Wheelchair and Community Equipment Strategy

Lord Hunt of Kings Heath Excerpts

Thursday 11th December 2025 Lords Chamber

Asked by

[Lord Hunt of Kings Heath]

To ask His Majesty’s Government what plans they have to publish a strategy for ensuring high-quality and equitable wheelchair and community equipment provision by NHS and social care services.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very grateful to all noble Lords who are taking part in the debate. I particularly welcome the noble Baroness, Lady Gerada, who is making her maiden speech. She has been an absolutely brilliant president and chair of the Royal College of GPs, but more than that, she has been an excellent GP and brilliant champion of primary care and the NHS. It is a pleasure to welcome her to this debate. I should inform the House of my patronage of the Wheelchair Alliance and the Health Care Supply Association, and my daughter Phillipa works for Back Up, which supports people with spinal injury.

The provision of wheelchairs and community equipment for disabled people is, to put it bluntly, a disgrace. The nub of the problem was described in the Guardian on 2 December by the distinguished academic Dr Paul Sagar. He was paralysed in a climbing accident and described how inconsiderate, illogical and incompetent many of the current wheelchair providers are. He talked about the bureaucratic barriers, organisational inflexibilities and patchiness of the services he encountered. Particularly telling for me were the words he quoted of a physiotherapist who has been working with people with spinal cord injuries for more than 20 years. He said:

“Many of her clients are discharged from hospital in heavy manual wheelchairs that an able-bodied person would struggle to push. Frequently, they are the wrong type or size, and are at the very least uncomfortable. ‘Often,’ she said, ‘people who have impaired function in their upper limbs cannot push these wheelchairs themselves, and become effectively housebound, in some cases confined to their bed. Sometimes, they develop complications from poorly prescribed wheelchairs, and it lands them back in hospital’. On average, she adds, people have to wait at least 10 months between being discharged and being assessed, let alone getting the wheelchair that is right for them”.


Unbelievably, some local wheelchair services refuse to assess a patient until they have left hospital. So much for integrated care, which I thought integrated care boards were established to achieve.

Dr Sagar’s experience is not unusual, of course. The Wheelchair Alliance has produced convincing evidence to show how inconsistent and under-resourced wheelchair services are. Over 50% of providers come from the private sector and there are real worries regarding the financial frailty of many of them, with a system that prioritises lowest initial cost over long-term value and reliability. There are no consistent national standards, no independent regulation and few clear paths for users seeking repairs, reporting faults or making complaints. As a result, many disabled people experience long waiting times, delays in hospital discharge, loss of independence, social isolation and, tragically, avoidable deterioration in health and well-being.

It is the same dismal picture with community equipment, embracing hoists, grab rails, harnesses, medical beds and a wide range of essential medical products. The All-Party Group for Access to Disability Equipment recently reported on the systemic crisis in this sector, saying that 63% of carers and 55% of equipment users feel that services are getting worse, not better. The all-party group concluded that the system is inconsistent, under-invested, fragmented and lacking leadership.

The Government state that at present, local authorities and integrated care boards share responsibility for community equipment. In practice, this means fragmented and inconsistent delivery. Equipment providers describe a landscape in which “every authority works differently,” without alignment or accountability. The consequence is a postcode lottery, with 74% of equipment providers being aware of patients experiencing delayed hospital discharge due to unavailable community equipment. I would argue—and I am looking forward to the speech of the noble Baroness, Lady Brinton, on this—that community equipment is the silent crisis at the root of the challenges we face in providing community and social care. The tragedy is that it would be so easy to sort this out if there were a will to do it.

In April, the Government published the Wheelchair Quality Framework to assist integrated care boards and wheelchair service providers to deliver high-quality provision. I have read it and it is welcome, but the problem is that, first, it is guidance. It lacks binding universal standards, does not guarantee equitable provision across the whole country and does not address systemic underinvestment. It does not mandate robust data reporting. It lacks external oversight or performance management, so there is no statutory, legally guaranteed entitlement ensuring that every person in need receives the right wheelchair or community equipment in a timely fashion.

What is required? I am absolutely convinced that we need a national strategy, underpinned by the appointment of a national clinical director accountable to Ministers and backed up by strong performance management. The remit of the director should embrace community equipment as well as wheelchairs. This needs to be underpinned by a vision—a national, comprehensive vision of what high-quality wheelchair and community equipment provision should look like. The Government should embrace the report by the All-Party Group for Access to Disability Equipment by introducing a dedicated national strategy for community equipment and wheelchair provision. Users must be around the top table with a real input into policy.

We need a nationally defined eligibility and quality standard for wheelchairs and community equipment that is uniform across all regions and removes the current postcode lottery; a legally guaranteed entitlement to appropriate equipment for all those assessed as needing it; a long-term funding model that accounts for the rising costs of equipment, manufacturing, maintenance, energy, staff and supply chain resilience; and a simple, user-friendly service for wheelchair users and carers to report issues, request repairs, make complaints, give feedback and be heard. We need to shift from lowest-cost procurement to value-based procurement. This is happening in general in procurement and ought to be extended to wheelchairs and community equipment. For community equipment, we need national training standards for clinicians, commissioners, OTs and other professionals and suppliers involved in equipment provision.

I do not think anyone in this debate will argue that wheelchair and community equipment is absolutely woeful. The tragedy, as I have said before, is that it would be so easily sorted if the Government were prepared to say that they will do what I have suggested and have national leadership. So many of the issues and blockages in community care would be dealt with if this were really taken seriously. We all know what happens: neither the NHS nor local authorities regard it as at all serious, and many people suffer as a result.