weak purchasing power
b) Information and need assessment: there appear to be problems for some consumers
with being able to make informed price comparisons between products such as mobility
equipment or more complex products, especially for those without internet access it can
be difficult for consumers to obtain expert specialist advice and assessment prior to
making private purchases or obtaining equipment through public provision
c) Marketing and sales: it appears that some poor marketing practices exist according to
anecdotal evidence but the scale is unknown. The quality of sales advice is also critical
as consumers may need specialist expert help, given the potential risks of unsuitable or
unsafe products
d) Waiting times: consumers often reportedly have to wait for considerable periods of
time to obtain suitable equipment through public provision, for example for wheelchairs. It
is unclear whether this is due to the lack of trained professionals to make assessments,
waiting times for the goods, or budgetary constraints. There can also be long waiting
times for orthotic and prosthetic services
e) Postcode lotteries: eligibility criteria for public provision of community equipment vary
between areas in England. The range and types of equipment available locally may also
be shaped by budgetary pressures rather than people’s needs. These factors lead to
inequities in public provision at local level

f) Quality and design: if people do not obtain the correct equipment to meet their
individual needs, there can be risks to health and safety. Poorly designed or poor quality
equipment can also restrict people’s independence rather than enhancing it
g) Regulation and consumer protection: existing regulatory and inspection arrangements
for community equipment services need to be reviewed to ensure that they are
sufficiently robust and comprehensive
h) Market concentration: there appears to be a small number of global private companies
in some of the market sectors, such as mobility equipment, who tend to dominate
manufacturing and supply. However, there is an absence of reliable publicly available
data on market shares

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1. Introduction
Aims and context
This report for Consumer Focus is based on an exploratory scoping study of private and
statutory purchasing and provision of mobility equipment (such as scooters and
wheelchairs) and other types of community equipment that are aids to daily living, as well
as devices that are known as ortheses and prostheses. The main objectives of this
scoping study included:
 to map the types of equipment and products that are of particular importance for
disabled people’s health, safety and independent living where private
purchasing, in whole or in part, is relatively common
 to explore the size of the markets
 to scope out possible areas of consumer detriment and market imperfections
within these sectors and markets
 to suggest specific sectors or sub-sectors where Consumer Focus may wish to

consider making a super-complaint, and/or interventions on public policy issues
An important part of the context for the study is the heavy emphasis in public policy on
the promotion of individual budgets, self-directed care, personal budgets, and direct
payments. An integral part of this agenda is the idea and intention of developing greater
consumer choice, and a ‘mixed economy’ of health and social care provision (with private
funding augmenting public provision). These developments are affecting the provision of
many of the products covered in this study that can be described as ‘community
equipment’. More information on the types of products covered in this study is set out in
sections 5 to 7.
The sector (which should be characterised as a number of sectors) does not receive
sufficient attention, in large part because it does not fit easily into any particular
‘mainstream’ health or social care category. For example, while some products have a
clear health-and-rehabilitation function, others are often intended to enable someone to
live safely in their own home and locality instead of entering residential care.
Such products, and the arrangements which enable significant numbers of people to
access and use them, are rightly regarded by many as major advances – not just in
relation to technological development and design, but also in terms of people’s attitudes.
There are, undoubtedly, major benefits in regarding these aids or equipment as just
another type of product with potentially wider use across the population. On the other
hand there are undoubtedly risks involved for people’s health, safety and well-being when
purchasing privately. Many consumers who buy or need these sorts of products are
potentially vulnerable in some way. In addition, depending on the nature of the product
and people’s circumstances, consumers often require expert advice and assessment of
their individual needs before making a decision.
It should be noted that, in some sectors or sub-sectors it is not meaningful, or useful, to
view services and products through the lens of ‘markets’. For example, prosthetic limb
services are generally regarded by professionals and the public alike as an NHS, or
certainly a specialist professional/technical, service, with a strong bespoke element. For
most people the idea of ‘shopping around’ is not important (unless perhaps they are
seeking sports-related equipment).

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In the equipment sectors which we have been able to explore within the constraints of
this scoping study, we have sought to identify issues of potential interest and concern to
Consumer Focus, including market matters. But it is also clear from the scoping study
that there are broader areas of concern relating to people’s social care and health needs,
the adequacy of provision, information, advice and consumer protection issues.
Within the confines of what was an exploratory study, we found much that was
concerning, especially given the importance of these products to people, many of whom
are at risk of being vulnerable or otherwise disadvantaged. Some problems can be laid at
the door of market features, including difficulties in finding out what suitable products are
available and making informed choices. But others derive from the fact that the services
are not seen to fall within the mainstream health or social care category.
Our information sources were as comprehensive as possible given the time constraints
for the study, and we believe that we have ‘captured’ important features of this sector,
though not necessarily always with the degree of detail or depth which we would have
liked to have achieved. It should be noted that some information was provided by
interviewees on an unattributable basis but this does not undermine the authoritative
nature of their advice.
There is a significant number of individuals and organisations who we thank for their time
and patience in answering our questions (see list at end of report). We were often
heartened by their enthusiasm and commitment to improving the situation for disabled
people and their families. Importantly, several expressed a clear wish to work in
partnership with Consumer Focus if we decide to pursue further work in this field.

