HNY Policy and Pathway Repository - Humber

There are a multitude of devices which can be classified as equipment or medical devices. The primary route for provision being through the community equipment service. There may however be items which are outside the scope of the community equipment service and should be directed through alternative routes. The hierarchy of access is listed below.

NRS Healthcare: Commissioned Community Care Equipment and Integrated Wheelchair Service

The Community Care Equipment and Integrated Wheelchair Service should be considered in the first instance for the provision of medical devices. The Service has a core element for the provision of equipment and wheelchairs into community settings, however there are non-core elements which have developed over time.

Core Equipment

Community Care Equipment such as: mobility equipment (walking sticks), small items (Perching stools), nursing equipment (beds and pressure mattresses) and manual handling equipment (hoists) are available. Access is via authorised prescribers such as district nurses, occupational therapists, physiotherapists who each have different prescriber rights depending on their training and clinical role.

2016.03.02_CCES policy for prescribers

2016.06.20_Hull CCES Catalogue and Eligibility Criteria

Non-core Equipment

There are separate arrangements for access to community care equipment or medical devices in other settings:

Care Homes

There is an equipment and wheelchair into care homes policy which establishes what equipment is available through the service and what should be funded by the care home.

2016.08.23_Community Care Equipment Service

Schools

The majority of equipment provided into schools is funded by education. A budget has been allocated to NRS for the provision of equipment into schools. Access is via the Paediatric Therapy Team with the referral form available on the repository. 

Medical Devices

Arrangements are in place to provide limited types of miscellaneous medical devices such as suction machines and pulse oximeters to be provided through NRS Healthcare. Access is via authorised prescribers such as Community Physiotherapists and Nurses 01482 336505.

Wheelchairs

Please see: Integrated Wheelchair Service section on the repository.

NRS are commissioned to deliver the provision and assessment of wheelchairs for patients of all ages. There is a range of wheelchairs dependant on clinical needs. Access is via a referral to the NRS wheelchair therapists or trusted assessors.

2016.03.30_Hull NRS Wheelchair Service - Eligibility Criteria

Referral form on ARDENS

Alternative/ Augmented Communication Devices

Alternative and Augmented Communication devices (AAC) is the term used to describe various methods of communication that can ‘add-on’ to speech and are used to get around problems with ordinary speech. AAC includes simple systems such as pictures, gestures and pointing, as well as more complex techniques involving powerful computer technology.

NHS England commission regional “specialised commissioning” services. The Yorkshire and Humber service is provided by Barnsley Hospitals Trust. The general criteria being the requirement for a specialist device which cannot be controlled via a direct interface e.g. a switch is required such as eye gaze.

We are in the process of changing the pathway from the IFR Panel to the NRS Specials Panel. We will confirm when the change has occurred, until this point continue to utilise the IFR Process.

Referral Criteria Document Final V0.4

Decision Chart V4.1

Orthotics

Orthotics is a specialist medical discipline in which external orthoses or braces and supports are designed and fitted to an individual’s requirement. There is not an exhaustive list of provision however examples include foot orthotics, spinal brace, knee brace, splints and helmets. There are two services in Hull - paediatric therapy service providing the service for children on their case load and the HEYHT orthotics service who accept direct referrals from GPs and Community providers, for patients that do not need to be seen by a consultant. 

The Healthshare Hull MSK Service will provide orthotic consumables (including assessment and fitting) such as: heel wedges, metatarsal pads, insoles, back/spine braces and supports, wrist/hand supports, arm/elbow/shoulder supports and claps, foot/ankle and knee support and braces.

https://portal.yhcs.org.uk/group/hull-ccg/msk

Referral form on ARDENS

Administration and prescribing recommendations will only be made by suitably qualified medical/non-medical independent prescribers.

Consumables

There are a range of consumables items which are associated with medical devices. Where these are not available via a prescription, access is via the community nursing service. These include syringe equipment for PEG feeding and cannulas for suction devices. This provision is currently being reviewed by the CCG.

Self-fund

There are some items of equipment which are not usually available through either health or social care funding routes. These items are generally commercially available items which are considered to be the responsibility of the individual to fund. These items are usually low cost or can be considered a want rather than a need.

Examples include; car seats, buggies (excluding children under 36 months who have significant postural and mobility needs that cannot be met by commercially available buggies), built up/adapted cutlery, double handed cups/mugs, non-spill cups, plate guards, light weight kettles, one touch powered can openers, instant hot water dispensers etc.

IFR- Individual Funding Request

Hull CCG is responsible for commissioning non-routine treatment for the Hull registered population. An Individual Funding Request is a request to the CCG to commission healthcare for an individual who falls outside the range of services and treatments that the CCG has agreed to commission as a matter of routine.

Commissioning decisions on these requests are made collectively by a specially convened group – the CCG Individual Funding Request Panel. Individual Funding Requests should originate either from the patient’s GP or from a hospital consultant (to whom the patient has been referred), or in certain circumstances (to be decided by the Panel), other registered health practitioners. An IFR request should only be made once all the other routes above have been considered. 

 

No Red Flag Symptoms Listed

No Guidelines on Management Listed

No Referral Criteria/Information Listed