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The House of Lords is scheduled to consider the following question for short debate on 11 December 2025:

Lord Hunt of Kings Heath (Labour) to ask His Majesty’s Government what plans they have to publish a strategy for ensuring high-quality and equitable wheelchair and community equipment provision by NHS and social care services.

As health services are a devolved matter, this briefing focuses on wheelchair and community equipment services in England.

1. Wheelchair and community equipment services

In England, social care and support services can offer help to people who need practical assistance because of illness or disability.[1] Types of support include equipment to assist with day-to-day living such as grab rails, walking aids and wheelchairs.[2] This equipment can be free for the recipient if a person is assessed as needing them. Local authority social services departments carry out needs assessments to determine a person’s eligibility for free equipment.[3] In some situations, social care and support is provided by the NHS instead of a local council.[4] This is usually free and includes situations where a person has complex or serious health conditions. Integrated care boards (ICBs) sitting under integrated care partnerships (ICPs) are responsible for commissioning services to meet the health needs of the local population in their areas.[5]

However, various reports have highlighted issues in recent years about the provision of wheelchair and community equipment services in England.

1.1 Concerns about wheelchair services

A series of research reports produced between 2022 to 2024 by economics consultancy Frontier Economics, and insight and innovation agency Revealing Reality, considered the state of England’s wheelchair services.[6] The Wheelchair Alliance—a community interest group that champions national accountability for wheelchair users—and the Motability Foundation charity had funded them.[7]

The first report, ‘An economic assessment of wheelchair provision in England’ (6 May 2022), highlighted variation in the quality of access and outcomes to wheelchair services across regions of England.[8] Key issues identified included limited data collection on the number of wheelchair users, inconsistent user experience and a lack of communication channels for users to provide feedback.[9]

The second report, ‘The value of a wheelchair’ (December 2023), estimated the potential value that high-quality wheelchair provision could provide to wheelchair users and society. It said analysis had “unambiguously” shown that providing high-quality wheelchair services could have “a significant positive impact on people’s lives and also lead to meaningful financial benefits for the NHS and society”.[10]

The third and final report, ‘Wheelchair provision: How to drive effective change’ (November 2024), contained recommendations on how to provide effective change in wheelchair services. Key recommendations included:[11]

  • the creation of an NHS England senior responsible officer role to be accountable for the overall development and ongoing delivery of high-quality wheelchair services
  • NHS England to mandate a set of standardised eligibility criteria across all services to ensure wheelchair users across the country are entitled to the same care, regardless of where they are located

1.2 Concerns about community equipment services

The All Party Parliamentary Group (APPG) for Access to Disability Equipment recently described the community and medical equipment system as being “in crisis”.[12] This was based on evidence obtained during the APPG’s three-month inquiry into barriers preventing people from accessing medical and community equipment. Referring to its findings, the APPG said the “crisis” situation was in part caused by “regional inequalities and the lack of national accountability, direction and leadership”. Of the 626 responses to the APPG’s survey, 63% of carers and 55% of equipment users had said services were getting worse.[13]

The APPG said inadequacies in the current system extended to the types of equipment available for people, with those with more complex conditions often finding it harder to receive specialised equipment.[14] It said access to more expensive equipment such as powered wheelchairs showed that “many of the systemic challenges affecting community equipment services, such as delays, funding constraints, and eligibility disputes, also occur in other equipment pathways”.[15] For example, it referred to evidence from respondents that wheelchair provision, whilst being a separate system to other medical and community equipment, had reported similar issues of restricted access due to cost.

The APPG’s report contained various recommendations to address the issues identified in its inquiry.[16] A key recommendation called on the government to develop a national strategy for community equipment.[17] The APPG said this strategy should set out a plan for reform, establish “consistent national standards”, and ensure “accountability at every level”.

2. Stakeholder reaction

Various charities and associations have welcomed calls for improvement in England’s wheelchair and community equipment services. For instance, Whizz-Kidz, a UK charity for young wheelchair users, said the 2022 report by Frontier Economics had echoed its experience of working with what it described as “underfunded, inaccessible, and fractured” NHS wheelchair services.[18] In addition, the Spinal Injuries Association said “unacceptable” funding levels for wheelchair services in England had been compounded by a “significant lack of accurate wheelchair user data”.[19] The Motor Neurone Disease Association has also called for greater prioritisation of wheelchair services in the NHS.[20]

On community equipment, the chief executive of the British Healthcare Trades Association (BHTA), David Stockdale, said the system urgently needed “a coordinated national approach that provides clear accountability, consistency across local areas, and robust, long-term investment”.[21] Newlife, the charity for disabled children, has also described the difficulties faced by children with disabilities to access support such as specialist equipment.[22] Ceara Chamberlin, campaign and public affairs manager at Newlife, has called for national action to ensure that children can access the equipment they need.

3. Measures to improve wheelchair services

NHS England has acknowledged that variation in wheelchair service provision can affect timely access to necessary equipment and services.[23] In turn, it has said this impacts clinical outcomes and the life quality of people who rely on those services. NHS England has also said addressing these inconsistencies is crucial to ensure equitable access and improved outcomes for all wheelchair users.

NHS England has taken various steps in recent years to improve wheelchair services, including establishing the national wheelchair dataset and personal wheelchair budgets (PWBs).[24] PWBs provide financial assistance to support a person’s choice of wheelchair, either within or outside of NHS-commissioned wheelchair services.[25] Most recently, it published a wheelchair quality framework in April 2025 that was co-produced with the NHS England National Wheelchair Advisory Group.[26] The framework includes core principles and quality standards for ICBs and NHS wheelchair service providers. These are intended to benchmark current wheelchair provision, as well as help ICBs and wheelchair providers to continually review and improve their services. Under the framework, quality standards expected of ICBs and wheelchair providers include offering PWBs and ensuring accessible information about the assessment process and eligibility criteria.

