TY - UNPB

T1 - Use of patient centred outcomes measures alongside the personal wheelchair budget process in NHS England: a mixed methods approach to exploring the staff and service user experience of using the WATCh and WATCh-Ad Tools

AU - Tuersley, Lorna

AU - Quaye, Naa Amua

AU - Edwards, Rhiannon Tudor

AU - Bray, Nathan

PY - 2022/8/16

Y1 - 2022/8/16

N2 - Background and Objective Personal wheelchair budgets (PWBs) are offered to everyone in England eligible for an NHS wheelchair, to support their choice of equipment. The WATCh (Wheelchair outcomes Assessment Tool for Children) and related WATCh-Ad tool for adults are patient centred outcomes measures (PCOMs) developed to help individual users express their main outcome needs when obtaining a wheelchair and rate their satisfaction with subsequent outcomes after receiving their equipment. We explored their use in a real-world setting, aiming to produce guidance for use alongside the PWB process.Methods Three wheelchair service provider organisations across four sites participated. Staff and users completed surveys about their experience of the WATCh and/or WATCh-Ad tools used in the assessments. Towards the end of the study, selected patients were interviewed after receipt of their equipment, and staff were interviewed after experiencing a number of assessments. Thematic analysis was undertaken using the tool, survey and interview data.Results Information on 75 assessments by 15 staff was obtained. Over three-quarters of users or their carers rated the use of the tools in the assessment process as ‘helpful’ or ‘very helpful’. Staff reported that use of the WATCh tools had been considered ‘useful’ in developing individual care plans in around 1 in 3 cases and affected the prescription in 1 in 4 cases. Concerns were expressed around the length of time taken to administer the tools in clinic, although some staff noted this reduced with more hands-on experience, and by providing the tools to users in advance of the appointment.Conclusions The WATCh and WATCh-Ad PCOM tools are suitable for routine use by wheelchair service providers to assist the assessment process. It is recommended that tool materials are provided in advance to users/carers, and that staff are allowed time to develop their ways of working with them.Competing Interest StatementThe authors have declared that no competing interests existFunding StatementLT and NB were supported in this work by funding from NHS England. Members of NHS England Health and Personalised Care Group were involved in the steering group otherwise funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.Not ApplicableThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:WALES REC 5 (20/WA/0007) relating to IRAS 274858I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.Not ApplicableI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Not ApplicableI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.Not ApplicableData cannot be shared publicly as the authors consider that the small number of specialised sites in discrete geographic areas, combined with the timing of attendance and information on underlying problems could uncover anonymity. Data will be available on reasonable request from the corresponding author.CCGClinical Commissioning GroupCOVID-19COrona VIrus Disease 2019EoIExpression of InterestGDPRGeneral Data Protection RegulationsIoMInstitute of MedicineLRECLocal Research Ethics CommitteeNHSNational Health ServiceNIHRNational Institute for Health Researchn/sNot statedNWAGNational Wheelchair Advisory GroupOTOccupational TherapistPCOMPatient Centred Outcomes MeasurePTPhysiotherapistPWBPersonal Wheelchair BudgetR&DResearch and developmentRERehabilitation EngineerSUService user (term used in responses)WATChWheelchair outcomes Assessment Tool for CHildrenWATCh-AdWATCh tool for ADults

AB - Background and Objective Personal wheelchair budgets (PWBs) are offered to everyone in England eligible for an NHS wheelchair, to support their choice of equipment. The WATCh (Wheelchair outcomes Assessment Tool for Children) and related WATCh-Ad tool for adults are patient centred outcomes measures (PCOMs) developed to help individual users express their main outcome needs when obtaining a wheelchair and rate their satisfaction with subsequent outcomes after receiving their equipment. We explored their use in a real-world setting, aiming to produce guidance for use alongside the PWB process.Methods Three wheelchair service provider organisations across four sites participated. Staff and users completed surveys about their experience of the WATCh and/or WATCh-Ad tools used in the assessments. Towards the end of the study, selected patients were interviewed after receipt of their equipment, and staff were interviewed after experiencing a number of assessments. Thematic analysis was undertaken using the tool, survey and interview data.Results Information on 75 assessments by 15 staff was obtained. Over three-quarters of users or their carers rated the use of the tools in the assessment process as ‘helpful’ or ‘very helpful’. Staff reported that use of the WATCh tools had been considered ‘useful’ in developing individual care plans in around 1 in 3 cases and affected the prescription in 1 in 4 cases. Concerns were expressed around the length of time taken to administer the tools in clinic, although some staff noted this reduced with more hands-on experience, and by providing the tools to users in advance of the appointment.Conclusions The WATCh and WATCh-Ad PCOM tools are suitable for routine use by wheelchair service providers to assist the assessment process. It is recommended that tool materials are provided in advance to users/carers, and that staff are allowed time to develop their ways of working with them.Competing Interest StatementThe authors have declared that no competing interests existFunding StatementLT and NB were supported in this work by funding from NHS England. Members of NHS England Health and Personalised Care Group were involved in the steering group otherwise funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.Not ApplicableThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:WALES REC 5 (20/WA/0007) relating to IRAS 274858I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.Not ApplicableI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Not ApplicableI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.Not ApplicableData cannot be shared publicly as the authors consider that the small number of specialised sites in discrete geographic areas, combined with the timing of attendance and information on underlying problems could uncover anonymity. Data will be available on reasonable request from the corresponding author.CCGClinical Commissioning GroupCOVID-19COrona VIrus Disease 2019EoIExpression of InterestGDPRGeneral Data Protection RegulationsIoMInstitute of MedicineLRECLocal Research Ethics CommitteeNHSNational Health ServiceNIHRNational Institute for Health Researchn/sNot statedNWAGNational Wheelchair Advisory GroupOTOccupational TherapistPCOMPatient Centred Outcomes MeasurePTPhysiotherapistPWBPersonal Wheelchair BudgetR&DResearch and developmentRERehabilitation EngineerSUService user (term used in responses)WATChWheelchair outcomes Assessment Tool for CHildrenWATCh-AdWATCh tool for ADults

U2 - 10.1101/2022.08.14.22278761

DO - 10.1101/2022.08.14.22278761

M3 - Preprint

BT - Use of patient centred outcomes measures alongside the personal wheelchair budget process in NHS England: a mixed methods approach to exploring the staff and service user experience of using the WATCh and WATCh-Ad Tools

PB - MedRxiv

ER -