In February 2019, a BBC investigation in the West of England drew attention to the community loan equipment sector and the millions being spent on mobility and living aids. One of the more controversial claims made in the report was that councils in England are opting to throw away & replace rather than recycle and reuse loaned equipment due to cost considerations. It is a claim that is heard regularly in the industry; however, Medequip’s Michaela Harris reveals that there is more behind the decision-making process than just costs.

The community equipment landscape

Up and down the country, people with disabilities are provided a range of equipment to help individuals maintain their independence and facilitate hospital discharge. The equipment can range from simple aids for daily living to more complex pieces of equipment, such as beds and mattress systems.

The amount of equipment loaned to patients is substantial, with 3.5 million items loaned out to the community between 2017/18.

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Community Equipment Services are tasked with the provision and management of this equipment, with health authorities and councils spending £207million on community equipment in 2017/2018.

With the sheer amount of equipment loaned out however, the amount of equipment that ends up in landfill after use has been condemned by campaigners. According to the BBC’s report, out of the 3.5 million items that were loaned to patients, only around two million were returned.

Looking specifically into the West of England, the region spent £17.5million on community equipment in 2017/18, issuing 431,000 mobility and living aids, however, in that year, only 271,000 pieces were returned.

The numbers reveal a worrying trend of loaned equipment never being returned by patients, requiring councils and the NHS to purchase replacement equipment rather than cleaning and reissuing the devices back into the community.

Cheaper to get rid than recycle?

Interestingly, alongside equipment ending up in landfill or collecting dust at the back of cupboards because people do not know how to return it or simply forget, the BBC’s report highlighted that some local authorities do not wish some used items to be returned.

Interviewing recipients of community loan equipment, Nikki Fox, the BBC’s disability correspondent, highlighted that some Community Equipment Services have purportedly encouraged individuals to throw their equipment away rather than send it back.

Often, the reason cited is the cost involved in recycling and reissuing of community equipment.

A spokesperson from the Local Government Association said: “Each council has to balance the costs of collection, cleaning and reissuing devices against the costs of providing new equipment.

“It is not always financially viable… especially given the difficult financial pressures currently facing councils.”

Just a question of economic viability?

It is this question around the financial cost and environmental viability of attempting to recycle all community loan equipment items that has been at the forefront of recent media coverage and is a problem many loan stores and the NHS have been working to address.

Aiming to shine a light on the community equipment process and the challenges involved, integrated community equipment service Medequip has highlighted to THIIS some of the steps the organisation takes to redress the balance between economic and environmental viability.

One of the longest serving providers of contracted out Community Equipment Services, Medequip works with local councils and commissioning groups across the UK, supplying equipment ranging from simple walking aids through to sophisticated bed packages.

Michaela Harris, Business Support Manager for the company, explained the organisation’s approach to this question: “Although we appreciate that some commissioning bodies do have a minimum value below which they consider it uneconomical to provide a collection service, or indeed a reuse option, we do believe in collecting everything where possible and when requested,” she stated.

“We also operate repair services at all of our depots and decontamination facilities to optimise recycling rates and remain committed to the Return, Recycle, Reuse concept.”

The Return, Recycle, Reuse campaign was originally developed in partnership with West Suffolk NHS and has seen return and reuse rates rise significantly in the West Suffolk area, prompted by a number of initiatives which are now being rolled out in other areas where Medequip operates community loan equipment contracts.

How does the recycling scheme work?

The process for collecting items, successfully returning them to stock and then reissuing for further use is constantly developed and refined says Medequip.

At the heart of the community equipment loan process are bespoke IT systems that enables the company to know exactly where each item out on loan is located, whether it is large or small. Each and every item carries a barcode and unique identifying code in line with MHRA requirements and also carries a number the user can call to organise collection.

Although details can vary from contract to contract, the process is relatively straightforward notes Medequip, with equipment collected from designated addresses by a fleet of Medequip vehicles, each of which has ‘dual capacity,’ with separate doors and areas for clean and dirty items and antibacterial linings, maximising logistics capabilities and reducing journey numbers.