Coverage

The scope of this study had to be limited because of the vast range of products and
equipment which are usually regarded as aids to independent living, and time constraints.
The product areas covered include mobility aids and equipment and other aids to daily
living – often described as ‘community equipment’. The study also looked briefly at
equipment which is usually described as prostheses (for example artificial limbs) and
ortheses (for example external braces). The geographical focus of the study was on
England unless otherwise stated.
Due to time constraints, the study did not specifically cover equipment and systems
commonly regarded as telecare or telehealth. In large part this is because of the sheer
range of equipment involved (such as personal alarms, remote sensing of the
temperature of rooms, remote monitoring of people’s medical condition, and intercoms).
Hearing aids, building adaptations and additions, and spectacles and contact lenses also
had to be excluded.

What we did
This study involved a combination of desk research and interviews with a number of key
stakeholders. The desk research included government publications, reports by specialist
organisations and material from the main trade association. Some commercial market
reports were also obtained but these proved of very limited use for the purposes of this
study. The interviewees included senior Department of Health officials, experts in a
number of specialist charities and other organisations, and some individual professional
experts including occupational therapists (see list at end of this report).

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Structure of the report
Section 2 highlights the importance of these products and services, particularly to enable

many disabled people and older people to live independently. Issues relating to market
sizes and supply channels are discussed in section 3. An overview of some of the main
channels for provision and funding arrangements is set out in section 4. Matters relating
to the market for and provision of mobility equipment are discussed in section 5. Section
6 explores issues regarding community equipment products and services (a term
commonly used to cover what is in reality a wide range of often disparate products that
are aids to daily living). Section 7 briefly outlines some key points relating to the provision
of ortheses (externally applied products which offer support designed to give stabilisation,
immobilisation, relief and/or correction); prostheses (in very general terms ‘replacement
parts’ such as but not only artificial limbs); and cosmeses (items to help preserve, restore
or enhance physical appearance). Section 8 highlights some key factors relating to
consumers’ needs and circumstances, and sets out a number of potential areas of
consumer concern in this field that merit further investigation.
Annex 1 briefly outlines the NHS Supply Chain; and Annex 2 details the Government’s
Fair Access to Care Services guidance. A list of organisations contacted and sources are
provided at the end of this report.

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2. Why these products matter
Official estimates of the number of disabled people are 11 to 13 million in the UK,
depending on the definitions used. It is instructive that there are no reasonably definitive
figures regarding the number of people who need, and/or use, mobility aids, community
or independent living products, prostheses or ortheses, or other types of assistive
technologies and products. Even the terminology used is varied and ever changing.
Conceptually there is usually no difference between a product like a mobility aid such as
a rollator or wheelchair and a pair of reading glasses or contact lenses. But although we

have moved on from the days of invalid carriages and the ‘Invacar’ tricycle, some types of
equipment and aids are still largely seen as ‘medical aids’ especially if they have a
defined ‘therapeutic’ significance. Others are simply seen as aids to independent living,
for example, lightweight collapsible wheelchairs which people may need to get around,
including getting to and from work.
The differning perceptions of equipment and products, and the lack of prioritisation in
State provision, have helped to lead to a postcode lottery where what is on offer from
public sources varies in terms of accessibility and product choice for the consumer.
For example, a disabled young woman in one area of the country may find it impossible
to access the equipment which would enable her to attend a training venue and
subsequently to apply for and get a job, get her own shopping and go out with friends,
while her counterpart somewhere else can do so. Similarly, such inequities might mean
that an older man in one locality is effectively housebound and has to consider going into
residential care against his wishes. His equivalent elsewhere may be not only living in his
own home but also able to visit family and friends ‘under his own steam’.
Although these brief illustrations have been drawn rather ‘starkly’, wide variations in
people’s ability to access and use community equipment and products in order to make
the most of their abilities raises fundamental questions about discrimination. They are
also at odds with common statutory and policy-based equality frameworks, and with
policies to enable disabled people and others who may be frail or have sensory or
cognitive impairments, to remain in their homes. Independent living aids and community
equipment (including mobility products) may well be of crucial importance to people,
either all of the time or for some of the time. They should not be regarded as ‘an extra’.
The current situation is widely regarded as deeply unsatisfactory (much harsher words
were employed by some interviewees). The critical point is that many of these products
are crucially important to enable people with disabilities or other types of impairment to
maximise their independence, to live safely and healthily, and to reduce the likelihood of
people being socially or economically excluded.
For example, in an independent living forum organised by Which? last year among over45s (about assistive technologies):

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 81 per cent agreed products have the potential to improve their quality of life
 79 per cent of non-users said they would be willing to use them
 82 per cent could spontaneously think of a benefit that one or more products
could bring
 85 per cent said they were likely to use products that prevent accidents 2
For disabled children and young people, in particular, timely access to suitable products,
especially perhaps mobility products, could set the trajectory for the rest of their lives. For
example, proper wheelchair and suitable seating not only brings physical benefits but
also a vast increase in the likelihood of a child attending a mainstream school, and being
able to join in social activities with their peers.
Mobility, digital hearing aids and other equipment make it much more likely that disabled
people are able to obtain and maintain paid work, and have a social life. The right aids
and equipment can also reduce the physical and mental challenges faced by carers.
The right equipment can help reduce the likelihood of people having falls in the home and
outside, and therefore reduce injuries and incapacities. Equipment to enable people to
make easy transfers into and out of beds and chairs, and specialist mattresses and
pressure-relieving seating, can reduce the likelihood of pressure sores and ulcers (which
is a major cost to the NHS), and unnecessary circulatory and other physical problems.
Mobility problems are the most commonly-quoted source of pain, distress and exclusion
in official surveys on disability. Equipment which can help consumers to use their
bathroom, to move around their own home safely and with relative ease, and to get into
and out of bed, for example, is clearly enabling.
The profound benefits of self-propelled wheelchairs at home and/or in the outside world
include economic inclusion, freedom of movement and easier access to facilities, and
social activity – be it engaging directly in sporting activities or having a meal with friends

