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To maximise functional independence, and to minimise the development of pressure sores and deformity, it is critical that an in-depth evaluation of postural management need is made. Every seating support solution is bespoke to that individual and may well require an amalgamation of several different manufacturers component parts to effectively achieve agreed client centred aims and objectives.

The human body is designed to move and yet for wheelchair users we so often expect them to remain in the same piece of equipment all day and every day.

If specific specialised postural management needs have been identified as being necessary in a wheelchair it is not unexpected that specific needs in static seating are additionally required.

Having access to a range of equipment affords the client choices and the opportunity to adjust and/or modify their orientation in space.

With ever increasing advancements in the development of technology, clients who, even 10 years ago, were not able to achieve independent mobility are now much more likely to be able to achieve a degree of independence.

However, the more complex the drive controls of a powered wheelchair chassis solution the more bespoke is the solution and less readily available are back up solutions should the equipment require maintenance or repair. It is therefore considered good practice for back-up solutions to be provided.

This may mean the provision of a second powered chassis or the provision of a secondary manual chassis. The may be additional life style considerations that make it necessary to have a manual wheelchair chassis as well as a powered one.

Different types of both manual and powered chasses fulfil different social, environmental as well as clinical need. Decisions on this are best being client centred and made in conjunction with all stake holders.

If the management of posture is deemed necessary and appropriate in wheelchair seating and in static seating, then it is highly likely that the client may need to be considered for support in lying when in bed/ resting.

The detailed client evaluation will identify the effects of gravity on muscle tone and spasticity patterns etc. This will help us to inform the most appropriate solutions being trialled and selected for supportive products required over a full 24 hour period.

For Wheel of Health to work effectively and professionally, being able to offer our clients the standard of support that is required, it is imperative that there are in place excellent working relationships with the kind of equipment suppliers who understand the complexity of the clients with whom we work.

We need to always have up to date knowledge of products and their development and we need to know that if a product requires a maintenance visit urgently that that too can be met. So, we will only select equipment supply partners with whom we have confidence that that level of support can be provided.

So, it is not just about making sure that the equipment has been appropriately trialled and agreed, it is also about ensuring that it is supplied by the most appropriate supplier for that individual clients’ needs.

Products used by clients with complex needs never sit alone. There is always a relationship with allied equipment. For example, a complex postural support seating system is only ever as good as the way that someone has been positioned correctly in it such that they are getting maximum benefit from it. Therefore, it is important that the moving and handling equipment that is used for the transfer process can facilitate that positioning repeatedly and reliably.

The relationship between a wheelchair seating support unit and a vehicle has to be right so that the vehicle can cater for the clients’ needs. It is always preferable to agree a wheelchair seating support system in advance of a vehicle. Adaptations and modifications to a previously purchased vehicle can be costly and time consuming to implement.

Accessing other independence equipment such as bathing, meal preparation will hinge on ease of access from the chosen postural management equipment.

Referrals to Wheel of Health typically come from several different sources but whatever the source it is critical that costs are carefully monitored and decisions given clinical justification.

Referrers may not necessarily be clinical in background so reporting on findings needs to be concise and clear but professionally accurate and fulfilling the requirements of professional best practice.

Members of the Wheel of Health team are all professionally qualified and are required to work to the best practice guidelines of their professional body.

The complex nature of client assessment and product consideration can only be implemented by clinically supervised equipment/ product trials so that adjustments and modifications can be made to products to fulfil their practical application.

For some clients it may be necessary to carry out several product trials with different products and/or different component parts. This can be a time-consuming process but decisions made at this stage should ensure longevity of product as the clients condition changes and evolves. Ideally a product selected should have enough adjustability that at reviews modifications can be made without the necessity to purchase new products.

However, it should be noted that products do not last for an indefinite period and consideration should be made at the point of assessment as to how on-going needs can be met for the long term.

Wheel of Health likes to work alongside the clients, their families, and carers and other professionally involved personnel to ensure that decisions made are agreeable to all concerned. It is rarely possible to achieve a 100% solution 100% of the time and compromises are inevitable. It is advisable therefore that the consequences of those compromises are well understood and all stake holders agree the decisions.

Clients’ needs continually evolve and progress – either because of progression of the condition negatively or positively or because of changes in treatment or rehabilitation. Additionally, gravitational effects and the ageing process lead to postural changes and the impact of that on functional independence and systemic function.

To manage the consequences of these changes it is advisable that pre-programmed scheduled reviews are diarised so that the clinician and equipment supplier can make minor supportive modifications on an on-going basis rather than leaving a client for a longer period and then discovering that a whole equipment replacement process has become necessary. Ideally a review schedule should be part of the initial assessment process so that long term plans can be put in place.

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Associate advertisement

Locations: Home based (Greater London and surrounding counties/East Anglia/South West/ Midlands/ North East/ Scotland/ Wales).


1. Senior Associates
We are looking for Occupational Therapists/Physiotherapists to work as self-employed Associates. Applicants should have experience of Wheelchair seating/Posture management/ Pressure care/ 24hr posture management and associated areas, such as wheelchair controls and associated moving and handling and transportation issues.


The role will give you the opportunity to use your skills to find innovative and creative solutions to meet client needs. You will be required to carry out needs led assessments for wheelchair users with complex clinical needs, ensuring timely and clinically appropriate solutions. You may then be involved in liaising with equipment suppliers to carry out product trials resulting in a detailed specification before ensuring set up and handover of equipment.


Applicants should be able to demonstrate that they have completed post graduate training and have post graduate experience within this specialism. You will be able to demonstrate a high standard of professional and comprehensive report writing.


2. Associates
Additionally, we are looking for Occupational therapists/ Physiotherapists to work as self-employed associates who have some base line core experience in neurology, paediatrics, associated wheelchair seating etc. and who would like the opportunity of developing their skills in this field by working with clients with mild to moderate needs. Applicants will be mentored and supervised by existing senior associates and/or team leaders and would be expected to work towards the self-funded completion of post graduate training. Additionally, they will be required to demonstrate that they are developing their experience in this field.


This role is an opportunity to work towards becoming a senior associate within the Wheel of Health team and evolve your professional experience and opportunity at a more senior level.
These opportunities would suit those who wish to extend their professional experience into the private sector and gain autonomy in personal case management within this specialist area.


For further information please contact: –
Lucy Weech, Clinical Director Wheel of Health Limited
Email | Lucy.weech@wheelofhealth.co.uk
Office | +44 (0) 23 8076 8583
Mobile | 07830 072700

Arab Health 2016We teamed up with RMS Limited as part of Arab Health 2016. See our clinical director @ 0:01:25



Wheel of Health came recommended to me by a colleague as I had a client with complex and unusual seating and posture needs.

The therapist who assessed my client was professional, reassuring, very clinically skilled and experienced, and focussed on overcoming barriers to provide a solution to my client’s needs. The team still continue to work with my client four years after the first consultation providing a high level of clinical expertise. They have an excellent relationship with the client, his family, the equipment suppliers, including a wheelchair company based in Europe, local therapists and carers.

Most important is that they have improved my client’s comfort and quality of life by finding the correct solution to his wheelchair and seating needs. I highly recommend the team”.

Midshires have been working with Wheel Of Health for several years now in collaboration with our wheelchair and seating specialists which have included difficult and complex seating solutions.

The skilled approach of the clinical team to their clients’ needs and situations, together with a management team’s determined drive to company growth and evolvement provides clients with a truly first class service

Paul Cushen | Managing Director, John Brown | Operations Director