- NHS England failed to meet its 18 week waiting time target
- “Postcode lottery” gap between best and worst performing CCG
- Charity said delays “affecting some of the most vulnerable disabled children in society”
Thousands of disabled children who need a wheelchair are still being forced to wait more than four months from the time of their referral to the equipment being delivered, an exclusive HSJ analysis of official data has revealed.
NHS England statistics, branded “alarming” by campaigners, show local commissioners made only marginal progress against the 18 week waiting time standard last year, with the target being missed in more than 5,100 cases.
Around 82 per cent of eligible children received a wheelchair within 18 weeks in 2017-18, against a target of 92 per cent, according to the recently published official data.
This was a slight improvement from 81 per cent in the previous year, but suggests local commissioners will find it difficult to meet NHS England’s more ambitious target, of 100 per cent, by the end of 2018-19.
Analysis of the data by HSJ also found wide variation between the best and worst performing clinical commissioning groups.
Around 20 CCGs missed the target in more than half of the cases, compared to 10 in the previous year.
Worst performing CCGs in 2017-18
|CCG Name||Number of children waiting >18 weeks||Performance against 18 week target|
|NHS KINGSTON CCG*||1||0%|
|NHS DARLINGTON CCG||44||27%|
|NHS ROTHERHAM CCG||127||32%|
|NHS PORTSMOUTH CCG||39||34%|
|NHS SOUTH LINCOLNSHIRE CCG||68||34%|
|NHS WEST HAMPSHIRE CCG||143||35%|
|NHS SOUTHAMPTON CCG||81||35%|
|NHS WEST SUFFOLK CCG||44||35%|
|NHS LINCOLNSHIRE EAST CCG||76||37%|
|NHS FAREHAM AND GOSPORT CCG||52||40%|
|NHS GREATER HUDDERSFIELD CCG||62||41%|
|NHS SOUTH WEST LINCOLNSHIRE CCG||68||43%|
|NHS CALDERDALE CCG||73||45%|
|NHS NORTH DURHAM CCG||21||45%|
|NHS LINCOLNSHIRE WEST CCG||126||45%|
|NHS SOUTH EASTERN HAMPSHIRE CCG||39||46%|
|NHS HOUNSLOW CCG||52||49%|
|NHS ISLE OF WIGHT CCG||18||49%|
* due to the low volume of children assessed under Kingston CCG, HSJ excluded this result when discussing postcode variation
Twelve CCGs achieved 100 per cent against the target last year, compared to just five in 2016-17 (see table below).
This variation conflicts with the NHS wheelchair charter, drawn up by campaigners in 2014 and later adopted by NHS England. It says access and provision should be equal for all “irrespective of age or postcode”.
The data also showed that children with high or specialist needs waited longer for wheelchairs in 2017-18 than they did in 2016-17.
Dave Bracher, campaigns manager at the Spinal Injuries Association, said: “These alarming statistics show a continued widespread postcode lottery that is affecting some of the most vulnerable disabled children in society, including those with spinal cord injuries.
“These delays inevitably affect a child’s rehabilitation and daily life – such as attending school, contributing to family, and being with friends and therefore has significant long term consequences”.
NHS England began collecting performance data against the 18 week target for the first time in 2016-17, and began regulating CCGs against the target in 2017-18. It said it wanted the target to be met in all cases by the end of the current financial year.
A spokeswoman for NHS Clinical Commissioners said its guidance had sought to improve outcomes for patients needing wheelchairs “within the current financial context and demand pressures they are facing”.
Dame Tanni Grey-Thompson, the former Paralympian who campaigned for NHS England to adopt the wheelchair charter, told HSJ that its adoption had been a “big step forward”.
But she said she wanted to see “big improvement” in relation to access and added: “If a child doesn’t have the right chair it means they cannot go to school, it means children are harder to handle for parents, it means potentially more respite care.”
HSJ approached the worst performing CCGs, who said they were working with providers to improve performance. Ipswich, East Suffolk and West Suffolk CCGs said performance had recently hit 100 per cent in the current year.
An NHS England spokesman said: “The new target has been introduced to drive improvements in access to and availability of wheelchairs for children across every part of the country, however there will be cases for example where children chose bespoke wheelchairs which may take longer to arrive.”
New personal wheelchair budgets are also being introduced to give people greater choice of wheelchairs and service providers.
Children with high or specialist needs waited longer for wheelchairs in 2017-18 then they did in the year prior, HSJ analysis also showed.
Over 4,200 children, two fifths of all those with high needs requiring wheelchairs, had to wait more than nine weeks in 2017-18 to receive their wheelchair once their needs had been assessed – a rise of around 6 per cent compared to the year prior.
Another 5,105 children waited more than nine weeks for their specialist prescription to be signed off once they had been referred to a wheelchair service. This amounted to 36 per cent of all children with high and specialist needs who applied for a chair – a figure that had not improved since 2016-17.
Best performing CCGs in 2017-18
|CCG Name||Number of children waiting >18 wks||Performance against 18 week target|
|NHS AYLESBURY VALE CCG||0||100%|
|NHS HARINGEY CCG||0||100%|
|NHS HEREFORDSHIRE CCG||0||100%|
|NHS MERTON CCG||0||100%|
|NHS RICHMOND CCG||0||100%|
|NHS SOUTH TYNESIDE CCG||0||100%|
|NHS SUTTON CCG||0||100%|
|NHS WALTHAM FOREST CCG||0||100%|
|NHS WEST LANCASHIRE CCG||0||100%|
|NHS WEST NORFOLK CCG||0||100%|
|NHS WYRE FOREST CCG||0||100%|
All quarters from and inclusive 2016-17 to 2017-18
- Children's services
- Commissioning support
- Equality and diversity
- Finance and efficiency
- Health inequalities
- NHS Calderdale CCG
- NHS Darlington CCG
- NHS Fareham and Gosport CCG
- NHS Greater Huddersfield CCG
- NHS Haringey CCG
- NHS Herefordshire CCG
- NHS Hounslow CCG
- NHS Kingston CCG
- NHS Lincolnshire East CCG
- NHS Lincolnshire West CCG
- NHS Merton CCG
- NHS North Durham CCG
- NHS Portsmouth CCG
- NHS Richmond CCG
- NHS Rotherham CCG
- NHS South Eastern Hampshire CCG
- NHS South Lincolnshire CCG
- NHS South Tyneside CCG
- NHS South West Lincolnshire CCG
- NHS South Worcestershire CCG
- NHS Southampton CCG
- NHS Sutton CCG
- NHS Waltham Forest CCG
- NHS West Hampshire CCG
- NHS West Lancashire CCG
- NHS West Norfolk CCG
- NHS West Suffolk CCG
- NHS Wyre Forest CCG
- Policy and regulation