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

Abstract

SummaryBackground and ObjectivePersonal 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.MethodsThree 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.ResultsInformation 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.ConclusionsThe 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.