Wheelchair Provision: Independent Review Body

Daniel Francis Excerpts

Tuesday 21st April 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab) [R]]

I beg to move,

That this House has considered the potential merits of establishing an independent national review body overseeing wheelchair provision.

It is a pleasure to serve under your chairship, Dr Murrison, and I thank the Backbench Business Committee for agreeing to this morning’s debate. I declare an interest as co-chair of the all-party parliamentary group for wheelchair users, alongside Baroness Tanni Grey-Thompson; as the chair for the all-party parliamentary group for access to disability equipment; and as the parent of a wheelchair user.

Through the APPG’s work, we have heard directly from stakeholders and service users about the unacceptable delays that wheelchair users face in accessing suitable equipment, often with reduced health outcomes as a result. Too often we also hear that service users are confined to using completely inappropriate wheelchairs as that is, frankly, their only option. The issues I will discuss today in patients accessing disability equipment are also all too evident to me as chair of the APPG for access to disability equipment. I pay tribute to the Wheelchair Alliance and Whizz Kidz for their dedication in their advocacy for wheelchair users across the UK and for their support in preparing for today’s debate. I am grateful to have secured the debate and, as Members know, I am the parent of a wheelchair user and have lived and breathed the issues that so many wheelchair users face in accessing wheelchair provision.

The wheelchair quality framework, published in April 2025, outlines that wheelchairs provide

“a significant gateway to independence, wellbeing and quality of life for thousands of adults and children. They play a substantial role in facilitating social inclusion and improving life chances through work, education and activities that many people who do not need wheelchairs take for granted.”

While I welcome the framework for introducing some minimum standards and expectations, in my experience—and I will come to that later—it is the case that the user deals with the contractor, not the integrated care board. The ICB appears to have little or no idea, quite often, what the actual experience for users is when dealing with the contractor.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank my hon. Friend for securing this very important debate. I know this is a subject on which he has much knowledge, experience and passion. ShopMobility, a group of volunteers who provide mobility aids at the shopping centre to get people out and about in the town centre, have recently reported to me that many of their customers are coming to them waiting for wheelchair provision from the contractor, sometimes for more than six months. I have also had young people with cerebral palsy and other conditions unable to get basic repairs to their existing equipment. Does he agree with me that these are simply unacceptable levels of services for what is vital equipment, not optional extras? Is that not exactly why, as he says, we need an independent review body to scrutinise the poor performance of the contractors and commissioners?

[Daniel Francis]

Absolutely; I completely agree. I will refer later to the position that we now know of, how ombudsman complaints have risen exponentially in recent years, and to the experience of many people, including that of my own daughter, who has quadriplegic cerebral palsy, in the kind of delays that my hon. Friend has outlined.

In the 2024-25 financial year, there were 630,000 wheelchair users registered in England, with 70,600 of them under 18 according to NHS data. However, that figure does not include those who have purchased their wheelchairs privately, or those unable to obtain the right equipment through the NHS. In 2018-19, the Wheelchair Alliance estimated there were a total of 780,000 users. That was an estimate due to lack of robust evidence to back those assumptions. There is no set location on NHS health records to identify whether someone is a wheelchair user. With many users purchasing their wheelchairs privately, or being provided a wheelchair through a charity, NHS data does not provide an accurate picture and we remain in the dark about the true number of wheelchair users in England. Unfortunately across the country we are seeing countless examples of wheelchair users being systematically failed by their service providers, and I am sure we will continue to hear horror stories throughout this debate. Wheelchair users face long waiting times, poor fitting and unsuitable equipment, and complex and fragmented access pathways, with reports of a postcode lottery in accessing wheelchair provision.

[Olivia Blake (Sheffield Hallam) (Lab)]

Alongside the postcode lottery my hon. Friend outlines, the impact on young people accessing education has huge implications. Not being able to view that data also impacts our understanding of why children might not be attending school. Does he agree that that is why data is so important for under-18s?

[Daniel Francis]

My hon. Friend is completely right. Last year I helped launch a report commissioned by Whizz Kidz about children who are wheelchair users accessing education, which highlights the issues my hon. Friend has brought to our attention.

The Parliamentary and Health Service Ombudsman has received a significant increase in complaints about wheelchair services, from four in 2018 to 76 in 2025, mainly about long delays in receiving equipment and poor communication. I would like to highlight the Wheelchair Alliance’s 2022 report, “An economic assessment of wheelchair provision in England”, which I will refer to throughout the debate. The report highlighted three areas of concern: wheelchair services in England do not consistently work for service users; NHS-provided wheelchair services should be subjected to more rigorous and mandated regulation; and the true scale of demand is not known.

