By Jeremy Biggin

Back in the year 2000, when Alan Milburn was Secretary of State for Health, I approached the NHS with a website concept…. nobody wanted to listen.

I had for several years been involved with designing websites and when my 80 year old father was suffering with Alzheimer's and my mother, although lovingly attentive, was finding it difficult to cope. It struck me how little I knew about aids to daily living that could make life a tad easier for them. There was plenty of love and family involvement, but an ignorance of practical things. We had excellent help from the medical profession, doctors, district nurses and physios, but we had to accept what we were told. I asked myself “How do I find out, as an individual, what is available for the disabled in terms of equipment?”

When working normal hours and snatching the odd moment to phone father's doctor and more often than not choosing the wrong moment, it struck me that a website would be the answer and that there must be many people in the same situation.

A website which shows Jo Public the aids to living equipment available, on loan, from the NHS could be the answer. Access would be 24/7, an ideal facility for anxious relatives, carers, friends of the permanently or temporarily disabled. Knowledge gained would be used to discuss in a more educated way the patient's needs with the patient and his/her medical advisors.

The idea was “hawked” around as an “I have an idea, but I'm not going to tell you until I see you!” Eventually the then Chair of the Sheffield Regional Hospital Board gave me an interview and felt that the idea had merit. She introduced me to the local NHS Equipment Loan Service to whom I presented the concept in November 2001. At that time the DoH was encouraging Local Authorities and NHS to coordinate the equipment loan activities - “Guide to Integrating Community Equipment Services”- Local Authority Social Services had the responsibility for supplying and fitting those items which required installing (e.g. grab rails and items to support daily living activities) whilst the NHS supplied the “free-standing” equipment (e.g. commodes, hospital beds). The website idea was seen as an ideal way of combining the whole range of loan equipment “under one roof”. Sheffield having the foresight to pioneer this route and incidentally to meet the DoH integration target set for 2004

The website went live in the spring of 2003 as a joint venture between the NHS and Sheffield City Council's Social Services Department, and as well as showing the community what is available also allowed authorised medical professionals, by login, to requisition equipment online…for the very first time. A key aspect of the website content being liaison with the medical professionals and administrators who would use it, thereby ensuring everyone was onside.

The software was a combination of “off-the shelf” and bespoke. There were around 100 items of equipment contained on site carrying thumbnail photographs, the items' specifications (details of dimension, load capacity etc) and application. The equipment was broken down into sections relevant to “Bathing”, “Moving & Handling”, “Toileting” etc and the easy to navigate site quickly became popular with medical professional users, some of whom readily admitted that they themselves were unaware of some of the equipment on offer!

Frequently asked questions (FAQ's) are answered on site as are issues concerning equipment maintenance assistance, there are links to other useful websites and there is a news page

The site was upgraded in January this year and a website for Pressure Relief and Redistribution Equipment added with full access to authorised personnel only, due to the expertise required in this area. It has also, for the first time, been promoted to the general public, in Sheffield, through GP Practices, Pharmacies, Charitable Organisations and other public venues. Local Group Practices are being encouraged to carry a link to scels from their website.

Part of the original concept was to encourage NHS approved advertising and sponsorship. This was difficult to promote to equipment manufacturers when the website was purely local with a very low visitor count. However as visitor levels grow and we suspect they will, the advertising possibilities become more realistic. Click-throughs to manufacturers' websites, linked to the scels site, would enable purchases to be made by the public for items which they prefer to buy (self-fund) than obtain on loan…this procedure would suit all parties. In the Sheffield area alone there are around 40,000 users of the service at any one time and to that figure can be added carers and relatives

The other development areas discussed with the Sheffield Community Equipment Loan Service include

• On line training in the use/installation of equipment for medical professionals.
• Practical in-situ demonstrations on the correct use of the equipment for users/patients/carers, partially through links with equipment manufacturers' websites
• Amnesty! – return those items of equipment no longer required
• For information only to show the cost to the NHS of each piece of equipment, thereby hopefully encouraging an appreciation of material value. This has been flagged-up on the scelspr site which covers cushions and mattresses
• An automatic email to those who have requisitioned equipment a week prior to the equipment being due for return. This reminds the medical professional and gives time to advise of any longer loan period requirement
• An area for very special and high value items which have become available. This could be used as a national facility and may prevent unnecessary purchases in other parts of the NHS (i.e. a stock database)
• Audio for the partially sighted
• Other languages
• Search by ailment (e.g. back injury/broken ankle etc)
• Links with sites which make life easier for patients and their carers (e.g. online shopping, mobile services for meals, local pharmacy opening times, working from home)
• Recruitment/career opportunities
• “Live Helper” – two-way text facility where a user/carer and authorised staff member can discuss salient points relating to specific equipment
• Service monitoring – discovering the perceived level of service given

The motto of the scels website is “the click that can make life easier” and it is aimed, importantly, at the community at large. There is the bonus of medical professional requisitioning but by using the site as a first port of call the general public have a far better idea of what is available. Spin-offs from this being the time saved by medical professionals in answering initial queries and the fact that as the site becomes more widely known , within the community, the public will already be aware of availability prior to contacting their medical advisers.

Rolled out nationally this type of uncomplicated website has, I believe, huge benefits to the public, the NHS, Local Authorities and to the manufacturers of equipment.