Published: 27/06/2002, Volume II2, No. 5811 Page 21
Ask frontline NHS staff what would most improve services to elderly and disabled patients and many would say greater availability of good-quality equipment. An Audit Commission report (news focus, page 18) on the failings in this area describes 'the vicious circle' into which equipment services are locked.
Most users are grateful for the poor-quality service they receive at the moment which, unfortunately but understandably, leads commissioners to neglect equipment services.
Funding is then diverted to other priorities and commissioning maintains the status quo.
An under-managed, under-resourced service is delivered, which means low profit margins for the supply industry and little incentive for research or for new firms to enter the market. The result is lack of creativity in service delivery and so the wheel turns again.
The report makes sensible recommendations about maximising the advantages that come from developing larger centres of operation, but it is another conclusion which, if followed, would have the greatest long-term impact. The commission calls for 'a national focus on services that are designed to support independence such as is available in Scandinavia and the US'. The Department of Health is pretty keen to pick up on ideas from these sources, so it should take up the report's recommendation to sponsor 'a national organisation' to develop good practice and raise profile. Without this national champion, equipment supply is likely to go on being a Cinderella service and, unwittingly, contributing significantly to core problems like delayed discharge.
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