Implementing Configura® seating in Dudley MBC

The challenge 

Dudley MBC highlighted a concern regarding the significant and increasing spend on specialist seating. Although the service user needs identified by the prescribers were appropriate and essential, alternative solutions to reduce spend were required. Dudley MBC highlighted that there were a range of additional concerns with the seating provision that also needed to be resolved. Deb started researching on how to be more cost effective, but also how they provide a more efficient and effective service where therapists could be upskilled and more in control of their seating recommendations and decision-making.

Dudley MBC identified the following issues with seating provision prior to 2020:

• Spend on seating was very significant and escalating
• Many used specialist chairs were stored on the shelves in the warehouse and were unable to be reissued to other users unless another individual was the same size as the previous person and had very similar needs 
• The pressure care could be easily adjusted, however there were minimal adjustments that could be made to posture management and no size adjustment options 
• Clinical staff were very dependent on one supplier to carry out joint visits and identify the appropriate chair due to limited knowledge of the chair range 
• Most of the clinical staff were not familiar with the chairs in the stores or how to make amendments for other service users 
• The clinical staff that were familiar with the chairs were unable to make amendments themselves due to limited options and ease of use
• The moving and handling of the chairs being issued was a concern due to their weight and structure
• Bespoke chairs in stock and the community could not easily be repaired by CES technicians, leading to costly repairs or replacement chairs, again with a dependency on the current supplier. 

The solution

Deb approached Accora at the OT show in 2019 and was introduced to the Accora Configura range. Further discussions with Accora and Croydon IPH highlighted that there was already a partnership for procurement in place which negated the need for a tendering process. 

The Configura range of seating allows for the chairs to be set up for a specific service user. It is also possible to adjust the chair as the user’s needs change or for the chair to be reissued to other service users, due to the flexibility of being able to configure the size, pressure care and postural support.

In March 2020, Accora was chosen as the preferred supplier for Dudley’s seating requirements. Deb highlighted that the first training session to introduce Dudley Community Service Technicians to the Configura range took place just the day before Lockdown 1, the tension was high and there were a lot of unknowns at this time due to Coronavirus. 

Introducing a new company and range of chairs to a service at this very difficult and unpredictable time was not easy and an unexpected challenge.

Classroom training with Occupational Therapists was cancelled due to the pandemic, and later facilitated by Accora using Microsoft Teams. We were all learning to adapt to this new way of training, and the outcome was more staff were trained by this method, with positive feedback from participants.

Deb reports that the implementation had gone much better than she hoped, and overall, the changeover to Accora has gone very well.

Feedback was received from the August 21 Equipment Review Group, Deb specified that “the professionalism, general approach, training and documentation provided by Accora has been so good – especially as it was through the pandemic”. 

The support provided by Accora includes:

• Availability of a product specialist to carry out joint visits with prescribers, allowing service users to trial the chair in their own home. During these visits, the product specialist ensures that the prescriber is fully aware of the variety of chairs available and the functions each one has, and will then work with the prescriber to ensure the most cost-effective, suitable chair is prescribed, without over-prescribing. 
• A sales director and product manager are readily available to ensure that all those involved are aware of the range of chairs, their differences and compatibility with manual handling equipment. They advise on logistics and technical support, and ensure both online and in person bespoke training is available to technicians, prescribers and the commissioning team as required. 
• A technical advisor is available and provides support and regular training to technicians and drivers to ensure they are familiar and confident with the use of the chairs.
• Accora’s two Consultant Occupational Therapists are readily available to provide training from a clinical perspective and have been adapting the training to cater for all levels of expertise and provide advice on appropriate provision for specific users as required.

The joint goal for Dudley and Accora is for the prescribers to become more familiar with the range of chairs and make more informed choices when prescribing chairs for service users. The prescribers will become more familiar with what adjustments are available, and how the adjustments can be made without any extra tools. As a result, the prescriber is likely to be able to prescribe a chair without the need for a joint visit, which speeds up provision to the service user and reduces cost of provision.

Feedback one year on

Deb reports that overall, the service’s experience has been a positive one. There have been no complaints or negative feedback to date from the prescribers, technicians/drivers or commissioners. Prescribers report that they have found Accora to be efficient and responsive and have advised that the videos available to describe each chair have been very helpful, as well as finding the option to purchase chair parts rather than whole chair advantageous. There has also been recognition of the work Accora does with the Motor Neurone Disease Association. Overall the teams report to all feel very well supported by the Accora team. Deb also reported that the prescribers and technicians are more in control due to increasing familiarity with the chairs and their built-in adjustments.

Saving on overall seating spend 2020/2021 has been 57%, which equates to £134k, when comparing the spend on specialist seating 2019/2020 before Accora were the preferred supplier.

Deb advised that the changes made are significant and although she can quantify the cost savings, there are other benefits that are not as easy to quantify, such as reducing the time required by prescribers to provide and trial chairs, meeting service users’ needs more efficiently, reducing hospital admissions, reducing care packages and building the prescribers’ skill set and confidence.

Deb also advised that the chairs are already being recycled and provided an example of a Configura chair being ordered in 2020 for a specific service user which was returned to stores when that service user no longer required it. Within a matter of months it was reissued to another service user and all that was required was an accessory. This resulted in very speedy chair provision to a service user and significant savings as a new chair would have otherwise been required.

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