Personal Wheelchair Budgets

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Re: Personal Wheelchair Budgets

Postby Burgerman » 01 Sep 2018, 23:36

Sounds very sensible!

My payment is always about 6 to 18 months LATE. Thats how fast the socialised medical systems work. Its all meetings, budgets, assessements, more meetings, coffee, approval panels, re-meetings, decisions, paperwork, pricing more coffee, etc etc repeat infinitely. I was even ADVISED to remind them of this and re-apply a year before my 3 years is up...

The other problem is that they assess me, (well they come and nod and agree with my well written 6 page super detailed tech assessement that they dont understand but dare not show it as I take the P rather well) and agree it. But then they go away and work out what that would cost THEM at their trade prices to the NHS. They then add an arbitrary figure for 3 years maintainance, and a figure for the cushion/back you use. Then thats the figure they pay out.

In my case they give me about 6k for the chair. Which is OK ish, since I can buy that chair cheap/trade, so it all works out. But its still wrong. Because if they expect others that dont have my contacts or abilities, then it will not cover the chair. They should be paying retail, plus extras and maintainance etc. Or why would any normal person take it up? So I am about to ask for a breakdown, and reasoning, and explain that this isnt how its supposed to work! So some fun ahead.
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Re: Personal Wheelchair Budgets

Postby steves1977uk » 02 Sep 2018, 09:51

I wrote a complaint e-mail to the main CCG in Norfolk about WCS, let's see what happens. :roll:

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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 10:07

Did it sound like you meant it?
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Re: Personal Wheelchair Budgets

Postby steves1977uk » 02 Sep 2018, 11:28

Yes it did BM, I said if nothing is done then I shall complain higher up and get my local MP involved. Hopefully I won't have to wait too long. :argument

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Re: Personal Wheelchair Budgets

Postby MichaelB » 02 Sep 2018, 13:30

Burgerman wrote:Sounds very sensible!

The other problem is that they assess me, (well they come and nod and agree with my well written 6 page super detailed tech assessement that they dont understand but dare not show it as I take the P rather well) and agree it. But then they go away and work out what that would cost THEM at their trade prices to the NHS. They then add an arbitrary figure for 3 years maintainance, and a figure for the cushion/back you use. Then thats the figure they pay out.

In my case they give me about 6k for the chair. Which is OK ish, since I can buy that chair cheap/trade, so it all works out. But its still wrong. Because if they expect others that dont have my contacts or abilities, then it will not cover the chair. They should be paying retail, plus extras and maintainance etc. Or why would any normal person take it up? So I am about to ask for a breakdown, and reasoning, and explain that this isnt how its supposed to work! So some fun ahead.


This is the reason that my WCS don't want to give PHB's, they don't want to chance getting into an argument over giving their cost price instead of retail price. If they lost and had to give retail payments they know it'll be a lot more. Totally wrong, you should be given what a chair will cost you. My Access to Work payment is 5/7ths of the retail price based upon me working 5 days a week and having use of the chair on 2 non working days. That seems like it is fair to me. I do the research, supply 3 quotes, about 3 weeks later get a confirmation letter, I buy the chair, give them the invoice and 3 weeks after that the payment is in my bank account. Hence why I am not bothered about WCS other than the principle, I guess if I could get PWB I could use it for the personal use part of A2W which would help. No fighting or assessments, nice and simple.
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 13:35

This is the reason that my WCS don't want to give PHB's, they don't want to chance getting into an argument over giving their cost price instead of retail price.


I am about to have this discussion. But its NOT THEIR DECISION TO MAKE. If they refuse to fund it properly the NHS england can take the CCG over and the term given is "special measures" while they straighten it out. That can and has meant hiring and firing and banging of heads in the past.
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Re: Personal Wheelchair Budgets

Postby MichaelB » 02 Sep 2018, 14:10

Burgerman wrote:
This is the reason that my WCS don't want to give PHB's, they don't want to chance getting into an argument over giving their cost price instead of retail price.


I am about to have this discussion. But its NOT THEIR DECISION TO MAKE. If they refuse to fund it properly the NHS england can take the CCG over and the term given is "special measures" while they straighten it out. That can and has meant hiring and firing and banging of heads in the past.


There must be an official NHS document with PWB policy clearly explained, I've got the national framework for Continuing Health Care for example. It lists the process, qualifying criteria and even states that finances are not to influence a decision. There has to be something similar for PWB but who would have it and how do we get it? Then there could be no argument, just point to the relevant policy.
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Re: Personal Wheelchair Budgets

Postby woodygb » 02 Sep 2018, 14:52

I have no idea if this information is relevant ...

There appears to be 211 CCG's in England.

A recent performance report https://www.england.nhs.uk/wp-content/u ... 201718.pdf

States....."We introduced an expanded Personal Wheelchair Budgets model to 18 CCGs and providers in 2017/18"
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 15:15

We introduced an expanded Personal Wheelchair Budgets model to 18 CCGs and providers in 2017/18.


