Holistic, considerate, comprehensive assessments are vital to prescribing the right equipment solution first time, considering individual care pathways and lifestyles to meet changing personal needs.

Holistic

Millbrook Healthcare clinicians are trained to look beyond clinical need at how equipment will improve day-to-day life and help service users achieve their goals.

Millbrook clinicians Jayne Brewer and Tracy Frowen have a combined 35 years of experience completing clinical assessments in a variety of environments accessing Community Equipment Services (CES), helping users access the best equipment for them.

“Equipment helps service users achieve their own personal goals and maintain independence in key areas of daily living such as washing, mobility, eating, and drinking… Things that most of us take for granted,” says Tracy Frowen.

“Some of the most important things to be aware of when assessing a service user are the functional impairments which prevent them from being independent, what tasks are important to them, and how they want to achieve those tasks,” says Jayne Brewer.

For example, someone with restricted mobility who wants to actively participate in their community but doesn’t have private transport would need a reliable, durable, and easily manoeuvred mobility aid for use on public transport.

It’s also important to assess the environment and the people who will share the same space as the user.

“Occupational Therapists look at the whole environment when risk assessing and thinking about what solution would work best, including the social interactions with other family members and carers, cultural implications that may prevent the use of equipment, and the physical environment,” explains Tracy.

“If equipment is mobile, clinicians need to consider the flooring in the person’s house, threshold doorways and any other obstructions,” says Jayne. “Clinicians also need to ensure there is enough space for equipment in order not to create further risks.”

For example, when using a mobile hoist, carers need adequate space around the bed to operate the equipment. There needs to be appropriate flooring on which to move the hoist, and enough space to store it when not in use.

Considerate

Empathy is a key skill for clinicians, who need to be able to understand challenges from the user’s perspective. Assessments should respect users’ specific communication needs and provide accessibility.

Considerate assessments enable users to make choices. Often, clinical decisions are made jointly with the user, with input from their prescriber or carer/family member.

“We have to understand what users want to achieve and balance that with what they need to achieve to be safe and not put others at risk,” says Jayne. “This takes into account restrictions around certain pieces of requested equipment, like cost and availability.”

Risk management forms a key part of every assessment to keep users safe and find pre-emptive solutions.

“Sometimes users have to take risks to remain independent, and clinicians have to help minimise those risks,” says Jayne. “Clinicians are continually completing risk assessments and attempting to reduce risks for the service users, family and carers.”

User-focused assessments look beyond equipment, avoiding risk through small, easy changes like removing rugs and trip hazards in the home or prescribing additional equipment. Someone with poor sitting balance, for example, may struggle to use a bath board when washing. Clinicians discuss concerns during their assessment, prescribing non-obtrusive aids (like a grab rail) to make sure equipment is used safely. Risk management also considers the needs of people accessing the same facilities.

“An example might be a raised toilet seat for the user, specifically for their height,” says Tracy. “This would need to be removed for others and put back into place afterwards. This means that demonstrations on how to fit equipment would need to be shown to all members of the household.”

Comprehensive

Clinicians are responsible for demonstrating equipment use to the user, carers and family members, providing clear instructions in the required format (including easy read and braille) to support accessibility and understanding.  

“We use technology too, such as mobile phone apps which sit alongside the equipment we put in place,” says Tracy. “This is very useful for people with learning difficulties who may find it easier to communicate non-verbally.”

To help users get the most out of their equipment, clinicians carefully explain what has been recommended, and why. Involving family and carers can make individuals feel more comfortable and encourage equipment use.

If a clinician is unsure how to address a particularly complex need, they can seek advice from Millbrook’s Clinical Lead, who will recommend suitable products based on the assessment, signposting to approved and often local retailers. Millbrook’s experienced National Clinical Team of eight Band 7/8 professionals also advise and support clinicians.

“It may be that the clinician has tried standard stock equipment which has not been successful. The Clinical Lead could be involved to provide alternatives, working with one of our Recycled Specials Technicians to obtain information on what is available,” says Jayne.

Looking forward

In the past few years, clinical assessments have evolved into a single, integrated process to provide continuity of care and reassurance, considering all aspects of users’ lives.

“The single assessment process means that the first clinician involved with the user completes an initial assessment of all areas, including daily activities, mobility, pressure care continence, medication and diet, rather than the user answering questions from several different professionals. Any area of concern can then be addressed by the specialist,” says Jayne.

In future, assessments will become even more holistic through secure data sharing between health and social care organisations, leading to a single medical record that covers all medical, clinical and personal needs.

Self-assessment tools are also giving users more control and choice while prescribers focus on more complex tasks.

“We know the key to happier, healthier service users is to look at the whole picture and understand how they want to live their lives,” says Tracy. “This means that when we prescribe equipment solutions, we can be sure it will achieve their care outcomes while helping them feel more fulfilled.”

To find out more about our Community Equipment Service and assessment process, visit https://millbrookhealthcare.co.uk/pages/community-equipment-services/.