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Council and voluntary sector leaders have welcomed a government plan to replace state provision of community equipment with a market model, but raised concerns about its financial implications.

Under the plan, service users would be given prescriptions to exchange for equipment at shops run by companies or charities.

The Department of Health's Care Services Efficiency Delivery team (CSED) said the model could deliver efficiencies for councils and improve services for users.

Councils, in tandem with primary care trusts, would issue prescriptions covering the full cost of equipment to people who met eligibility criteria, which could be topped up to buy more expensive models.

Current self-funders could buy prescriptions from new independent assessors - typically, occupational therapists or physiotherapists.

CSED, which is responsible for promoting efficiencies in adult social care, said the new system would make it easier for service users to find information, which in itself would be an incentive for providers to improve services.

Additionally, the removal of councils' provider role would release resources that could be invested in therapeutic services.

Sarah Pickup (pictured), co-chair of the Association of Directors of Adult Social Services resources committee, said the model had benefits but raised questions over whether it would deliver efficiency savings on the scale imagined by CSED.

She said: "The way the proposal stands, the responsibility for assessments would sit with social care. If we've still got to do that how is it that the money is freed up?"

Brian Lamb, director of communications at the Royal National Institute for Deaf People, welcomed the plan but said people now receiving free services may feel forced to top up prescriptions if they only covered a "bog standard" model.

He added: "We've got to warn against it substituting individual costs for state costs."

GRAB RAILS TO HOISTS
Community equipment services provide items to promote independence for disabled people, from grab rails to hoists.

They are provided by both the NHS and social services, but a landmark 2000 Audit Commission report, Fully Equipped, found integration between the two was poor. Since then the Department of Health has pushed for services to be fully integrated, which they are in many parts of the country.

Equipment is provided free to those with an assessed need and 1.5-2 million people are receiving a service.

Further information
Community Equipment: A Vision for the Future
ADASS
RNID
Audit Commission Fully Equipped report

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 Mithran Samuel