This site is intended for health professionals only

Resources and advice for disabled people

Melanie Wynne-Jones
MB ChB MRCGP DRCOG
GP and GP Trainer
Stockport

Although the NHS is mostly free at the point of delivery, some services carry a charge that may be waived if the patient is receiving certain benefits or is on a low income. These include:

  • Cost of travel to hospital for treatment (or if accompanying a child for treatment).
  • Travel and accommodation costs of visiting someone in hospital.
  • Prescription charges.
  • Dental charges.
  • Opticians' charges.
  • Wigs and fabric supports.

War pensioners may be entitled to additional benefits; hospital and voluntary charities may also be able to help. 
The NHS leaflet HC11 Are You Entitled to Help With Health Costs? can be obtained from post offices or accessed at www.doh.gov.uk/nhscharges/index.htm. This also provides information about related leaflets and forms.

Social Services and tax benefits
These are notoriously complex and include:

  • Incapacity Benefit.
  • Severe Disablement Allowance.
  • Disability Living Allowance and Premium.
  • Disability Working Allowance.
  • Therapeutic earnings rule - allows some work ­without loss of benefits.
  • Disabled Student's Allowance.
  • Income Support.
  • Housing benefit.
  • Cold weather payments.
  • Disabled Person's Tax Credit (www.inlandrevenue.gov.uk/dptc).
  • Council tax discount.
  • Social Fund - discretionary community care grants or interest-free budgeting/crisis loans.

Many organisations for disabled people offer help in claiming benefits (see Resources). The Department for Work and Pensions website gives details of the regulations.

Other sources of funding
Social services may pay for daily living (non-nursing/ medical) equipment such as hoists, bath rails and household gadgets. Home nursing equipment such as commodes, bed tables and hoists can be borrowed via district nurses (and sometimes social services) from the local community nursing/home equipment store. Some voluntary agencies also have equipment for short-term loan.
Housing authorities award means-tested disabled facilities grants for major adaptations that improve access in the home, such as stair lifts, extensions or downstairs bathrooms.
The education service may fund access equipment such as ramps or platform lifts, as well as writing, speech and computer equipment. SKILL, the National Bureau for Students with Disabilities, provides advice and information, and AbilityNet lists sources of funding for computers.
Speech and language therapists can advise on funding for communication aids or provide these on loan. Autodialler alarms (to summon assistance) may be cheaper from Social Services, or borrowed from Help the Aged, who have a service called SeniorLink.
Local or national charitable agencies may loan or fund specific items, for example powered wheelchairs or scooters (www.motability.co.uk).

Aids and equipment
Disabled people's needs range from something as simple as a broad-handled vegetable peeler to major adaptations to their living space. GPs and other members of the primary healthcare team are often well placed to identify the particular difficulty, but an occupational therapist who can carry out a full functional assessment will probably find the best solution.
Patients can also self-refer for an appointment at one of the 47 Disabled Living Centres located around the country. These are staffed by occupational therapists, who can demonstrate and advise on a wide range of aids and equipment including:

  • Adjustable beds.
  • Bathlifts.
  • Chairs and cushions.
  • Adapted toilets and showers.
  • Feeding aids.
  • Hoists.
  • Gardening.
  • Household.
  • Kitchen equipment.
  • Mobility.
  • Personal care.
  • Scooters.
  • Seating.
  • Sensory equipment.
  • Stairlifts.
  • Telephones.
  • Walking aids.
  • Wheelchairs, including powered wheelchairs.

Staff liaise closely with manufacturers and other organisations to locate the precise gadget that will best suit someone's disability. They can also provide advice on:

  • Benefits and grants.
  • Clothing adaptation.
  • Continence.
  • Driving assessments.
  • Housing advice.
  • Leisure activities.
  • Pressure relief.
  • Social activities.
  • Support groups.
  • Where to buy.

Several websites provide factsheets about choosing products, comparisons and online shopping, including:

Mobility
Walking sticks and frames can be obtained from the community physiotherapy department. The NHS wheelchair service provides vouchers that can be put towards powered and nonpowered wheelchairs. The Disabled Living Foundation publishes a comprehensive wheelchair guide. The Red Cross loans wheelchairs for short-term use such as holidays.
The Motability Charitable Fund provides grants for adapting vehicles to include hand controls, swivel seats, automatic transmission, wheelchair hoists and so on and may pay for special driving lessons. Severely disabled drivers may qualify for assistance from the government's Mobility Equipment Fund or Drivers Fund. 
Disabled drivers or passengers can apply to the Benefits Agency for the Disability Living Allowance, which enables them to lease or buy a car or electric wheelchair through the Motability Scheme, and to Social Services for a blue (formerly orange) parking badge. The Disabled Persons Railcard offers train fare reductions and many local authorities give discounts on bus or taxi travel.
Driving with a disability is governed by the Driving and Vehicle Licensing Agency regulations (www.dvla.gov.uk). If it is not clear whether someone is fit to drive (eg, after a stroke) the patient can be referred to a Disabled Drivers' Assessment Centre. 
Organisations such as The Winged Fellowship Trust provide holiday and respite opportunities for people with physical disabilities and their carers (www.wft.org.uk).

Employment
Many organisations and charities for the disabled offer advice on work (such as government initiatives, skills and training, finding work, self-employment and adapting the workplace), including Queen Elizabeth's Foundation, Disability Alliance, Employment Oppor­tunities (www.opportunities.org.uk) and Remploy (www.remploy. co. uk). Disability Employment Advisers, based at local jobcentres, provide advice including how to obtain equipment for employment. The Access to Work Scheme provides payment for equipment, adaptations and support workers.

Make a difference
Primary care professionals can make a huge difference to disabled patients' daily lives by spotting their needs, pointing them in the right direction to get assistance and encouraging them to claim their entitlement.

Resources
Department of Health
W:www.doh.gov.uk/disabledguide/
W:www.disability.gov.uk
Disability Rights Commission
T:08457 622633
W:www.drc-gb.org
SKILL
T:0800 328 5050
W:www.skill.org.uk
AbilityNet
T:0800 269545
Help the Aged
T:0808 800 6565
W:www.helptheaged.org.uk
Disability UK
W:www.disabilityuk.com
Department for Work and Pensions W:www.dwp.gov.uk
Disability Alliance
T:020 7247 8776
W:www.disabilityalliance.org
The Disabled Living Centres Council
T:0161 834 1044
W:www.dlcc.co.uk
The Disabled Living Foundation
T:0845 130 9177
W:www.dlf.org.uk
Citizens' Advice Bureau
W:www.nacab.org.uk
W:www.adviceguide.org.uk
Queen Elizabeth's Foundation for Disabled People
W:www.qefd.org