Overall, NHS England has said the framework is intended to help ICBs and providers to address inconsistencies in wheelchair service provision to ensure equitable and improved access for all wheelchair users.[27]

4. Government position

The government has maintained that ICBs have responsibility for providing and commissioning local wheelchair services.[28] It has highlighted various steps taken by NHS England—such as the publication of the wheelchair quality framework—to support ICBs to improve services and reduce regional variation in the quality of NHS wheelchair provision.[29]

For community equipment, the government has said local authorities are responsible for providing equipment that supports daily living and independence.[30] The government has noted that, under the Care Act 2014, local authorities have a duty to shape their care market and to commission a range of high-quality, sustainable and person-centred care and support services to meet the needs of the local population.

5. Read more

5.1 Parliamentary material

5.2 Other material

Image by Freepik

References

  1. NHS, ‘Introduction to care and support’, accessed 3 December 2025. Return to text
  2. NHS, ‘Household gadgets and equipment to make life easier’, accessed 3 December 2025; and NHS, ‘Walking aids, wheelchairs and mobility scooters’, accessed 3 December 2025. Return to text
  3. NHS, ‘Getting a care needs assessment’, accessed 3 December 2025; and NHS, ‘Walking aids, wheelchairs and mobility scooters’, accessed 3 December 2025. Return to text
  4. NHS, ‘Introduction to care and support’, accessed 3 December 2025. Return to text
  5. House of Commons, ‘Written question: Disability aids (93806)’, 3 December 2025; and NHS England, ‘What are integrated care systems?’, accessed 3 December 2025. Return to text
  6. Wheelchair Alliance, ‘Wheelchair Alliance launches third report’, 14 November 2024. Return to text
  7. Motability Foundation, ‘About us’, accessed 3 December 2025. The Motability Foundation invests in research, transport programmes and support to improve accessibility in transport systems for disabled people in the UK. Return to text
  8. Frontier Economics, ‘An economic assessment of wheelchair provision in England’, 6 May 2022, p 12. Return to text
  9. As above, pp 8–10. Return to text
  10. Frontier Economics and Revealing Reality, ‘The value of a wheelchair’, December 2023, p 8. Return to text
  11. Frontier Economics and Revealing Reality, ‘Wheelchair provision: How to drive effective change’, November 2024, pp 7–9. Return to text
  12. All Party Parliamentary Group for Access to Disability Equipment, ‘Parliamentarians warn systemic failures are leaving children and adults without critical community care equipment’, 28 October 2025. APPGs are informal groups of members of the House of Commons and House of Lords with a common interest in particular issues. The views expressed in the report are those of the group. APPG reports are not approved by either House or its committees. Return to text
  13. All Party Parliamentary Group for Access to Disability Equipment, ‘Barriers to accessing lifesaving disability equipment’, October 2025, p 5. Return to text
  14. All Party Parliamentary Group for Access to Disability Equipment, ‘Parliamentarians warn systemic failures are leaving children and adults without critical community care equipment’, 28 October 2025. Return to text
  15. All Party Parliamentary Group for Access to Disability Equipment, ‘Barriers to accessing lifesaving disability equipment’, October 2025, p 5. Return to text
  16. All Party Parliamentary Group for Access to Disability Equipment, ‘Barriers to accessing lifesaving disability equipment’, October 2025, pp 6–7. Return to text
  17. As above, p 6. Return to text
  18. Whizz Kidz, ‘Open letter to the UK government’, accessed 3 December 2025. Return to text
  19. Spinal Injuries Association, ‘Wheelchair Alliance calls for action on wheelchair services’, accessed 3 December 2025. Return to text
  20. Motor Neurone Disease Association, ‘New report calls for better wheelchair services’, 4 December 2024. Return to text
  21. British Healthcare Trades Association, ‘MPs warn systemic failures are leaving children and adults without critical community care equipment’, 28 October 2025. The BHTA co-funds the APPG for Access to Disability Equipment’s secretariat, Tendo Consulting Ltd: UK Parliament, ‘Register of All Party Parliamentary Groups: Access to Disability Equipment’, 1 December 2025. Return to text
  22. Newlife, ‘Newlife backs APPG report exposing national crisis’, accessed 3 December 2025. Newlife also co-funds the APPG for Access to Disability Equipment’s secretariat, Tendo Consulting Ltd. Return to text
  23. NHS England, ‘Wheelchair quality framework’, updated 1 August 2025. Return to text
  24. NHS England, ‘Improving wheelchair services’, accessed 3 December 2025; NHS England, ‘Wheelchair data collection’, accessed 3 December 2025; and NHS England, ‘Personal wheelchair budgets’, accessed 3 December 2025. Return to text
  25. NHS England, ‘Personal wheelchair budgets’, accessed 3 December 2025. Return to text
  26. NHS England, ‘Wheelchair quality framework’, updated 1 August 2025. The group consists of members with lived experience using wheelchairs, clinicians, commissioners and organisations including the British Health Trade Association, Posture and Mobility Group and the Wheelchair Alliance. Return to text
  27. As above. Return to text
  28. House of Commons, ‘Written question: Wheelchairs—standards (69858)’, 27 October 2025; and House of Lords, ‘Written question: Wheelchairs—NHS and social services (HL11356)’, 7 November 2025. Return to text
  29. House of Lords, ‘Written question: Wheelchairs—NHS and social services (HL11356)’, 7 November 2025. Return to text
  30. House of Lords, ‘Written question: Wheelchairs—NHS and social services (HL11355)’, 7 November 2025. Return to text