Challenging recommendations about NHS disability equipment

This information applies to England and Wales.

If your doctor, occupational therapist (OT) or specialist’s recommendations do not work for you, here’s how you can get the equipment you need.

Find out what equipment is available

Find out what equipment is on offer from your:

• local NHS trust or Clinical Commissioning Group (CCG) in England
• Local Health Board in Wales

Knowing what equipment is available to you through the NHS can help you suggest alternatives.

Find CCG services tool (NHS)

How to contact your CCG (GOV.UK)

Local Health Boards (NHS Wales)

Your local authority can provide some equipment

If your NHS cannot give you the equipment or your CCG refused a personal health budget, find out if you can get equipment through your local authority social care services.

Find your local authority (GOV.UK)

Talk to your healthcare professional again

You are an expert in your body or condition. But sometimes it can feel hard when you disagree with your doctor, OT or specialist.

You know what you need. Your healthcare professional is there to help you find the right support. They should listen to you and your experience. They must put you at the centre of your care and support.

If you feel your healthcare professional has not done that, talk to them about your needs again. Ask for more information about:

• the process
• what you should expect and when things will be done
• what equipment is available to you
• getting equipment that’s not available as standard

You might want to take a family member, partner or friend for support and confidence. You can also get support from advocacy services or the Patient Advice and Liaison Service (PALS).

Find your local Patient Advice and Liaison Service (NHS)

Advocacy services (NHS)

Explaining your needs

Before talking to your healthcare professional, it can help to prepare what you want to say.

Write down:

• what you want help with
• why the recommended equipment will not meet those needs
• what equipment you think will help and why
• what equipment you’ve tried and why it does not help

It can also help to ask other doctors, OTs or specialists you’ve worked with to:

• make recommendations
• share existing reports and recommendations across your healthcare services

They can give advice that helps inform new recommendations. This can be useful when moving to adult services or a new area.

Talking to medical professionals about the right equipment for you

Making a plan with your healthcare professional

Your doctor, OT or specialist should work with you to set goals for what you want to do.

Ask your healthcare professional to make a plan with you. You can use the plan to discuss any recommendations that do not help you achieve your goals.

If you feel equipment is missing from the recommendations, ask why it’s not included and explain why you think it should be. There will be some equipment the NHS cannot provide. But you can apply to your local authority for equipment and home adaptations too.

Getting a social care needs assessment 

Getting home adaptations

Trying equipment

Your healthcare professional may ask you to try out some basic equipment at home and any other places you’ll use it first. Then they’ll adjust their recommendations based on your feedback.

You should get a follow-up appointment. If you do not, you can ask for a review if the equipment does not meet your needs.

Sometimes trying equipment can help you show that it does not meet your needs.

Trying out disability equipment and assistive technology

Explain why equipment is not working

It’s important to say if equipment is not working for you. Explain what the problems are and why it’s not suitable for your needs.

It’s important to be clear about why equipment is not meeting your needs, such as making pain worse or creating more barriers. Some people say they feel guilty or ungrateful asking to change equipment the NHS has given them. But disability equipment is there to help you. If it’s not doing that, it’s OK to ask healthcare professionals to support you with this.

Asking for equipment

If there’s equipment you know will meet your needs, ask your healthcare professional for it. You will need to explain why you think the equipment will meet your needs better than their recommendation.

Non-standard equipment

If you think the standard NHS equipment will not meet your needs, ask if you can apply for a personal health budget.

Personal health budgets

Sometimes you can use a personal health budget to pay for specialist equipment that’s not available from an NHS trust or local authority, such as:

• an iPad with communication apps
• hearing aids with more functionality so you can do your job

What is a personal health budget? (NHS)

Choosing to have a personal health budget and your rights (GOV.UK)

If you’re eligible for a personal health budget will depend on:

• your local Clinical Commissioning Group (CCG)
• your assessed needs

Talk to your healthcare professional about what equipment you might be able to get with the budget and if you’re eligible. Your healthcare professional can apply for the budget on your behalf. The CCG will review your application. It can take time to apply.

If the CCG says you cannot get a personal health budget, they should give you a clear reason why in writing. If you disagree with the decision, you can ask for a review and follow the complaints process.

Talk to the Patient Advice and Liaison Service (PALS) for more information about personal health budgets.

Personal wheelchair budget

The process is different for wheelchair users. You may be referred for a personal wheelchair budget if standard NHS wheelchairs do not meet your needs.

Personal wheelchair budgets (NHS England)

NHS wheelchairs

If your health professional does not change their recommendation

Healthcare professionals must explain why they cannot change a recommendation or agree to equipment you think will help. If you do not understand an answer, ask them to explain again. You could also try asking:

• What does that mean for me?
• Why is the equipment not available?
• Why am I not able to get the equipment? How can we change that decision?
• What other ways are available to me to get the equipment?

You could also ask a family member, friend or professional advocate to go with you. They can take notes or advocate for you.

If your healthcare professional does not know the answers, they should find out for you. Your healthcare professional should make sure you get the equipment you need.

Complaints about healthcare professionals or health services

There are a few things you can do if you’re:

• having problems with the person handling your care
• struggling to change their recommendation or decision

Talk to a support service

First, get advice from a support service.

You can ask for support from:

• the NHS Patient Advice and Liaison Service (PALS)
• an independent NHS Complaints Advocacy Service

They can give you advice and come to appointments with you. Your local authority can tell you who your NHS advocacy service provider is.

Find your local authority (GOV.UK)

Your local Healthwatch or Citizens Advice can also give you information about making a complaint.

Find your local Healthwatch

NHS and social care complaints (Citizens Advice)

Meet with your healthcare professional again to complain

Tell them what you expected to happen and what you understood the outcomes would be. Explain why this has not happened and why you’re not happy with the service. Ask if you can work together to find a solution that will meet your needs.

Speak to your healthcare professional’s manager

If you’re still having problems, try speaking to their manager about the service or the problems you’re having. For example, it could be that they:

• are not listening to you
• cannot offer the equipment you need
• are not helping you get the equipment, such as applying for a personal health budget
• do not have enough knowledge about your condition or available equipment

Contact the service on the phone or by email. Ask to speak to a manager about an issue or the person managing your care.

If you feel the problem is with the person and not the service, ask to see a different healthcare professional, such as another OT or specialist.

Follow the complaints procedure

If you’re still not getting the support you need, follow the formal complaints procedure. Every NHS trust must publish their complaints procedure.

How to complain to the NHS (NHS)

Your rights under the NHS constitution (GOV.UK)

If the local authority is funding your equipment, you will need to follow the local authority’s complaints process.

Find your local authority (GOV.UK)

Keep a record

It can help to keep a record of your contact with your healthcare professional, such as:

• dates you tried to contact them
• emails you sent
• their responses or emails they did not respond to
• notes on visits or appointments
• things you discussed and outcomes or actions you agreed

You can ask a family member, friend or advocate to help with this.

You can also ask for a copy of your health records from the service providing the equipment. You may be able to use these when you complain. Contact the service to ask what you need to do to get your records. You may need to ask in writing.

If you’ve not been able to change a decision

If your complaint is unsuccessful and you still feel that you’re not being listened to, you could try going to the Parliamentary and Health Service Ombudsman.

If you want advice on whether you can take legal action against a decision, you could try visiting your local Law Centre.

Find your local Law Centre

Finding free or affordable legal help (Citizens Advice)

Fundraising

Some equipment or assistive technology may not be covered by the NHS, social care or benefits payments. You could try to get the equipment through grants or charitable funding instead.

Paying for disability equipment

Fundraising for things you need