in a restaurant. Having the proper wheelchair (or wheelchairs) may also remove or
reduce the need to rely on domestic care services for tasks relating to everyday living.
For example, having a ‘riser’ powered wheelchair can enable the user to have much
greater choice and freedom in doing things like cooking or reaching up to a cupboard. It
may also reduce the need for expensive alterations in the home to adjust the height of
work surfaces. 3
Then there is the enormously wide range of other independent living aids and products,
many of which are relatively inexpensive but which help significantly improve people’s
health, safety and well-being in a variety of ways. For example, some nine million people
have arthritis, many of whom find it difficult or impossible to control their kitchen or
bathroom taps properly, or for whom getting their socks and shoes on is a serious trial.
Some of them, and people with a variety of other disabilities, can find getting in and out of
the bath or shower dangerous or difficult. Opening cans, jars and packaging, handling a
kettle full of boiling water or getting a packet of food down from a high shelf can be a trial,
or feel like an impossibility.
Not being able to do these and other sorts of everyday things can be effectively disabling,
and seriously affect people’s confidence and self esteem. Being able to get the right
equipment at the right time, free or at an affordable price, may also help enable people to
view themselves increasingly in terms of their abilities, not in terms of their ‘condition’ or
‘disability’.
2

Which? briefing: Tools for independent living forum, October 2009
Out and about: Wheelchairs as part of a whole-systems approach to independence, Care
Services Improvement Partnership, 2006

3

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3. Market sizes and supply
channels
3.1

Financial value

It has proved extremely difficult to obtain robust and up-to-date assessments of the sizes
of the markets for community aids and equipment in financial terms and in terms of the
numbers of users/consumers. A key complicating factor is the sheer range of products
involved. For example, the term ‘community equipment’ covers an enormous range of
very different types of products such as bath seats, cutlery, commodes, and hoists which
cannot be described as individual product/market sectors or sub-sectors. Where figures
have been produced that indicate market sizes, different organisations employ different
definitions of a particular market sector, and it is often not made clear what types of
equipment have been included.
There is a lack of comprehensive up-to-date publicly available data on the different
product sectors (figures on community equipment are frequently bundled together with
those relating to medical devices for example). While some commercial market reports
exist, they are primarily aimed at corporate investors and their focus is on the financial
performance etc of the companies involved. The usefulness of such reports is also often
limited as it is not always clear what products are covered.
Consequently, figures on market sizes in this area need to be treated with considerable
caution. Some estimates of market sizes are set out below.
According to the British Healthcare Trades Association (BHTA), the estimated annual
sales values of the following product sectors in the UK are as follows (including sales to
statutory bodies as well as the public):
Mobility products

(largely wheelchairs and scooters):

£200 million

Community equipment:

£270 million

Pressure area care products:

£105 million

Ortheses:

£90 million

Prostheses:

£55 million

There are some published commercial market reports including a recent report by
Plimsoll Publishing, which estimated total UK market size for what it termed ‘disabled
equipment’ at £1.67 billion 4 (but it is not clear what equipment is included). Keynote
Publishing also stated that the market for what it termed ‘equipment for the disabled’
stood at around £1.6 billion in 2008, up from £1.43 billion in 2004. 5 As Keynote
commented: ‘The market's value is very difficult to measure because of the diverse range
of distribution channels, from the NHS to specialist retail outlets.

4
5

UK disabled equipment – An industry overview, Plimsoll Publishing Ltd, 2010
Equipment for the disabled market report 2009, Keynote Ltd, 2009

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Sales are highly fragmented: a wide range of equipment is on offer and there are many
niche sectors in the market, which are served by hundreds of specialist companies.’
Meanwhile another Plimsoll report estimated the UK market for powered wheelchairs and
scooters at £800 million last year. 6 However, this figure is different to another estimate
from the Keynote report referred to above which put the UK market for mobility equipment
at £501 million in 2008. This range of figures highlights the difficulties that arise in
assessing market size in these sectors. 7
As far as community equipment is concerned, the Department of Health estimated that
the costs of products provided through community equipment stores in England totalled
around £248 million. 8

3.2

Manufacturing and supply

Obtaining a clear picture of the market structure or supply chain for these aids and
equipment is an equally tricky task, not least because of the difficulties of defining the
different market sectors. As we discuss in more detail in sections 5 and 6, a number of
global manufacturers and suppliers are involved but there are also many smaller
companies including niche manufacturers (some of whom may not be involved long
term).