Pesonal wheelchair budgets were introduced across all of england the previous 2 years. 2015, 2016, to 2017. https://www.england.nhs.uk/personal-hea ... r-budgets/

So this EXPANDED word which isnt explained is what they introduced this year. What does EXPANDED refer to?
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Re: Personal Wheelchair Budgets

Postby segreen » 02 Sep 2018, 15:30

Is the amount they give you supposed to get you a chair or to go towards a chair? I've been offered £2,266.33 and the chair recommended is Sunrise Medical Salsa with comfort seating and a Roho cushion. As you can guess the amount is not enough for the chair, it's short by about 50% if I wanted to get one of those chairs which I don't.

They also won't entertain you building your own chair before anyone asks.

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Re: Personal Wheelchair Budgets

Postby MichaelB » 02 Sep 2018, 15:31

I think that the 18 were the trial CCG's.

This is the line from that report that is the real problem "NHS England and the DHSC are working at providing more consistent access to CHC funding and supporting CCGs to make efficiency savings" I get CHC and local CCG's have rewritten a national policy to include costs when the policy specifically excluded them. The outcome is that if your at home care package costs more than a care home guess where you end up despite the "person centred" policy?. NHS England know that it is happening in breach of their policy and do nothing or the opposite and support the efficiency saving. CHC allows me to have my own personal health budget which is just like PWB but... if I did it they would expect it to be substantially less than a care company and I would be expected to not get anything for managing and employing 7 or 8 people and a £200k pa budget. It is all smoke and mirrors, they make policies, say that it is person centred then do what they want to save money.
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 15:38

segreen wrote:Is the amount they give you supposed to get you a chair or to go towards a chair? I've been offered £2,266.33 and the chair recommended is Sunrise Medical Salsa with comfort seating and a Roho cushion. As you can guess the amount is not enough for the chair, it's short by about 50% if I wanted to get one of those chairs which I don't.

They also won't entertain you building your own chair before anyone asks.

Steve

Really. Thats what the scheme is for! It all started specifically so I could build and maintain my own, using whatever new or used parts I wanted. Have a read of the blurb they HAND OUT!!!

The amount depends on prescription. And what they would pay, If you need tilt/recline/lift/centre footplate etc, they price it up, deduct their trade discount, and then add cushion, maintainance and thats the price they offer you. 6K in my case.

How much money will people get in their personal wheelchair budget?

Each CCG will develop local processes to calculate the amount of money in a personal wheelchair budget. The amount will be based upon what it would cost the NHS to meet the person’s assessed postural and mobility needs via the wheelchair service currently commissioned by their CCG. https://www.england.nhs.uk/personal-hea ... questions/


You are all getting fobbed off. Their main job is to avoid change and save money. Your job is to explain to them why thats not going to happen.

So... How is it they can hand these leaflets out, while claiming you cant build your own???
READ THE FIRST 3 SENTENCES!!!

I will type it out.

TITLE: PERSONAL WHEELCHAIR BUDGETS

SENTENCE 3: John uses his personal health budget to pay for mechanical parts, so he can build high spec customised wheelchairs for himself... Shot in foot or what? Even their own literature shows they are lying to you.
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 15:47

ALL of you are ALLOWING these idiots to guide you along their choosen simple cheap easy to control path!!!
JUST DON'T ACCEPT IT!!! :fencing

Do you think they didnt try all this safety nazi bullshit with me too? :lol:
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Re: Personal Wheelchair Budgets

Postby MichaelB » 02 Sep 2018, 15:50

So from this quote "The amount will be based upon what it would cost the NHS to meet the person’s assessed postural and mobility needs via the wheelchair service currently commissioned by their CCG." they will give you what it costs them, that means the discounted price they pay not more!

That makes it very clear, you can't argue with it.
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 15:55

It does, but I still can!!!

In any case, by the time you add a 700 cushion, and a 350 back, and a 3 years maintainance its still pretty good if like me you also BUY RIGHT... And use it to modify, build your own, rebuild older ones as new, keep spare backup chairs etc. Works out pretty good. And you get the chair you want.
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Re: Personal Wheelchair Budgets

Postby segreen » 02 Sep 2018, 15:56

Doesn't matter how much you shout about it, John, they won't entertain you using it for building a chair well at least not here in the Northwest. I've shown them your leaflet and other supporting evidence and argued till I'm blue in the face and they still don't budge. I'm sick to death of arguing with them for a couple of thousand pounds. All I wanted was a couple of batteries and sets of tyres a year but it falls on deaf ears. It's not worth the hasstle especially when I can afford to buy my own as I have been doing for thirty-years. Trouble is here in Bolton you've got women running a service who don't know one end of a chair from another and trying to explain or argue with them is hopeless. I for one will give way to someone who has more time and more patience then I have! czy
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Re: Personal Wheelchair Budgets

Postby MichaelB » 02 Sep 2018, 16:05

Well, you can argue but for the majority it is not going to help as the wording does set what you will get. Not everyone can get a cheap deal or make/modify their own, bit difficult for me when I can't move anything below my neck :D Now if it was an electric mountain bike it would be different, might just manage to sort a deal on that.