It is then returned to the depot serving the contract, with every Medequip depot boasting its own CECOPS accredited decontamination centre says Michaela.

Once returned to the centre, the used equipment is assessed to ascertain its suitability for recycling and reuse and where items are deemed unusable, attempts are made to salvage individual components to facilitate repairs to other equipment.

Using the barcode labels, all equipment is scanned onto the vehicle and scanned off at the decontamination facility. It is then scanned at every stage of the process; collection, pre-cleaning, cleaning, post-cleaning, repair, back to shelf, onto the delivery vehicle, and into the client’s property.

According to the Community Equipment Services’ specialist, the IT system produces reports at each of these stages, providing Medequip with complete visibility and total awareness of stock availability.

This enables the procurement team to manage stock levels in line with anticipated requirements, as well as using available recycled equipment before buying new.

Understanding the human element

With such comprehensive systems in place and continuous tracking of products through the loan process, why does Medequip only receive 77 percent of loaned equipment back?

Whilst the IT systems aim to deliver increased efficiencies, Michaela points out that the company understands that due to the sensitive nature of the service and the products, there are important human considerations to bear in mind.

With this consideration in mind, the organisation operates a specialist bereavement collection service to manage such collections with dignity and care says Medequip, however, it is this human element which can also prove the most difficult to manage.

Despite its thorough IT systems and processes to deliver and manage the extensive amount of equipment loaned and returned, no system is perfect.

“…we do believe in collecting everything where possible and when requested” Michaela Harris

According to Medequip, it is this human element that results in equipment being lost, passed on to family members, given to charity shops or even, where it may have a greater intrinsic value, sold on the open market.

To mitigate this, the company works in partnership with local councils and commissioning groups to attempt to increase return rates by making the returns process easier and more transparent for patients, encouraging more returns.

Alongside the returns phone number on barcode labels found on every piece of loaned equipment, Medequip provides a leaflet with full details on how to return the items once they are no longer required, as well as also clearly stating that equipment is on loan.

In addition, to promote awareness of the importance of returning equipment, Medequip produces posters for display at locations including hospitals, GP surgeries, community centres, care homes and similar areas, also promoting the Return, Reuse, Recycle message on social media channels,

In some areas, the company is also working with domestic waste recycling centres to collect equipment which may have been disposed of by the service user, and the organisation has also established ‘amnesty bins’ in convenient spots to enable people to drop off items no longer required.

How effective are returns and recycling initiatives?

According to Medequip, its efforts to prompt patients to return equipment is working, reporting that out of the currently 77 percent of all equipment successfully returned – higher than the 55 percent national average – 91 percent is successfully recycled.

The remaining nine percent consisting of items considered no longer fit for purpose due to damage or excessive wear and tear or because they are not suitable for recycling, such as raised toilet seats and urinal containers.

Some local authorities have also attested to the financial benefits of recycling equipment. The NHS in Barnsley has established its own mobility equipment recycling initiative which has enabled it to collect around 14,000 mobility items, with a reported 94 percent of items were able to be recycled, resulting in a cost saving of approximately £300,000.

With collection of all equipment, particularly individual lower-cost aids, not financially feasible for budgetarily stretched local authorities, it is the challenge of Community Equipment Services and local authorities to continuously drive the message to equipment users to return their equipment after use.

Whilst putting the impetus on patients to return freely loaned equipment will inevitably lead to equipment being lost, transparent and convenient integrated processes like those championed by Medequip will be key for reducing equipment wastage as increasingly more equipment is required in the community.

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We respect your privacy SarsbyIndustry Deep DivesTrade FocusBBC,community equipment,Community Equipment Services,living aids,Medequip,Mobility aids,mobility equipment,mobility equipment recycling,mobility sectorIn February 2019, a BBC investigation in the West of England drew attention to the community loan equipment sector and the millions being spent on mobility and living aids. One of the more controversial claims made in the report was that councils in England are opting to throw away...News, views & products for mobility, access and independent living professionals