Focus on Equipment: Wheelchair Accessible Vehicles – Provision & Considerations
by David Herbert
The aim of this article is to educate and inform the reader on the decision-making process that an occupational therapist may go through when recommending a Wheelchair Accessible Vehicle (WAV) for one of their clients.
NOTE: resources are provided at the end for further reading and access to the various services referenced.
Occupational therapists have a key role in assessing for the provision of an appropriate WAV, based on their knowledge and experience of a range of physical conditions, how these impact function, as well as potential contraindications.
Case managers often refer to OT’s to either validate their view that the client would benefit from a WAV, or the need is identified by the OT as part of their holistic initial assessment of a shared client.
Either way the input of an OT into the process can be invaluable in ensuring the correct vehicle and specification are purchased, combined with the additional environmental and access considerations being addressed.
What is a Wheelchair Accessible Vehicle (WAV)?
For those clients who are dependent on the use of a wheelchair to access the wider community, the need for an appropriate wheelchair adapted vehicle may be of huge benefit.
Put simply, a wheelchair accessible vehicle, or WAV, is a vehicle that has been specifically converted to allow someone to travel in their wheelchair, without necessarily having to transfer from their chair into a passenger seat.
Those requiring the use of a wheelchair, be that self-propelled, attendant propelled or electric, experience a range of injuries, conditions and health needs. These may include spinal injuries, lower limb amputations, stroke or head injuries, or respiratory conditions, to name a few. Therefore, each wheelchair user will have different considerations with regards to the use of a WAV, and what type is best suited to their needs. This is where specialist clinical assessment by an experienced occupational therapist, in conjunction with the companies’ technicians, is key.
This article has been written with the technical support of Matt Smith of GM Coachworks, a leading converter of WAV. He advises that there are a limited number of car models that lend themselves to conversion and adaptation. As such, the majority of conversion companies therefore tend to convert the same vehicles from mainstream manufacturers.
Types of WAV
Ultimately, the type of WAV required will depend on a variety of factors, including who intends to drive it, whether it will be the client or a family member, or whether the client may require an attendant or carer to accompany them. As such, any decision should also factor in the wider family or caring needs, as well as those of the client or cared for person.
There are four main types of WAV, with different levels of adaptation required, outlined below.
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Rear Passenger WAV
A rear passenger style WAV allows the person using the wheelchair to access the vehicle from the rear, whilst remaining seated in their wheelchair. Once inside, the person would remain as a passenger, seated at the back of the vehicle for the duration of the journey. -
Upfront Passenger WAV
With this style of WAV, the person would still access the vehicle from the rear, however it allows the person to sit in the front passenger position, rather than in the rear. This adaptation results in the loss of a seat in the back of the car to support access, therefore, it is worth taking into consideration the reduction in passenger seating capacity. -
Internal Transfer WAV
To aid independent transfers from a wheelchair to a car seat within the car, some WAVS can be fitted with a seat that swivels or pivots. The wheelchair can then be stored in the rear of the car. -
Drive From wheelchair WAV
It is possible to provide necessary adaptations to support the person using the wheelchair to drive the car independently whilst remaining seated in their wheelchair. It may be that cars needing this level of adaptation will require the work to be completed by a specialist car conversion company. As advised by GM Coachworks, this style WAV requires a higher level of conversion and engineering. However, the passenger can still access the vehicle from either the rear or side entrance.
It should be noted that should the person wish to drive the vehicle themselves, then consideration should be paid to whether the client’s medical condition or injuries may impact their ability to do so safely. Further guidance for medical professional on assessing fitness to drive is available from the DVLA here: https://assets.publishing.service.gov.uk/
In addition, the national charity Motaclarity coordinates a network of driving and mobility assessment centres for people with restricted mobility and older drivers. Assessment of both physical and cognitive ability is completed to identify whether a medical condition is impacting on safety to drive. This will further inform any recommendations for appropriate WAV’s and adaptations. Motaclarity can also provide advice on charitable funding and grant options if required. www.motaclarity.co.uk/wav-assessments
Ramps and Lifts
As well as lowering the vehicle floor, most WAVS will also need to be accessed via a ramp or lift. This adaptation may be an addition or conversion and should be factored into budget considerations. Ramp options include a manual ramp, mid-folding or a hydraulic assisted ramp.
If physical assistance is required for wheelchair use or to access the vehicle, then a remote-controlled rear or side entry platform lift may be a more appropriate option.
The OT will work with the rep and the client to establish if this is needed and if so the most appropriate specification.