Some companies are involved across the sectors, while others specialise in particular
product areas. It is often not clear whether companies are involved in both the design and
manufacture of products, and some manufacturers are also wholesalers and/or importers.
Moreover, some retailers also operate as wholesalers.
One of the reasons that it is difficult to ‘unpick’ the supply chain is that some products are
manufactured and supplied globally or least on a multi-national basis, sometimes with
primary manufacture being reportedly located in the Far East. In addition, some
interviewees have suggested that either primary manufacturers or intermediaries engage
in ‘badge engineering’ – essentially using different brand name badges for distribution in
different countries or regions.
Consequently, brand names do not necessarily denote or indicate which manufacturer, or
groups of subcontractors for instance, designed or produced the equipment or product.
Moreover, it appears that in some markets substantial and often long-standing importers
are regarded essentially by purchasers as their main ‘port of call’. Such suppliers may
source their supplies from a range of primary manufacturers and/or wholesalers.
In some product areas, it might appear that there is a strong EU ‘flavour’ about the
operations of the companies which manufacture and supply, and some do refer to ‘a
European market’. For example, in 2008, analysts Frost and Sullivan produced a report
on the European market for mobility aids and associated paramedical products, which it
valued at $1.4 billion annually. According to this report, the European market was
dominated by companies such as Invacare, Sunrise Medical, and Meyra. 9
Some complex (and expensive) products, like powered indoor and outdoor wheelchairs
with specialised seating and controls, may be provided in whole or part by large, multinational companies.
6

UK powered wheelchairs and mobility scooters – An industry overview, Plimsoll Publishing Ltd,
2010
7
Equipment for the disabled market report 2009, Keynote Ltd, 2009
8

Transforming community equipment services briefing, Department of Health, 2010
9
See for more information on Frost & Sullivan’s research European mobility
aids markets

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In the prosthetics and orthotics field, sector leader Blatchford (which also trades as
Endolite) combines the provision of a range of prosthetic-type products with a substantial
specialist clinical service in the UK (obtainable via the NHS and otherwise). But here
again, although Blatchford is based in the UK, it has additional clinical, manufacturing and
research and development locations in the USA, France, India, Russia and Malaysia.
The complex and often confusing nature of these markets gives rise to questions about
consumer pressure and how it can be exerted, especially when there are global
companies involved for whom the UK market may be a small part of their operations.
Product design may be carried out at a long distance from consumers in the UK,
particularly where global companies are concerned.

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4. Funding and provision –
an overview
There is a range of channels for the provision of community equipment. Local authority
social services departments and NHS bodies (such as acute hospital trusts and

community trusts) are among the key State providers, whereby equipment is offered on a
loan basis to those who qualify for help. In some areas, other forms of State provision
have been introduced where people are given vouchers or prescriptions for certain types
of equipment which can then be obtained from approved retailers. In such situations, the
product may be owned by the consumer rather than being loaned, and it may be possible
for people to top-up to obtain a more expensive product. Consumers can purchase much
of the equipment privately, for example, from retailers, mail order catalogues, and over
the internet. In addition, a number of charities supply various types of equipment direct to
consumers or offer equipment through sales or on a loan basis. Moreover, some
consumers can obtain scooters or wheelchairs from Motability if they receive the
qualifying benefits.

4.1

State provision and funding

Assessment of need
In order to access State help with obtaining community equipment, people have to have
their health and social care needs assessed. The basic right to such an assessment is
enshrined in the NHS and Community Care Act 1990, and in the Disabled Persons
(Services, Representation and Consultation) Act 1986. An assessment is supposed to be
offered to people who need help because they cannot manage personal care tasks or
domestic tasks, and/or are likely to neglect themselves. Children also have legal rights to
have their health and social care needs assessed. Carers too have the right for their
needs to be assessed if they care for someone for ‘a substantial amount of time on a
regular basis’. The relevant legislation here includes the Carers (Recognition and
Services) Act 1995, the Carers and Disabled Children Act 2000 and the Carers (Equal
Opportunities) Act 2004. (Other forms of statutory help include assistance for people in
work and education, for example, through the Government’s ‘Access to Work’ scheme.)
Once people have received an assessment, the statutory context for the actual provision

of assistance to meet someone’s health and social care needs (which may include
equipment) consists of various pieces of legislation, performance frameworks and official
guidance. Other relevant legislation and guidance also exists in relation to the provision
of equipment to assist people in employment and education.
The ‘Fair Access to Care Services’ (FACS) framework is a major plank of official
guidance in this respect (see Annex 2 for further information). In general, the right to have
health and social care needs met can be contested ground.

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Provision of equipment
Provision of community equipment is also conditional upon a range of local
circumstances and decisions, including budgetary constraints and local eligibility criteria.
In England, community equipment is provided and funded by local authorities for
example, through social services or adult care services and children’s services. Where
people are under the care of the NHS, equipment may also be provided by the NHS at
local level, for example through Primary Care Trusts (PCTs) and acute hospital trusts.
local authorities and local NHS bodies normally have commissioning teams, or
commissioning managers (or ‘commissioners’). Their key responsibilities include
assessment of local needs, priority setting, funding and setting contracts, and service
development and improvement.
Over the last 20 years or so, many efforts have been made to break down the divide
between health services and social care services (still often referred to as ‘social
services’). For many years local authority ‘social services’ were assumed to be solely
responsible for social care, while healthcare was the responsibility of hospitals, GPs and
health clinics. But for the patient, health and social care support are often equally
important and can overlap. Consequently the planning, commissioning, purchasing and

