Most recently, throughout the Care that is written into primary legislation “the Act…signifies a shift Bill debate in 2013, wheelchairs were – resonates with the NHS’s from existing duties on discussed on only four occasions, recognition that a wheelchair is “not local authorities to provide each time within the House of simply a piece of medical equipment, particular services, to the Lords, and on only one of these four but often essential to all aspects of a occasions were wheelchair services person’s life” (NHSIQ, 2014: 37): concept of ‘meeting needs’ referenced and identified as requiring 2. “Wellbeing [refers to:] (set out in sections 8 and improvement (HL Deb, 2013-14: 745 18–20 of the Act). This is col. 818). The Care Act 2014 itself does (a) personal dignity (including the core legal entitlement not discuss wheelchairs; however the treatment of the individual for adults to care and statutory guidance recognises the with respect); support, establishing one provision of short-term wheelchair (b) physical and mental health loans as an example of a secondary and emotional wellbeing; clear and consistent set preventative service (Department of duties and power for all of Health, DH, 2014a: 9). This (c) protection from abuse and people who need care and acknowledges the preventative value neglect; support.” of short-term wheelchair loans, but (d) control by the individual over does not create a duty to provide them day-to-day life (including or an entitlement to receive them. over care and support, or According to a legal analysis Currently, the two most significant support, provided to the commissioned by the Red Cross sources of health and social care individual and the way in 9 policy are the Care Act 2014 and its which it is provided); (Knight, 2014), the responsibility of local authorities to provide supporting guidance, and the NHS (e) participation in work, wheelchairs also lacks clarity. Where Five Year Forward View (5YFV; NHS, education, training or an individual is “substantially and 2014). The former represents the recreation; permanently disabled”, under the largest and most comprehensive National Assistance Act 1948 (section transformation of adult social care (f) social and economic 29(1)), a local authority is obliged since 1948; the latter presents a wellbeing; to provide welfare services in order compelling vision of NHS reform. (g) domestic, family and to meet the individual’s needs, The Care Act and the 5YFV share a personal relationships; including through the provision of number of priorities that make this an “practical assistance for that person opportune time for local authorities, (h) the individual’s contribution to in his home” or “the provision of the NHS and the voluntary sector society” (Care Act, 2014: 1). any additional facilities designed to to work together to ‘put the wheels The 5YFV identifies promoting secure his greater safety, comfort or in motion’ and deliver this report’s wellbeing and preventing ill health convenience”, as found in sections recommendations (see Section 4). as the main goals of the NHS 2(1)(a) and (e) of the Chronically Sick These shared priorities of wellbeing, and Disabled Persons Act 1970. integration and prevention are However, because most people who explored below. need short-term wheelchair loan Wellbeing “The concept of ‘meeting will not conform to these stringent The Care Act 2014 reframes the social needs’ recognises that criteria, local authorities, according care responsibilities and activities of everyone’s needs are to the 1970 Act, will not be obliged to local authorities within the concept of different and personal to provide one. promoting individual wellbeing (Care them. Local authorities While there are many powers Act, 2014: 1). The statutory guidance must consider how to that might be said to enable a is clear that “the core purpose of meet each person’s local authority to make short-term adult care and support is to help specific needs rather wheelchair loan available (Section 29 people to achieve the outcomes that than simply considering of the 1948 Act and Section 45 of matter to them in their life…local what service they will fit the Health Service and Public Health authorities must promote wellbeing Act, 1968, in relation to older people; when carrying out any of their care into. The concept…also and Section 3 of the Carers (Equal and support functions in respect of recognises that modern 10 Opportunities) Act 2004 ) there is no a person (DH, 2014a: 1; bold and care and support can be statutory duty requiring them to do so underline in the original). provided in any number (Knight, 2014). Despite short-term wheelchair loans of ways, with new models 9 Prior to the Care Act coming into force on 1st being omitted from the legislation, emerging all the time….” April 2015. the Care Act’s new framework of (DH 2014a: 2). 10 This duty might require a local authority to promoting individual wellbeing – request a wheelchair is provided to a disabled including the definition of ‘wellbeing’ person to ease the burden on a carer. 5