What is short-term will be able to provide equipment to receive longer-term provision wheelchair loan and on a temporary loan” (National from the NHS. While some people why is it important? Wheelchair Managers Forum, borrow a wheelchair to facilitate 2013a). The guide advises people to their participation in social activities, contact their local NHS wheelchair such as attending events, groups service to be signposted to other and classes, the negative impact of “Not simply a piece of organisations that might be able to social isolation on physical health is 6 medical equipment, but provide short-term loans, citing the well proven and worth preventing. often essential to all Red Cross and St. John’s Ambulance By meeting the need for short-term aspects of a person’s life” as examples. The corresponding wheelchair loans, the Red Cross online version of Frequently Asked enables people with mobility issues to (NHSIQ, 2014: 37). Questions reiterates this advice, with be discharged from hospital; maintain the additional suggestion to “try these their independence at home; attend links”, beneath which is a single link hospital appointments, school or According to NHS best estimates, to the Red Cross independent living work; maintain their dignity at the there are 1.2 million wheelchair users page (National Wheelchair Managers end of life; and participate in family in the UK, two-thirds of whom use Forum, 2013b). and social activities from which their wheelchairs regularly (NHSIQ, While ‘short-term’ is generally used they would otherwise be excluded 5 2014). Wheelchairs are recognised to refer to a period of six months or (Gardiner and Kutchinsky, 2013). by the NHS to be “not simply a piece less, the distinction between short- of medical equipment, but often term and long-term provision is In addition to the challenge of essential to all aspects of a person’s blurred and contentious, providing accessing short-term wheelchair life” (NHSIQ, 2014: 37). The NHS another barrier to provision. As provision highlighted above, the makes a distinction between short- identified in the Red Cross report NHS E-digest further identifies eight term and longer-term provision of by Gardner and Kutchinsky (2013), issues around the acquisition of wheelchairs. ‘Short-term’ is generally A Prisoner at Home, and despite wheelchairs for longer-term use. Two used to refer to a period of six months recognition by the NHS that a of these are especially relevant to or less. NHS wheelchair services wheelchair is “not simply a piece considerations around short-term are focused primarily on longer-term of medical equipment, but is often wheelchair provision: “unacceptable provision: “wheelchair services are essential to all aspects of a person’s waiting times for assessment and available to people of all ages who life” (NHSIQ, 2014: 37), short-term repairs” and “need for consistently have a long-term need for mobility wheelchair use is associated with applied eligibility criteria” (NHSIQ, help” (NHS, 2015). Local eligibility meeting social needs. The report 2014). The former is relevant criteria and thresholds for longer-term includes findings from a Red because unacceptable waiting provision can “vary depending on Cross survey of NHS wheelchair times for long-term wheelchair where [one lives]” (NHS, 2015). service managers. The majority of loans create demand for short- managers reported the main reason term loans. The latter is important Individuals can apply to the NHS because, in most areas, eligibility for short-term wheelchair loans for short-term wheelchair loans not criteria do not incorporate short-term after being discharged from being provided by the NHS is that needs, resulting in patchy provision hospital following, for example, an short-term need is a social need, and variation in the corresponding accident or injury. However, a study rather than a clinical one (Gardiner entitlements of individuals. conducted by the Red Cross found and Kutchinsky, 2013). The NHS is that 127 out of 151 NHS wheelchair unambiguous that the “wheelchair Although the Red Cross loaned services would not provide a service will not provide a wheelchair 83,000 wheelchairs last year, we wheelchair for short-term use. if it is only required for day trips or know that there remains unmet need Those that did provide short-term outings” (NHS, 2015). for short-term wheelchair loans, wheelchair loans almost always did Yet the majority of people who particularly in London, where there so in instances of terminal illness use the Red Cross wheelchair is currently no Red Cross wheelchair 7 (Gardiner and Kutchinsky, 2013). loan service are referred by health service provision. In A Guide to NHS Wheelchair professionals (hospital staff, 6 A Brigham Young University study found “that Services, the NHS recognises that “it therapists and GPs) for reasons such individuals who were socially isolated, lonely or as recovering from fractured limbs, living alone at study initiation were more likely is unlikely an NHS Wheelchair Service to be deceased at the follow-up, regardless the fluctuation or deterioration of of participants’ age or socioeconomic status, long-term conditions, and end-of- length of the follow-up, and type of covariates 5 The British Red Cross has previously identified accounted for in the adjusted models” (Holt- that this figure was a result of 91 completed life needs (Gardiner and Kutchinsky, Lunstad, et al., 2015: 233). The same authors questionnaires conducted by the NHS 2013), as well as associated reasons identify that substantial research “has also Purchasing and Supplies Agency 14 years ago. elucidated the psychological, behavioural and Consequently, the data is insufficiently robust such as attending appointments biological pathways by which social isolation to provide an accurate estimate and the actual for those with limited mobility. and loneliness lead to poorer health and figure is likely to have changed with an annual decreased longevity” (ibid: 235). population growth of 0.8%, improved neonatal Some of the people who use our 7 We plan to reintroduce a mobility aids service care and increased life expectancy (Gardiner wheelchair loan service are waiting in London in 2016, or – if funds permit – late in and Kutchinsky, 2013: 6). 2015. 3