Direct Payments for equipment

Did you know that you can now request a Direct Payment for disability equipment?

"Direct Payments" were introduced in 1996 to enable disabled people to buy in care, and pay for it themselves, but did you know that Direct Paments are also available for equipment?

This page looks at some of the issues involved, and questions you should ask if you are considering opting for a Direct Payment from your local authority, so that you can purchase an item of equipment yourself.

Contents:


What are Direct Payments?

  • A Direct Payment (DP) is money paid by a local authority (local council) to an individual who has been assessed as needing community care or children’s services. Instead of the local authority arranging the services, the person uses the payment to purchase the relevant services themselves.
  • DPs enable users to purchase and control the services of personal assistants; but it is less well known that this facility can also be used for equipment, giving the disabled person more choice and control over what equipment they have.
  • Direct payments can only be used to purchase services stated in an individual’s care plan, and the local authority must still be satisfied that the person’s assessed needs will be met.
  • The council should advise you that you have the right to request a Direct Payment for equipment, and it has a legal duty to give you a DP, if you ask for one, provided certain criteria are met.


Assessment of need

  • A decision about a Direct Payment can only follow a statutory assessment of need.
  • The disabled person must have been assessed by a relevant person, such as an occupational therapist, as needing that item of equipment.
  • If a person wishes to use a Direct Payment to purchase equipment which does not meet the assessed need, the Local Authority should not provide a Direct Payment for that purpose.
  • If there is a waiting list for assessment, an individual will still have to wait to be seen. You cannot jump to the head of the queue, even if you do not want the Local Authority to provide the equipment. It is unclear how this might work if you arranged an independent assessment though.
  • Note that local authorities can use their “Fair Access to Care” criteria to decide if someone even qualifies for an assessment.


What sort of equipment would Direct Payments cover? And what is excluded?

  • Direct Payments can only be used to purchase services/equipment stated in your care plan (following assessment).
  • They can only be used for equipment which would be provided by the local authority (under community care legislation).
  • They cannot be used to purchase services or equipment that would otherwise be provided by other bodies, for example the NHS or health authority. Thus items such as wheelchairs, walking sticks, environmental control systems or ventilators would not be covered by Direct Payments. Since some items such as beds can be a bit of grey area, individuals would need to clarify the position with their local authority.
  • Direct Payments cannot be used to purchase any services or equipment that would otherwise be provided by the Housing department; they are not a substitute for a Disabled Facilities Grant.


How much should a Direct Payment be? And who can receive one?

  • A Direct Payment should cover the reasonable cost of obtaining the necessary (assessed) item of equipment. This is likely to be the cheapest one that meets your assessed needs.
  • If you wish to purchase a better model, then you can choose to top-up the amount and upgrade the equipment – so long as it still meets your assessed needs. For example the Local Authority may assess someone as needing a mobile hoist. The individual could ask for a Direct Payment, and then add in some of their own money, in order to buy a more expensive model, or a mobile hoist which folds and can be transported.
  • Where the local authority is able to buy equipment at a cheaper rate than an individual could (eg due to bulk volume discounts or special rates given to local authorities) the DP should cover the actual price that the user would have to pay for that item, if this is higher.
  • To be eligible for Direct Payments, the individual must consent, and must be able to manage the payment, with or without assistance. Where necessary the DP could be made to a third party (eg parent of a disabled child)
  • Direct Payments do not affect Social Security benefits and are not taxable


Breakdowns, maintenance & repairs. Ownership

  • It is important to clarify whether the local authority or the individual is responsible for ongoing repairs and maintenance; this may be something to consider before opting for a Direct Payment.
  • In general, if the item of equipment is one that the local authority would maintain, then it would seem reasonable for the DP to include money for the user to pay for the same level of maintenance. Alternatively it could be arranged that even though the item was purchased with a DP, the local authority will still be responsible for maintaining it.
  • Similarly, arrangements for breakdowns/repairs should be addressed when the DP is set up.
  • For more complex or expensive items, it is also advisable to clarify who will own the item if it is no longer needed. This is likely to be more of an issue if the individual put in some of his/her own money, and purchased a more costly item.


Advice, and long-term needs

  • Advice may be needed especially for larger,more costly or complex items, to ensure that the item purchased is safe and appropriate.
  • In theory DPs could be used to lease rather than purchase equipment, if this was a cost-effective way of meeting the need.
  • If the individual’s needs change, such that the equipment is no longer suitable, then the person should be re-assessed in exactly the same way as before, and if necessary another DP can be offered to cover the cost of a different piece of equipment.


Where do Direct Payments apply?

Although the legislation varies, Direct Payments for equipment apply to all areas of the UK (England, Northern Ireland, Scotland and Wales). Locally however, statutory provision of equipment may be very good, so that take-up of Direct Payments is low.


Further information

  • Speak to your local Social Services or Social Work department
  • Carers And Direct Payments Act (Northern Ireland) 2002. See Section 10.5 of DHSSPS Guidance on Carers and Direct Payments Act which was published in April 2004. Visit this link:www.dhsspsni.gov.uk/publications
  • The Community Care, Services for Carers and Children's Services (Direct Payments) (England) Regulations 2003. Visit this link for more information:
    www.legislation.hmso.gov.uk