Wheelchair and Community Equipment Strategy

Lord Blencathra Excerpts

Thursday 11th December 2025 Lords Chamber

[Lord Blencathra (Con)]

My Lords, I am delighted to be the first Conservative to congratulate the noble Baroness, Lady Gerada, on an excellent maiden speech, as one would expect from such a distinguished doctor. How wise of her to speak today and not step into the maelstrom of assisted dying tomorrow—although there will be plenty more days and opportunities for her to give a view on that as a distinguished former president of the Royal College of General Practitioners. We shall also expect her to singlehandedly save the NHS and solve the serious problems of general practice moving patients into hospital care. We all look forward to hearing from her again.

I also congratulate the noble Lord, Lord Hunt of Kings Heath, on securing this debate and on his excellent contribution. NHS wheelchair provision has been widely criticised for inconsistency, long delays and poor suitability of equipment. Costs are driven up by inefficiencies and the false economy of supplying inadequate wheelchairs. A cost-effective strategy would focus on standardising services, improving assessments and investing in fit-for-purpose equipment to reduce downstream health and social costs.

What are the key criticisms of NHS wheelchair provision? First, it is a postcode lottery, as services vary significantly across regions, leading to inequitable access. Secondly, there are long waiting times. Delays in assessment and delivery leave users without mobility support for months. Third is the poor suitability of equipment. Many wheelchairs provided are heavy, cumbersome or not tailored to users’ daily lives, forcing some to buy their own. Fourthly, there is limited user involvement. Assessments often fail to consider lifestyle needs, reducing independence and social participation. Fifthly, standards are inconsistent. NHS England acknowledges variation in service quality and outcomes. Putting it simply, NHS wheelchairs are dirt cheap and for that you get big, heavy, ugly things which appal young people who may need to use them. The wheels may not detach. Car transport can be difficult, if not impossible.

Noble Lords have seen my sophisticated wheelchair parked around the corner. It is similar to that of the noble Baroness, Lady Brinton. However, these wheelchairs are of a 10 year-old design. They are on a solid steel frame and very heavy, no doubt designed for 40 to 50 stone Americans. A replacement these days would be lightweight aluminium. Lightweight aluminium wheelchairs have been taking over the scene in the last few years. That is what people want and need, but there is a higher cost.

That cost could be contained if there was a national NHS strategy. First, it would standardise provision nationally, implement the NHS wheelchair quality framework across all ICBs to reduce variation, and appoint a senior NHS England lead to oversee wheelchair services. Secondly, it would improve assessments and user involvement, ensuring that assessments consider lifestyle, employment and education needs rather than just the medical factors, and co-design services with wheelchair users to avoid unsuitable provision. Thirdly, it must invest in fit-for-purpose equipment, providing wheelchairs that meet individual needs, reducing downstream costs from poor health outcomes as they get worse in the future with bad wheelchairs, and expand personal health budgets to allow choice and flexibility. Fourthly, it must streamline procurement and maintenance, centralising purchasing to leverage economies of scale and introducing rapid response maintenance contracts to minimise downtime. Fifthly and finally, it must measure outcomes, not just costs, tracking independence, employment and health outcomes as key performance indicators—the value added—and using data to demonstrate long-term savings from better provision.

While upfront costs of better equipment and services may rise, the long-term savings in health, social care and productivity would make this a cost-effective strategy. Standardisation, user-centred assessments and investment in suitable wheelchairs are the most impactful reforms. I beg your Lordships to support this.