Despite that report being published three and a half years ago, the findings are still relevant. Wheelchair users’ experiences have, if anything, deteriorated further. The report concluded that wheelchair users may be exploited due to a lack of clear regulation, independent review body or information about who to approach regarding repairs, complaints or suggestions for service improvements.

I am grateful to the Chamber engagement team for its support in preparing for today’s debate and for sharing the experiences of the 653 people who contributed to its survey on disability equipment. One respondent said:

“My husband has a basic wheelchair that is the wrong size and broken. It causes pain and pressure sores. He can’t self-propel more than 50 metres in it, making any kind of independence impossible. He is exhausted and in severe pain all the time.”

Another said:

“I had to put off starting university for a year because I couldn’t access a wheelchair in time. I spent a year at home unable to go out and see friends or access education or to even just go to the shop on my own.”

Wheelchair users already face everyday accessibility issues, from transport to housing and work. Having an unsuitable wheelchair adds not just an extra complication but often a debilitating and painful experience, and needs to be resolved. The current system is not working. Wheelchair providers need to work in cohesion rather than compete for contracts and undercut other providers.

National leadership and accountability of the service is necessary to ensure that service providers are held to account. Funding reform is needed to give wheelchair users the right piece of equipment, rather than the cheapest. The better, more appropriate yet expensive piece of equipment can often be the cheapest later down the line, with savings in health care and users better able to contribute economically. I will refer to that later in my personal experience.

Better and more conclusive data is needed. We are still not sure exactly how many adult and child wheelchair users there are in this country. We cannot, therefore, accurately access the current need or where gaps lie. To improve services, we need wheelchair users to be involved from the start in co-production, service design and commissioning. To get the service right and address the individual needs of wheelchair users, we need to hear directly from them. Ultimately, a national review body overseeing wheelchair provision is required to ensure that the service provided is of a good standard. As a result, wheelchair users will receive better quality care and outcomes.

I have five asks from recommendations to put to the Minister. First, it is clear that national leadership and accountability are needed. Service providers need to be held to account, as we have heard and will surely hear more during the debate. There are far too many examples of the service failing wheelchair users, leading to poor health outcomes. The Wheelchair Alliance’s 2022 report, “An economic assessment of wheelchair provision in England”, highlighted that NHS-provided wheelchair services should be subject to more rigorous and mandated regulation. Addressing the current inconsistent and fragmented service will improve outcomes for users, as forms of provision are held to account effectively.

The report suggests that mandatory regulation of wheelchair services could, for instance, be the responsibility of the Care Quality Commission, to address the gaps in accountability, guarantee a minimum standard of quality and, therefore, reduce the current postcode lottery in support. That could also cover private sector providers and additional regulations for private retailers, to give wheelchair users greater confidence and more oversight of the services they receive. Across the country, 45% of wheelchair services are not run directly by NHS trusts and are often commissioned to private companies. I would be grateful if the Minister could outline whether the Department has considered appointing a national lead or regulator to oversee the provision of wheelchair services to hold providers to account and ensure that wheelchair users in England are no longer at the mercy of a postcode lottery determining the quality of the service that they receive.

The second issue is budget. Increasing baseline funding in line with current needs and inflation would not only be beneficial for wheelchair users but would likely result in future long-term savings for the NHS. The Wheelchair Alliance’s 23 December report, “The Value of a Wheelchair”, showed that a £22 million per year increase in equipment spending to the average level among ICBs that currently report average levels of per patient spending would represent an estimated 14% increase in the current total annual NHS spending on wheelchair services. That would make a meaningful difference to the total equipment budgets in half of ICBs—and a big difference to wheelchair users. The research shows that this could reap £60 million—along with £315 million in wider societal and economic benefits—in NHS savings.

Budget should also be flexible and innovative, including in individual personalised wheelchair budgets, where users have found gaps in the funding, including not covering additional costs such as shipping or repair and maintenance, resulting in a need for users to self-fund for elements of care. The 2023 report outlines that some users felt the availability of support and funding was inflexible and not always optimally allocated. Whizz Kidz’ research has found that 22% of wheelchair users were offered a wheelchair budget as an option. Many more individuals had to fundraise and source charity support to allow them to get the right wheelchair. Reports from Frontier Economics show that, on average, the NHS spends £125 per wheelchair user per year, covering all types of equipment, staff, service, insurance and maintenance. Establishing an independent national review body to oversee wheelchair provision would help show where the gaps lie in the current funding and provide more efficient budget management, and where this can be improved. Could the Minister therefore outline whether steps have been taken to review current funding and whether consideration has been made of the benefits of introducing baseline funding in line with other complex and individual needs of wheelchair users?

