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

Community Equipment –Community Equipment –A case study.A case study.

Peter GagePeter Gage

Clinical Service ManagerClinical Service Manager

Mid & West Essex Wheelchair Mid & West Essex Wheelchair ServicesServices

• 2 Wheelchair centres – 25 miles apart2 Wheelchair centres – 25 miles apart

• 12,000 Wheelchair users.12,000 Wheelchair users.

• Contracted out repairs & maintenanceContracted out repairs & maintenance

• Engineering audits & PPM audits carried Engineering audits & PPM audits carried out annually.out annually.

BackgroundBackground

Different Manufacturer but this style of Different Manufacturer but this style of

Attendant pushed WheelchairAttendant pushed Wheelchair

Relationship with ManufacturerRelationship 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 Purchasing this model for 5 years before event.event.

However:However:

• Handbook recommends 6 monthly inspection.Handbook recommends 6 monthly inspection.

• Year 2000. Trust begins 24 monthly PPMsYear 2000. Trust begins 24 monthly PPMs

• Manufacturers approval of our maintenance Manufacturers approval of our maintenance scheduling.scheduling.

• Question 1.Question 1.

• Was it a reasonable cost/benefit Was it a reasonable cost/benefit judgement to have a maintenance judgement to have a maintenance variation understanding with the variation understanding with the manufacturer? 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.

The StoryThe Story

• Chair supplied on 8Chair supplied on 8thth July 2003 (PDI check) July 2003 (PDI check)• Delivered to client 19thJuly 2003Delivered to client 19thJuly 2003• Failed PPM attempt Oct. 2004Failed PPM attempt Oct. 2004• Brake adjustment Jan 2005 – No PPM done.Brake adjustment Jan 2005 – No PPM done.• Dec 2005. Technical Bulletin emphasising 6 Dec 2005. Technical Bulletin emphasising 6

monthly PPM intervals.monthly PPM intervals.• Feb 2006. Technical Bulletin stating upgrade Feb 2006. Technical Bulletin stating upgrade

castors/wheels/brakes then 60 month intervals.castors/wheels/brakes then 60 month intervals.• Advisory: Service intervals relate to client Advisory: Service intervals relate to client

usage.usage.

• Question 2.Question 2.

• Should the manufacturers have funded Should the manufacturers have funded the equipment upgrades to support the equipment upgrades to support the 24 month servicing schedule?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.

The EventThe Event

• Rear wheel falls off while being Rear wheel falls off while being pushed.pushed.

• Occupant OK uninjured.Occupant OK uninjured.

• Carer sustains knee injury supporting Carer sustains knee injury supporting client.client.

• Surgery fails & has to be re operated.Surgery fails & has to be re operated.

• 12 months off work – Injury claim/ 12 months off work – Injury claim/ Ongoing.Ongoing.

• Question 3Question 3

• Could the wheelchair user be Could the wheelchair user be responsible for initiating a free service?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.

What changes have we What changes have we made to maintenance made to maintenance

systems ?systems ?

• Cost /Benefit analysis regarding the Cost /Benefit analysis regarding the upgrades.upgrades.

• Initiated professionally assessed scoring Initiated professionally assessed scoring criteria to be completed at assessment. - criteria to be completed at assessment. - ODPMODPM Objectively Directed Preventative Objectively Directed Preventative Maintenance.Maintenance.

• Introducing a client review at the same visit.Introducing a client review at the same visit.

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