Alternative cost solutions
As well as purchasing a new or converted WAV, there are a number of suppliers offering second hand options that could also be considered should funding be limited. Here are some suppliers who provide such services:
The OT Assessment
Having first identified whether a WAV would be appropriate to meet the client’s needs, the occupational therapist would then arrange a joint visit with an appropriate company representative to explore and trial suitable vehicles. The OT is there as the expert in the client’s level of current and likely future functional ability, the WAV company representative is there as a product specialist. Both components should be present to ensure an accurate, appropriate and robust specification and quote can be provided to the case manager.
The following will be being considered as part of the OT assessment:
- The client’s physical ability, medical conditions, and prognosis
- Specific challenges to the passenger and the vehicle
- Storage capacity for a wheelchair or scooter, if required.
- Fastening considerations of the wheelchair to the vehicle and the client to the chair
- The carer’s position in the vehicle relative to the passenger, and their ability to safely and comfortably provide care if necessary.
- Any wider family needs i.e., does the vehicle need to support a family travelling together.
- Access to and from the vehicle.
- Parking and storage of the vehicle
Each type of WAV will have additional considerations that may include:
- The client’s requested travelling position, as well as the size of their chair and height when seated. This is to help ensure that there is sufficient space in order for the client to sit upright, taking into account the risk of hitting their head if going over speed bumps or potholes in the road.
- The client's:
- upper body mobility
- ability to use hand controls
- eyeline when seated in their wheelchair, if using a drive from wheelchair WAV. Clients should be able to see out of the windows comfortably, without the need to stretch or crane their necks or straining other parts of their body.
- In order to maintain the client’s sense of wellbeing and engagement, they should be able to clearly see the other passengers and participate in conversation.
Parking
To aid parking closer to the person's desired destination, particularly within congested areas, participation in the Blue Badge parking scheme can be incredibly useful.
For up-to-date qualifying criteria and to apply for (or renew) a Blue Badge, this can be done via the government websites for England, Wales, Scotland and Northern Ireland.
- Applying for a Blue Badge in England
- Applying for a Blue Badge in Wales
- Applying for a Blue Badge in Scotland
- Applying for a Blue Badge in Northern Ireland
The need for dropped kerbs or a covered drive port at home to aid parking and transferring during poor weather can also be considered as part of the occupational therapist’s wider assessment. This would be dependent on environmental restrictions but can form part of the wider considerations when preparing a package of home adaptations/property requirements and equipment/WAV provision for a case management client as appropriate.
Regulations and standards
Mainstream cars produced at higher volume are provided “type approval”, whereby the national authorities certify that a particular car model meets safety, environmental and conformity of production standards, without the need for each individual car to be certified. However, for cars that are adapted to bespoke specifications, or manufactured in smaller numbers, such as WAV’s, these require “Individual Vehicle Approval”, as certified by a government representative from the Vehicle Certification Agency (VCA). In addition, all necessary restraints are tested to ensure that these meet required standards.
Insurance & maintenance
Insurance: This is an important consideration for case managers as the WAV might be the initial cost but there are the ongoing maintenance and running costs that also need to be considered. For insurance, if the car were to be purchased privately, then it would be down to the individual to source an appropriate insurance provider as per any private purchased vehicle.
Maintenance: Vehicles typically come with a three-year warranty as standard, with servicing and repairs via manufacturer accredited garages. The case manager would normally have this discussion directly with the representative to ensure that the quote included the relevant costs.
Conclusion
As outlined above, there are a range of vehicle and adaptation options available to suit each client’s specific needs. In partnership with WAV providers, occupational therapists hold a key position in accurately assessing and recommending the most appropriate, bespoke solution for both a client’s immediate and longer-term needs.
To request an assessment for the provision of a suitable Wheelchair Accessible Vehicle, please contact The OT Practice Case Management Team on 0330 0249910 (option 4) or email enquiries@theotpractice.com
Useful links
https://www.motaclarity.co.uk/charitable-grants
https://www.gov.uk/apply-blue-badge
https://www.alliedmobility.com/allied-mobility-news/understanding-wheelchair-accessible-vehicles/
https://www.motability.co.uk/find-a-vehicle/wheelchair-accessible-vehicles/
https://www.rica.org.uk/features-reviews/out-and-about/wheelchair-accessible-vehicles-wavs-0
https://www.wavsgb.com/different-types-of-wheelchair-accessible-vehicles/
https://www.brotherwood.com/the-brotherwood-difference/
https://www.gmcoachwork.co.uk