The third recommendation was about data and transparency. To further improve wheelchair services, data collection needs to be vastly improved. As I have touched on, we do not know the number of wheelchair users in the country and while there is the national wheelchair data collection quarterly publication, it is essential that the available data also includes outsourced providers to ensure that they have a full picture of service provision across the UK. An independent national review body with oversight of all wheelchair services, including the NHS as well as private providers, would help to provide a greater understanding of the current provision, along with more accurate data to help identify gaps—whether in funding or in a postcode lottery of service users having different experiences based on where they live.

Wheelchair users and patients should also have a role. Their feedback and suggestions would illustrate the reality of the current provision and the impact that it is having on their lives. Currently, there are limited avenues for users to provide feedback on the quality of service received, resulting in reduced mechanisms for providers of care and ICBs to identify gaps in the service provided. The Wheelchair Alliance has found communication issues across multiple aspects of wheelchair provision, with users not being provided with an explanation for delays and a lack of communication between providers of care, resulting in users undergoing multiple unnecessary assessments. Giving users the opportunity to report those experiences to one body with national oversight would allow for greater improvements sector wide. Without an accurate national dataset and consistent reporting, unmet need and poor performance are not being addressed and continue to remain prevalent. Will the Minister therefore commit to improving the current collection of data on wheelchair users and their experience in accessing wheelchair provision and services?

The fourth ask regards procurement and value. Currently, many wheelchair users find that they are not given the most suitable wheelchair and are instead given the most cost-effective option. For example, in evidence provided to the APPG for wheelchair users by Charlie Fairhurst—and I declare an interest in that he is my daughter’s consultant at the Evelina—in his role as a consultant for 20 years and as the national lead for children’s neuroscience for the past eight, he outlined that in his experience, poor equipment provision leads to pressure sores and increasing scoliosis, all of which have a wider impact on the sector. Hip dislocation rates—which is a big issue for people, particularly children, with cerebral palsy—are increasing in both adult and child wheelchair users due to the wrong equipment being provided. My own daughter had to have her hip broken as a result and may need to have that done again because of those posture issues. Charlie described clearly to our APPG the issues for wheelchair users if they do not have the right equipment: they have to continue having the same operations to put their posture right again.

Another issue users encounter is the wheelchair they require not being suitable for their housing. One respondent to the survey said that the

“wheelchair I was offered weighed nearly 20kg and stopped me from moving around my very small home. Due to the size and weight of the chair, I spent almost four months not leaving the house.”

The NHS would experience cost savings as a result of improved provision, including providing patients with suitable wheelchairs from the beginning. I would therefore welcome the Minister’s comments on those issues.

The fifth recommendation relates to children. Currently, children aged three to five often miss out on receiving an appropriate wheelchair. The strict eligibility and issuing criteria that the NHS uses mean that young children are often deemed ineligible, despite their need not necessarily being any less than that of an adult or young person.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Member on securing the debate. On the issue of children getting access to wheelchairs, does he agree that sometimes the provision itself is fine, but parents subsequently establish that the wheelchair is not suitable and there can be difficulties in getting the best and most appropriate wheelchair for the child as they develop and age?

[Daniel Francis]

I absolutely agree. The hon. Member will hear my own personal horror story on that very matter in a moment. It is a big issue. Children grow, and the delays often mean that when the wheelchair finally arrives, the child is a very different size from when they were measured for it.

Instead of a wheelchair, younger children are offered a standard buggy, which often does not meet their clinical or social needs. It also impacts their social integration at a crucial age and limits their independence and participation at home, in school and at playtime. I would therefore be grateful if the Minister considered extending NHS wheelchair provision to children aged three to five so that they can get the right equipment.

The situation does not necessarily get any better for older children. In 2024, the national wheelchair data collection outlined that 80.9% of children under 18 received their wheelchair within the 18-week timescale, meaning that nearly one in five children are waiting over 18 weeks to receive their wheelchair. That figure unfortunately increases for children with more complex needs. In 2023-24, 29% of children assessed as having a specialist need waited over 18 weeks, and the figures for October to December 2025 showed that 1,563 children waited more than 18 weeks after a referral to NHS wheelchair services. A further 1,685 children were assessed with no equipment provided. That is despite the NHS England model service specification requiring services to have developed improvement plans by 2019 to ensure that all children who require a wheelchair receive one within 18 weeks.