provision of health and social care services are now often shared by local authorities and
PCTs. 10 Depending on the type of service, and on locally agreed arrangements, partners
can also include acute or specialist NHS trusts and services, GPs, and sometimes private
or voluntary sector organisations.
Once people have had their needs assessed by a local authority and/or NHS body, they
have to meet locally-determined eligibility criteria regarding their level of need in order to
qualify for assistance with equipment (and other health and social care support). If they
are deemed eligible for help, the equipment is usually provided on a loan basis via a local
community equipment store or by a local Wheelchair Service (see section 5.2). Provision
of the equipment is State-funded, by local authorities and/or NHS bodies, including costs
of repairs and maintenance. As equipment provided in this way is on loan, it may be
recycled, following any necessary repairs or decontamination.
Purchasing of community equipment is mainly carried out by local authorities and/or NHS
bodies on a bulk or ‘spot’ basis. Some ‘draw down’ from the NHS Supply Chain, which
mainly bulk buys through a variety of framework contracts (see Annex 1). Other local
authorities/health bodies purchase from suppliers directly, and some do both. It is
understood that about a quarter of the community equipment stores are run formally by
companies involved in the business.

Funding of State provision
According to figures obtained from the Department of Health, State annual spending on
community equipment (including approximately £82 million of
equipment it refurbishes and reuses) is over £318 million. Approx 60 per cent of this
value is for complex equipment – hoists, beds, etc. The remaining 40 per cent of current
State spending is on simple equipment such as bath boards, raised toilet seats and bath
lifts etc.
10

PCTs employ district nurses, therapists, health visitors, nurse advisers, school nurses, specialist
nurses and many other health professionals to provide services within a patient’s home, the local

GP surgeries and throughout PCT premises such as health centres, community hospitals and
walk-in centres. PCTs commission agreements with hospitals and other NHS Trusts as well as the
voluntary sector, to deliver other health related services, within the resources available. PCTs
control a major proportion of the total NHS expenditure to ensure that services are centred on local
needs

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These community equipment figures do not include State expenditure on wheelchair
services. According to the Department of Health, approximately £126 million was spent in
2006/07 on wheelchair services, of which £54 million was spent on equipment and
associated items.
The fragmentation and mixture of statutory provision make it difficult to investigate how
local authorities and NHS bodies, such as PCTs, make their purchasing decisions
(despite asking some PCTs about this for this scoping study, none responded). Also, it
would appear from our investigations that, while some statutory services purchase some
or all products via the NHS Supply Chain, others do not. We have been unable to
discover to what extent the use of the NHS Supply Chain by local services ultimately
benefits consumers. Official discourse around this tends to focus on the reduction of
costs available through bulk purchasing, and it is not clear what the effects might be for
consumers in terms of ranges of products or in helping to ensure that their needs are
met.
A key point from the consumer standpoint is how, and to what extent, statutory
commissioning and purchasing processes and decisions connect with what consumers
need and want – not only in terms of their physical needs, but also the design and
appearance of equipment and whether it helps them to maximise their independence.

Vouchers and prescriptions
The mechanisms for State provision of some types of community equipment have
changed in that people who are eligible for help may be given a prescription or voucher to
obtain the equipment from an accredited retailer or approved supplier. For example, most
NHS Wheelchair Services offer ‘vouchers’ which consumers can use to obtain a
wheelchair direct from approved suppliers, which may then belong to them rather than
the State (they may also be responsible for repairs and maintenance costs). The voucher
is funded by the State but consumers can choose to top it up with their own money if they
have the funds to obtain a different model to that prescribed (see section 5).
The Department of Health is currently rolling out a similar scheme for the provision of
‘simple aids to daily living’ (known as SADLs) through what is described as the ‘Retail
Model’ (see section 6 for information on what types of equipment are included). This
arose out of the Government’s ‘Transforming Community Equipment and Wheelchair
Services Programme’. Under the Retail Model, people who meet local eligibility criteria
are given a prescription (after an assessment) for a particular piece of equipment which
can be exchanged at any accredited retailer in their area or elsewhere. The equipment
belongs to the consumer who is likely to be responsible for its maintenance. The
Department of Health points out that the prescription only relates to simple equipment
which is unlikely to need to be maintained. People can also pay to ‘top up’ the
prescription in order to obtain a different model as long as it is functionally similar to the
one prescribed.
The Retail Model is now being rolled out across England. However, its adoption is
voluntary, and the decision is up to local authorities and health bodies at local level.
Where the Retail Model has not been introduced, existing local authority and NHS
arrangements continue, with the equipment provided on loan. It should also be noted that
the Retail Model only covers certain types of community equipment.
Under the Retail Model, accreditation and monitoring of retailers are carried out locally by
local authorities and NHS bodies. The intention is to ensure that retailers who are
accredited suppliers are able to meet core operating requirements and competencies,
such as the ability to display and demonstrate equipment, to fulfil prescriptions face to

face, and have customer-facing staff trained to a minimum level of competence.

