An exploration of how the wheelchair procurement system in Ireland compares to the needs and wants of the wheelchair users and clinicians, and how it influences everyday life
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Date
2023
Authors
Murphy, Jack D.
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Introduction: For many people, wheelchairs are an essential part of daily life to enable participation and engagement in occupations. Despite being a vital personal mobility aid, the literature points to inefficient systems which procure and provide wheelchairs to the users. This places undue stress and pressure on both clinicians and service users alike.
In Ireland, publicly funded wheelchair procurement occurs through the Health Service Executive [HSE] via use of a standardised national wheelchair contract. Prior to the introduction of the wheelchair contract, ownness for procuring wheelchairs fell to individual clinicians, and/or locally held contracts in some areas in Ireland. The aim of the new national wheelchair contract was to standardise the quality of wheelchairs provided by the HSE, reduce monetary waste, and reduce the workload on individual clinicians to procure wheelchairs.
The experiences of those who use the wheelchair procurement system in Ireland everyday are yet to be investigated. This leads to questions regarding how the wheelchair procurement system is working from the perspectives of both the occupational therapists and service users. This project aims to review how the introduction of a national standardised wheelchair contract impacts time-savings, monetary savings, administration load and quality of life of the wheelchair users.
Background: The background requires understanding two perspectives: how disability has been viewed historically and how this may have influenced daily life and policy engagement; and how the wheelchair procurement works here in Ireland, specifically using a wheelchair contract system to streamline the procurement process.
Literature: The literature indicates that wheelchair provision is studied frequently, however wheelchair procurement is rarely studied. The procurement of wheelchairs is an integral aspect of provision and has the potential to impact its effectiveness. The literature indicates the importance of the meaning of the wheelchair to the user, and its impact on identity. This presents an opportunity for investigation to explore if this meaning is reflected in the wheelchair contract in Ireland. Additionally, the literature looks more broadly at how the wheelchair systems impact the user in terms of the status, regulatory frameworks and funding of these devices.
Methodology: This project utilises a descriptive phenomenology methodology to explore the lived experiences of those whom the wheelchair contract directly impacts. Ethical approval was gained prior to commencement of data collection. This research was conducted in the midst of the COVID-19 global pandemic, which impacted the timeframes of the project. Five Occupational Therapists and four Manual Wheelchair Users were recruited for in-depth, semi-structured qualitative interviews, from gatekeepers including the Irish Wheelchair Association and the Association of Occupational Therapists Ireland.
Findings: The project has three main findings. These included Personal Factors, which describe all of the factors identified by participants which impacted decisions with regards to wheelchair procurement. Next, the Impact of the System refers to the structures in place which must be navigated by participants to obtain their wheelchairs. Additionally, the final theme is a description of the ‘Business’ of Wheelchair Provision. This section describes the realities of working with Businesses and this is reflected in how the HSE is run like a Business.
Discussion: The contract intended to streamline and standardise wheelchair provision and procurement for occupational therapists in Ireland. With wheelchair procurement being an important step in the overall process of wheelchair provision, the project uncovered interesting findings with regards to how it is used and its practical implementation. The wheelchair contract is used in different ways. The occupational therapist group use this directly, while the manual wheelchair user group use it indirectly.
Conclusion: The wheelchair contract was noted to be dichotomous in nature. Participants were frustrated with the system inefficiencies which impact procurement and provision. However, participants felt the wheelchair contract was a step in the right direction despite some of its shortcomings.
Description
Controlled Access
Keywords
Wheelchair , Wheelchair procurement , Wheelchair provision , Wheelchair service , Occupational therapy
Citation
Murphy, J. D. 2023. An exploration of how the wheelchair procurement system in Ireland compares to the needs and wants of the wheelchair users and clinicians, and how it influences everyday life. MSc Thesis, University College Cork.