My family and I have direct experience of that with our contractor in the London borough of Bexley. Back in October 2021, when my daughter—who, as I said, has quadriplegic cerebral palsy—was eight years old, it was agreed that she required a new wheelchair. The appointment to measure her for it was held three months later in January 2022, and the wheelchair arrived six months later in July 2022—nine months after the referral. Despite recommendations on the postural support that she required given that she has quadriplegic cerebral palsy, a standard wheelchair had been ordered, which then had to be repaired or have adjustments made to it on five occasions in the next four months. Despite those adaptations, it was still not fit for purpose.

After my wife and I got the ICB involved—how many parents out there know what the ICB is and how to get it involved?—a new fit-for-purpose wheelchair was ordered in January 2023. It arrived in April 2023, but no one advised us that it had arrived. I really believe our contractor rations appointments to manage its workload. When we chased the position in June 2023, we were advised that the wheelchair had been in stock for two months. An appointment was made in July 2023. Twenty-one months after the initial referral, my daughter received a wheelchair that was fit for her needs. That meant that the contractor had missed its 18-week deadline twice in an 18-month period in one patient’s case.

Importantly, as I have said, children grow and delays like that cause more work, given that the child will clearly be taller than they were when the referral was made. At such a crucial time in a child’s life, their mobility and independence matter. It is critical that children are given the necessary equipment to engage with their peers and participate in school. Having an independent national review body would help to give children and their families a voice and more ownership over their care and, in doing so, drive down waiting lists and improve patient outcomes. I look forward to hearing contributions from colleagues, and the Minister’s comments on the points I have made.

--- Later in debate ---

[Daniel Francis]

I thank all hon. Members who contributed to the debate. It was a great honour, though deeply disturbing, to hear of people’s lived experience as wheelchair users. To be brief, we heard good examples from my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) of mobility providers, and from the hon. Member for East Londonderry (Mr Campbell) of the growing needs of users. We heard from my hon. Friend the Member for Sheffield Hallam (Olivia Blake) about access to school. I urge all hon. Members to look at the Whizz Kidz report on that issue.

There was an interesting comment from the hon. Member for Upper Bann (Carla Lockhart) on all-terrain wheelchairs, which is something we looked at in a recent event across the road. The hon. Member for Strangford (Jim Shannon) is always here for these debates. It is good to hear about the position in Northern Ireland and, in particular, about veterans’ use of wheelchairs, which also featured at that event.

We heard about AJM Healthcare from my hon. Friends the Members for Scarborough and Whitby (Alison Hume), for Lichfield (Dave Robertson) and for Stoke-on-Trent South (Dr Gardner). I accept that it is the largest provider in the market—it was the provider I was referring to in my comments—but clearly there have been issues with delays across the country. I will come back to those, and to individual ICBs’ awareness of what was going on.

I was really sorry to hear from my hon. Friend the Member for Bassetlaw (Jo White) about the suitability and parts issues experienced by her constituent. I know those issues at first hand. My hon. Friend the Member for Stoke-on-Trent South talked about discharge delays. I would say that they are sad but, quite frankly, they are just disgraceful. I welcome the pressure to improve standards from the Lib Dem spokesperson, the hon. Member for Mid Sussex (Alison Bennett), and from the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), who also rightly brought up the point about NRS. I have met with officials from the Department of Health and Social Care in recent months on that and the overall framework for where the responsibility lies.

To my good friend the Minister, I will say that I will continue this pressure, as will other hon. Members. I accept that what happened during covid was very difficult. I was attending wheelchair appointments during that period and it was difficult—of course, delays were caused—but we have ended up in a position where there are far more ombudsman complaints now than before covid. I will not prejudge matters, but I think the ombudsman may have something to say about this later this year. Lots of wheelchair users have ended up having to go to the ombudsman because it is a complex system. That goes back to the framework and what I said earlier. How many people out there know what their ICB is and how to go to their ICB?

The wheelchair contract where I live is about to be tendered across three London boroughs: Bexley, Bromley and Greenwich. At the moment, those three boroughs have individual providers. It looks like they will have one provider going forward. When the consultation meetings were held around the new framework and the new contract, the provider, AJM Healthcare, was asked to advertise them. Did it tell any of the users? No, it did not, because if it had, they would have come to the meetings and told their horror stories.

I found out by accident because I am the Member of Parliament, and guess what? I was the only person who attended the meeting because none of the users had been informed that it was happening. That is my concern about ICBs monitoring those contracts and being able to say what is happening. It appeared to me in that meeting that, from my experience as a parent and from talking to other parents, I knew more about the problems in the system than the people commissioning the contract within my ICB. That is why we need continued monitoring and some kind of framework.

I absolutely welcome the Minister’s comments. There has been movement, but I will continue the pressure, along with other Members, in the months and years ahead.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of establishing an independent national review body overseeing wheelchair provision.