This chapter was last reviewed and/or updated April 2021.

KEY POINTS

  • The Lincolnshire community equipment service is provided by NRS via their Grantham Depot.
  • Practitioners will need a PIN number to prescribe equipment.
  • For any equipment that is not on contract practitioners must complete a non-contract special equipment request via Mosaic.

1. Introduction

Community equipment services in Lincolnshire are provided in partnership with the NHS through the Lincolnshire Community Equipment Service (LCES). Nottingham Rehab Supplies (NRS) Healthcare Ltd provides the service for LCES.

LCES uses an online prescribing system where prescribing rights are controlled with Personal Identifier Numbers (PIN). Prescribers should be assessors who have sufficient practice knowledge and training to prescribe within the limits of their PIN.

For those who have been allocated a PIN, further information about equipment prescribing procedures can be found in the documents section on IRIS (NRS Healthcare website).

IRIS is the NRS online ordering system and prescribers will need their unique PIN to access this system.

All products covered by the contract are detailed within IRIS with online product pages showing an image of the product, dimensions, safe limits for use and any other relevant information for ordering the equipment.

It also includes the process for the ordering standard items of equipment and also Non-Contract Specials (NCS) equipment.

There are strict guidelines that need to be followed when generating a NCS order; NRS will be unable to complete the order request if these guidelines are not followed. The documents section of the website contains a step-by-step guide on how to process a NCS order on the website. The website should be checked regularly for updates.

Please note: The website is only accessible to staff who have been allocated a PIN.

Process for prescribing Non Contract Specials (NCS)

NRS maintains a wide variety of ‘stock’ equipment that meets the majority of assessed need. There are however occasions where a client’s needs are more complex and they require a more bespoke solution. Practitioners are able in these circumstances to consider the most appropriate alternative to a stock item or another solution altogether.

Where an item of non-contract stock is being considered practitioners must follow the process as set out below (please click on the diagram to enlarge it):

2. Requesting an LCES Prescriber PIN

The procedure to request an LCES prescriber PIN is as follows:

  • the Lead Practitioner is required to confirm with the LCES Team within People Services, Information and Commissioning that they are confident the proposed prescriber is sufficiently skilled and equipped to assess needs and order community equipment;
  • the Lead Practitioner is required to complete the PIN application form which is available through the LCES team;
  • there are two different scenarios when creating a PIN, one is that the prescriber is a new starter and never used IRIS before and the other is that the prescriber has used IRIS before but has moved team/organisation and requires a new PIN.

Request for new Prescriber (never used IRIS before)

The LCES team will create the PIN for the prescriber. Once the PIN has been created LCES Team will then send an email to the prescriber and the Lead Practitioner (person who requested PIN) stating that a PIN has been created and NRS will be in contact regarding the link to the IRIS training. NRS will then send an email with details for IRIS training. All training from NRS is received on the hour. Once the training has been completed, the prescriber will receive an email from NRS with their PIN and temporary password. This is when the prescriber will then be able to access their account.

Request for Prescriber (previous access to IRIS)

The LCES Team will create the PIN for the prescriber. Once the PIN has been created, LCES Team will then send an email to the prescriber and Lead Practitioner (person who requested PIN) informing them that a new PIN has been created. The email will include the prescribers new PIN and temporary password, with a time and date of when the new PIN can be accessed. It will also state that NRS will still send the training to the prescriber however they do not have to complete this. As the training is sent out on the hour, this is when the PIN will become blocked. LCES Team will then unblock the PIN, this is when the prescriber will then have access to their account.

The LCES partnership has produced guidance in response to Frequently Asked Questions about how equipment is provided.

3. Disposal and Decommissioning of Community Equipment

To view guidance on the management of LCES equipment stock, please see Guidance for the Disposal and Decommissioning of Community Equipment.

Practitioners should always advise customers and families that equipment loaned through LCES may have previously been loaned to someone else, and will not always be brand new. However, the equipment will have been examined, cleansed and deemed to be safe and fit for issue.

4. Recording Equipment in Customer Records

Where a person has been prescribed equipment the practitioner must contact the person and record:

  • the equipment has been delivered;
  • the equipment has been fitted
  • the person is able to use it safely;
  • it meets the need and no further intervention is required;
  • if need is unmet and further intervention is required the rationale must be clearly recorded;
  • if a need for review is required the individual needs and circumstances of the client and clinical rationale and timescale for review.

Each individual equipment item issued should be recorded within the customer’s record.

The IRIS electronic ordering system provides an additional record and a source of structured ‘reportable’ data about actual items in the community. This system will be the primary source of structured data regarding equipment. For example, the distribution of specific items or lists to be identified in response to medical device alerts.

5. Equipment

Following assessment practitioners can sign post or prescribe equipment to maximise independence and enable the person to stay living in their home.

Equipment can be:

  • low level i.e raised toilet seats, perching stools, bed levers, kitchen trolleys, chair raisers;
  • major i.e hoist, slings, stand aid, stair lift;
  • bespoke i.e specialist seating.

All equipment prescribed or trialed must be recorded in the person’s record.

In some circumstances, following the provision of equipment, the practitioner may identify the need for a review. In these cases, the individual needs and circumstances of the client and clinical rationale and timescale for review must be clearly documented.

6. Evidencing Rationale for Decisions

Assessments and care and support plans should evidence eligible needs, what interventions are being put in place and what they are intended to achieve.

Whilst the IRIS system requires authorisation for certain equipment provision, it is not part of the customers care record and is accessed by NRS staff. It is therefore essential that needs and rationale for provision of equipment and any dialogue with equipment authorisers, including rationale for declining to authorise, is recorded in the customer record and not in the IRIS system.

7. Medical Device Alerts and Field Safety Notices

The Medicines and Healthcare Products Regulatory Authority (MHRA) is a government agency, whose aim is to protect the public, patients and users by ensuring that medical devices and equipment are acceptably safe.

It provides guidance and information which applies to some equipment arranged by the authority, for example mobility equipment, hoists, electrically operated beds and wheelchairs, which are used by Lincolnshire County Council customers countywide. Guidance, alerts, and publications can be accessed via MHRA Device Alerts).

Within Lincolnshire County Council, certain services may prescribe, use or supply social care equipment which is classified as ‘medical devices or equipment’. Typically these council services will involve social care (adults and children), schools and fire and rescue.

Safety issues associated with medical devices or equipment can be identified by manufacturers or by the MHRA following receipt of defect reports, customer feedback or adverse incident reports. In response manufacturers and the MHRA may issue information and alerts in the form of field safety notices and medical device alerts.

Full details of the field safety notices and medical device alerts can be found in the council’s Field Safety Notices and Medical Device Alerts procedure.