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Originally the national Community Equipment Dispenser Accreditation Body (CEDAB)
carried out retailer accreditation but this arrangement was discontinued by the
Department of Health at the end of September 2009. It is understood that some local
authorities are using their Trading Standards teams to accredit local retailers.
The Department of Health does not collect information on how many retailers have
registered with local authorities and NHS bodies for the purpose of providing equipment.
Similarly, it has not collected information on the number of retailers who may have
received accreditation through the Community Equipment Dispensing Accreditation
Board. (Hansard parliamentary answer, Minister of State, 20 January 2010).

4.2

Self-funding and charities

It is possible for consumers to self-fund by purchasing assistive aids and equipment from
specialist shops, via the internet and mail order and, increasingly, from some generalist
retailers such as B&Q (it has a ‘Can Do’ product range) and the Southern Co-operative
(its ‘Xest’ products). Some equipment can also be purchased from charities such as the
British Red Cross.
Some private purchases are made without the person or their family having relevant
contact with NHS bodies, local authorities or specialist charities. For example, some
consumers may buy products like a simple electric can opener or riser chair. Or people
may buy equipment themselves because they do not meet local eligibility criteria for State

provision. Some may prefer to buy and own equipment rather than have a previouslyused product on loan. However, from the interviews conducted for this scoping study,
lack of consumer awareness of potential statutory assistance is also a factor that helps to
determine whether they purchase community equipment themselves.
It has not been possible to obtain definitive and reliable figures to show the importance of
self-funding of community equipment, relative to other channels of provision. This is
because of the lack of published data and the vast range of products within this sector.
The Department of Health estimates that there are at least seven million people who
would benefit from community equipment of which three million equipment service users
are supported by the State, leaving potentially at least four million people who, in theory,
could be self-funding.
It should be noted that the situation in some product areas is best characterised as being
a ‘mixed market’. For example, some more expensive lightweight models of powered
wheelchairs are not available through the NHS Wheelchair Services, or in all areas of the
country because of locally-determined budgets and eligibility criteria. Powered scooters
are not available at all through statutory provision. Consequently, self-funding may be the
only channel open to consumers, unless they can obtain help from a charity, or some
may be able to obtain powered wheelchairs and scooters on contract through the
Motability scheme (see section 5). Children and young people under 18 may be able to
obtain wheelchairs and scooters from charities such as Whizz-Kidz.
Overall, it is very likely that there is significant need for community and mobility
equipment which is currently unmet. An important factor is that many consumers try to
cope themselves or they may well not know what products are available – interviewees
frequently referred to the ‘low visibility’ of community equipment. There is a very limited
amount of publicly available consumer research in this area. However, a research study
by Years Ahead (which involved over 1,000 people for the Department of Health
Transforming Community Equipment programme) showed that, when asked how they
dealt with the effects of ageing, a majority of people – over 55 per cent – said they coped
by just struggling on, and the proportion was higher among those aged 70 plus.

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This was partly due to their determination to stay independent but lack of awareness of
what might help was also influential. 11
The above research found that less than 20 per cent of interviewees would
spontaneously think about acquiring a daily living product as a means of dealing with the
difficulties they experience. There can also be stigma associated with use of community
equipment: fear of being stigmatised and labelled loomed largest in the minds of nonpurchasers interviewed for this research.

11

Better living in the years ahead – executive summary’, Years Ahead, 2008

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5. Mobility equipment
5.1

Products, prices and market players

There is a wide and disparate range of what might be regarded as mobility aids or
equipment, from a simple walking stick to a standing frame, to a wheelchair or scooter.
Retail prices of mobility equipment can range very widely – see table for some examples
of the ranges of current prices.

Selection of products
Standing frames with manual or powered mechanism to assist user
into a standing position
4-wheeled rollators
Metal walking sticks
Children’s active user wheelchairs
Children’s indoor powered wheelchairs
Children's powered wheelchairs with stand up mechanism
Attendant propelled wheelchairs (11.5-15kg)

Price ranges
£1,578–£4,645
£60–£529
£5–£23
£995–£1,730
£2,200–£2,500
£8,500–£10,750
£99–£509

Rigid frame active user wheelchairs (11.5–15kg)

£795–£1,730

Folding frame active user wheelchairs (11.5–15kg)

£860–£1,450

User propelled wheelchair (15.5kg and above)
Class 2 indoor/outdoor powered wheelchairs
(capacity 126kg and below)

Powered wheelchairs with reclining backrest mechanism

£84–£3,875
£765 – 6,955
£3,465–£7,500

Class 2 four-wheeled scooters

£299–£3,495

Class 3 four-wheeled scooters

£649–£4,495

Off-road powered wheelchairs, scooters and buggies

£3,645–£10,000

Source: Disabled Living Foundation website

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According to figures obtained from the BHTA, the estimated annual sales value of
mobility products in the UK (largely but not only wheelchairs and scooters) is around
£200 million. There are other estimates from commercial market intelligence companies,
for example Keynote Ltd estimates that the financial value of the market for mobility
equipment in the UK totalled £501 million in 2008, of which: the wheelchair market

