I will be very interested in the results of the evaluation, I know that
recently our trust purchased a Liko hoist that lifts upto 47 stone and
anybody over 25 stone is assessed by the moving and handling manager. Our
standard option manual wheelchairs limit us to 25 stone and anything over
this we have to order as a one-off which involves longer lead times for
delivery, which usually means that moving and handling for staff in the
interim period is very difficult. We recently dealt with somebody who was 29
stone and had to custom order the chair, we have dealt with 33 stone so it
is possible to some extent. Most of the problem comes from time to deliver
solution.

However even if you do provide a suitable chair, moving and handling
concerns can mean that nobody is willing to push the chair due to the user
weight. This leads you to two possible options: power chairs which can be
even more difficult to get built to heavy duty spec, or a power pack such as
the TGA and I am not sure what these are rated upto. In the latter case we
do not provide these due to resource restrictions and the first case would
only apply if the user was controlling the chair, again due to resource
restrictions.

Further interaction with manufacturers is essential to any review as we as
the purchasers are very demanding! We always demand cheapest possible chairs
through NHS contracts and the manufacturers at present do a pretty good job
of providing cheap chairs for transit purposes, which is a large percent of
chairs issued. Therefore if we want more readily available heavy duty chairs
over 25 stone we need to assess the numbers that we are talking about
nationally, if these numbers are still relatively small there is little
point in manufacturers stocking heavy duty chairs. In Grampian we have had 2
cases in the last year with a population of around 500,000 this could mean
we are only talking about 200-250 chairs for UK and these would have a range
of weight requirements and would we all buy from One manufacturer? This
indicates that at the present time I doubt it would be in a manufacturers
interest to stock these types of chairs unless we are prepared to pay more
in general. However, there is probably mileage in pursuading manufacturers
to be prepared and have extra heavy duty designs on paper available so that
lead times can be minimised where possible.

Maybe it is more important that we manage these types of patients more
effectively and are given more notice when a patient suffers an acute
episode so that community equipment can be procured more efficiently and
quickly. As indicated above our trust can manage the patient in an acute
setting but the problems usually arise at point of discharge. Trusts
certainly need to consider formulating policies on dealing with grossly
obese patients and we as equipment providers can contribute to these.

In summary I think it is possible to deal with heavy patients although our
experience stops at 33 stone but it can take time. We as equipment providers
cannot expect manufacturers to provide solutions from stock until we have
data to support our case. We as health care providers need to contribute to
providing a timely solution to ensure we are minimising delays within our
own systems.

This subject is definitely one that won't go away and would make an
excellent topic for discussion at a national meeting such as RAATE or PMG.
What do you think?

Gareth Adkins B. Eng. MSc. PGDip IPEM.
Rehabilitation Engineer
Mobility and Rehabilitation Service
Woodend Hospital
Eday Road
Aberdeen AB15 6LS



> -----Original Message-----
> From: Helen Pain at DEAC [SMTP:[log in to unmask]]
> Sent: 13 September 2002 09:32
> To:   [log in to unmask]
> Subject:      Eqiupment for heavier people
>
> As the proportion of the population that is over 25 stone (160kg) is
> increasing, more people of that weight are requiring assistive devices for
> seating and hoisting.
>
> Do you have any comments about:
>
>     the local availability of seating (including toileting and
> bathing devices) and hoists for heavier people;
>
>     The quality of the products;
>
>     The procedures when a person over 25 stone
>      needs equipment.
>
> The Medical Devices Agency has funded a project concerning these
> categories of equipment, and I am undertaking it at the Southampton
> Disability Eqiupment Assessment Centre, which is one of 3 national
> centres the MDA funds under its rolling programme of evaluations of
> equipment for people with disabilities.
>
> I would be pleased to hear from you about your experiences, and what you
> feel the most urgent issues are.
>
> Thanks
>
> Helen PaIn
>