comprised £140 million; scooters – £81 million; and walkers and other equipment – £280
million. However, the BHTA figure is likely to offer more reliable data.
Assessing manufacturers’ shares of the mobility equipment market is highly problematic
because of the lack of commonly agreed definitions of the market sectors, and of publicly
available robust market intelligence. From interviews for this study, it appears that there
are a number of large global companies which are dominant as suppliers in the
wheelchair and scooter sectors (it is understood that most are imported). These include
companies such as Invacare, Sunrise Medical, Pride, and Days. The UK-based
organisation Remploy (which provides specialist employment services for disabled
people) is also understood to be an important supplier of manual wheelchairs.
Furthermore, there are a number of smaller companies, some of whom manufacture
niche products.
There are a number of specialist retailers of mobility equipment. For example, C F
Hewerdine Ltd is one of the major specialist companies in the wholesale and retail parts
of the supply chain (it also supplies significant numbers to the NHS). It states that it works
closely with a number of manufacturers like Sunrise, Invacare, Otto Bock, and Moving
People. These suppliers and manufacturers often characterise their products as ‘highend’ equipment, which is taken to mean more expensive, better designed or higherquality products. Hewerdine also has a single-supply contract with the national charity
Whizz-Kidz (see below).
Until recently, the retailers involved in mobility equipment consisted mainly of specialist
shops. However, some generalist retailers are now stocking these products. For instance,
Halfords has teamed up with Sunrise Medical, selling three or four types of scooters.
Argos and Asda are also moving into retailing mobility equipment to a limited degree, and
the Southern Co-operative offers a few simple wheelchair products (currently using the
products supplied by Mangar). Some Aldi stores reportedly stock a small range of simpler
wheelchairs.
It has not been possible within the constraints of this study to determine whether UK
prices for mobility equipment such as wheelchairs and scooters are unduly high,
particularly in comparison to other countries. Barriers include the lack of publicly available
data (including suppliers’ and retailers’ costs and profit margins), and the difficulties in
making price comparisons about what are often individually tailored products. Moreover,

international price comparisons would need to take into account local factors such as the
range and types of channels of provision in each country, domestic taxes etc.
However, a number of experts we interviewed expressed concerns about whether retail
prices of scooters and wheelchairs are warranted in comparison to manufacturers’ and
retailers’ costs. Such concerns were also expressed by some interviewees about
scooters in particular.

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5.2

Public provision

Public or statutory provision of wheelchairs is carried out in England through NHS
Wheelchair Services. Having had their health and social care needs assessed, people
are required to meet locally-set eligibility criteria to qualify for such provision. Wheelchairs
are provided on loan but many NHS Wheelchair Services offer ‘vouchers’, which
consumers can use to obtain a wheelchair direct from approved suppliers who have to
meet certain standards. The voucher scheme has a ‘partnership option’ whereby the
consumer can choose an alternative type of wheelchair. The voucher reflects the value of
the wheelchair originally recommended and the consumer pays any difference in cost.
The wheelchair will be repaired and maintained free of charge. Under the ‘independent
option’, the consumer owns the wheelchair and is responsible for repair and maintenance
but the voucher includes an amount towards these anticipated costs.
The Department of Health estimates that there are 1.2 million wheelchair users in
England (it is understood that the figure relates to users of Wheelchair Services). The
most recent figures relate to 2006/07 when there were about 900,000 people registered

as wheelchair users, according to Wheelchair Services (see below), and about 185,000
people being referred annually to these services.
In 2008 there were around 150 Wheelchair Services in England, although the number is
probably lower now. Finance for wheelchair provision comes from PCTs who commission
the services. Providers are part of NHS trusts, including acute hospitals and community
services, with a handful supplied by local authorities, third sector organisations and
private companies. In addition, wheelchairs are provided through services such as the
education service and the Department for Work and Pensions. Data collection is carried
out in different ways at local level, resulting in a lack of comparable and useful data.
A comprehensive review of wheelchair services in England in 2006, carried out by the
Care Improvement Services Partnership for the Department of Health (following previous
reviews of the services over a number of decades) found that: ‘Concerns about economy
rather than overall good value predominate. The consequences for individuals, families
and carers can be profound.’ 12 Fragmentation of services, commissioning and
purchasing was identified as a major difficulty. The review concluded that: ‘Technical
advances are also affected by this fragmented approach, since industry is not
encouraged to develop integral systems for environmental control, communication and
mobility.’
The review found that, compared to other countries, England spent less on wheelchairs,
and it highlighted the wide variation in ‘per head of population’ annual budget allocations
for wheelchairs and special seating across a sample of Wheelchair Services. There is no
ring fencing of PCT funds for wheelchairs and the allocation for wheelchairs is integrated
into overall local funding. The review highlighted how such services can be the target of
cost cutting, particularly due to the absence of national targets. The long-term and wider
benefits of providing an appropriate wheelchair were often lost in favour of short-term
financial savings. The review also found that some Wheelchair Services impose a ceiling
on the amount to be spent on one chair.
Our intervies suggest the landscape for NHS provision of this equipment continues to be
highly fragmented. There are reportedly significant disparities between areas in waiting
times for people to obtain wheelchairs. Some Wheelchair Services are also using

eligibility criteria as a form of gatekeeping to manage their budgets.

12

Out and about: Wheelchairs as part of a whole-systems approach to independence, Department
of Health, 2006

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Last year, the Muscular Dystrophy Campaign had to resort to the use of Freedom of
Information (FOI) requests to PCTs and other NHS Trusts to obtain information about
average waiting times for the provision of powered wheelchairs for disabled children. The
results of their FOI requests revealed an average waiting time of five months, with the
worst performing PCT-based wheelchair service having an average wait of two years.
The average NHS ‘spend’ (eg via a voucher) on a powered wheelchair for a child was no
more than about 15 per cent of the true cost of a suitable chair. 13
Design of NHS-provided wheelchairs continues to be a source of concern, according to a
number of interviewees. The 2006 review of wheelchair services, cited above, pointed out
how investment in a high-specification wheelchair can reduce health and social care
costs and improve independence and well-being. As NHS wheelchairs are loaned to the
user, the emphasis is often on sturdiness of design so that the chairs can be re-cycled
and re-used, rather than on meeting consumers’ needs which may be better met by
lightweight models.
‘I'm hoping to get an electric wheelchair, the NHS will not provide one as the criteria in my
area is that you have to be unable to walk one step (I can walk about 15 metres with
crutches) but without one I am a lot less independant because I can't propell my manual
chair easily on my own.

However I receive direct payments for care and most of these hours are actually because
I need help with someone to push my wheelchair. I was wondering if there's any way to
make the justification that it would save social services in the long term to use the money
for a powerchair and reduce some of my care hours if that makes sense?
I'm in the process of going through a charity attempting to fundraise for the wheelchair,
but they only have half the money (£2,000 out of £4,000) and I was thinking about other
possible contributors.
I remember reading of an example in the DOH report on wheelchair services that stated
the above, but have no idea where to start or if I'm actually in cloud cockoo land!
Any advice would be helpful!’
From livejournal online messageboard:
/>Due to increasing concerns over the adequacy of statutory wheelchair provision, the
Department of Health announced in March this year that it is setting up large-scale pilot
projects in the east and south west of England. A key part of the pilot will be setting
standards for delivering timely services. According to the Department,’Too often, people
who need a new service following a life change have to wait too long. This can cut them
off from society as well as exacerbating physical issues, resulting in a greater cost to the
NHS in the long term’. (Department of Health press release, 19 March 2010). The pilot is
intended to encourage local health trusts to work together, possibly combining their
spending power to get better value for money from wheelchair suppliers, and also aims to
integrate wheelchair support with other services.
The Department of Health is particularly concerned that the NHS is failing to benefit from
its purchasing power as NHS purchasing is highly fragmented and there are few
economies of scale.

13

Equipment shortfall: How disabled children are being failed, Muscular Dystrophy Campaign,
2009

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Consequently the Department of Health considers that procurement practices need to
change. It is keen to encourage collaboration in commissioning at local level to drive
down the costs of the equipment and avoid duplication of associated running costs. The
Department of Health also states that its aim is to achieve better outcomes for users,
rather than making savings.

5.3

Mixed provision

From the interviews for this report and published material, it is clear that charities are an
important source of help for people needing mobility equipment, particularly those who
are dissatisfied with equipment offered by statutory Wheelchair Services and/or can’t
afford private purchases. These include the British Red Cross among others.
For disabled children and young people, in particular, timely access to suitable products,
especially perhaps mobility products, could set the trajectory for the rest of their lives. For
instance, proper wheelchair and suitable seating not only brings physical benefits but also
a vast increase in the likelihood of a child attending a mainstream school, and being able
to join in social activities with their peers. Therefore having enough choice in order to
obtain a product that is truly ‘fit for purpose’ may be absolutely crucial.
The national charity, Whizz-Kidz, is reportedly the biggest provider of mobility equipment
to children and young people up to 18 years of age, after the NHS. It provides powered
and lightweight manual wheelchairs, tricycles and other mobility equipment. The charity
has mobility therapists across the UK who carry out individual assessments. There is no
means-testing for provision of the equipment, and their assessments consider children’s

whole lifestyle needs, including how equipment may benefit them at home and school
and to be more independent generally.
Whizz-Kidz relies on voluntary funds to finance equipment for each child or young
person. According to the organisation, local wheelchair, social or education services
rarely help with joint funding and other funding sources are explored, including other
charities. The majority of beneficiaries are in low income families and therefore few are
able to make a financial contribution themselves.
Whizz-Kidz says that it is able to drive down prices of mobility equipment by purchasing
nationally in bulk. It is trying to shake up the market, drive down prices, cut waiting times
and achieve design improvements. However, there is a risk that PCTs will direct people
to Whizz-Kidz as an alternative to NHS provision, particularly with the pressures on NHS
budgets, and this may already be happening in some areas. 14
Lauren, aged 14, is unable to walk and has to rely on a powered wheelchair to get
around. She found dealing with the NHS very frustrating as the application process took
so long that by the time she got a wheelchair it no longer fitted her. Lauren’s family
applied to Whizz-Kidz who provided a powered wheelchair with many features that have
really made a difference to her life. She can take part in everything at school, and the
riser means she can reach the various heights of the desks.
www.whizz-kidz.org.uk
For adults who receive the higher rate mobility component of the Disability Living
Allowance (or the War Pensioners’ Mobility Supplement), they can use this allowance to
lease a new scooter or powered wheelchair on contract from Motability and, at present, a
hire purchase scheme is also available.
14

At the time of writing, the Government was seeking to improve wheelchair services for disabled
children through the Department for Children, Schools and Families’ ‘Aiming High for Disabled
Children’ programme

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