Hmm, thinking about it I got a Switch It micro guide joystick and neck harness from NHS, retail was over £3k just for those 2 bits, they would have to give me trade value which is probably still stupid money. The other good thing would be to see how much the dealer has in margin, that would be interesting!
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 16:09

If you cant be bothered to fight them, then they wore you down and thats the intention. They won. Saved money for more meetings. Do you think they didnt try all this with me?

Then let them assess you. Make sure it includes all tne things that you need like 4 pole so it steers and seating options, etc, and let them supply the chair. Then trash it about 15 times a year by using it quite normally... Complain about the programming, its hard not to, make sure that every time range suffers you harass them for batteries. Ring them daily and explain why its not working again and send them many letters... They will spend the next 3 or 5 years running around trying to make an inadequate chair with small controller and batteries work for an active user. I have been there and got the T shirt. Why do you suppose they rather I dealt with it myself?
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 16:15

The other good thing would be to see how much the dealer has in margin, that would be interesting!


The dealer has to have his margins. It pays wages, tax man, rent, vehicles, stock, theft, accountants, VAT man, hollidays and staff, repairs to property, heat, light, stationary, computers, etc. And most dont make much. Bad ones go broke. Good ones make a sensible living. The margin in most retail stuff varies from 20 to 100% so called profit, but after expenses isnt.

That said, many can get extra discounts if they buy more. So are often open to supply only deals. 25 to 30% discount and no VAT with parts only warranty is quite easy to organise if you know how to talk to a dealer. I have done that at least 4 times for new chairs.
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Re: Personal Wheelchair Budgets

Postby MichaelB » 02 Sep 2018, 16:27

Burgerman wrote:
The other good thing would be to see how much the dealer has in margin, that would be interesting!


The dealer has to have his margins. It pays wages, tax man, rent, vehicles, stock, theft, accountants, VAT man, hollidays and staff, repairs to property, heat, light, stationary, computers, etc. And most dont make much. Bad ones go broke. Good ones make a sensible living. The margin in most retail stuff varies from 20 to 100% so called profit, but after expenses isnt.

That said, many can get extra discounts if they buy more. So are often open to supply only deals. 25 to 30% discount and no VAT with parts only warranty is quite easy to organise if you know how to talk to a dealer. I have done that at least 4 times for new chairs.


Oh, I know that dealers need margin, I've got no problem with anyone making a living from a service they provide but when it gets above 35-40% GP for a traditional bricks and mortar shop, that has to carry stock and maintain a reasonable staff level I'd question whether it is being managed effectively. Don't mind paying for service I do for bad management. I've spent most of my life working for bike makers and distributors selling to dealers both with shops and now via the internet so have a reasonable understanding of how the game plays. For
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Re: Personal Wheelchair Budgets

Postby rover220 » 02 Sep 2018, 19:53

segreen wrote:Is the amount they give you supposed to get you a chair or to go towards a chair? I've been offered £2,266.33 and the chair recommended is Sunrise Medical Salsa with comfort seating and a Roho cushion. As you can guess the amount is not enough for the chair, it's short by about 50% if I wanted to get one of those chairs which I don't.

They also won't entertain you building your own chair before anyone asks.

Steve


spec a salsa up and itll cost you around 8k retail for a capable spec
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Re: Personal Wheelchair Budgets

Postby rover220 » 02 Sep 2018, 20:01

MichaelB wrote:
Burgerman wrote:
The other good thing would be to see how much the dealer has in margin, that would be interesting!


The dealer has to have his margins. It pays wages, tax man, rent, vehicles, stock, theft, accountants, VAT man, hollidays and staff, repairs to property, heat, light, stationary, computers, etc. And most dont make much. Bad ones go broke. Good ones make a sensible living. The margin in most retail stuff varies from 20 to 100% so called profit, but after expenses isnt.

That said, many can get extra discounts if they buy more. So are often open to supply only deals. 25 to 30% discount and no VAT with parts only warranty is quite easy to organise if you know how to talk to a dealer. I have done that at least 4 times for new chairs.


Oh, I know that dealers need margin, I've got no problem with anyone making a living from a service they provide but when it gets above 35-40% GP for a traditional bricks and mortar shop, that has to carry stock and maintain a reasonable staff level I'd question whether it is being managed effectively. Don't mind paying for service I do for bad management. I've spent most of my life working for bike makers and distributors selling to dealers both with shops and now via the internet so have a reasonable understanding of how the game plays. For


the discount depends on the dealers deal with each manufacturer, can be up to 48% for top tier dealers but it varies from product to product even from one manufacturer.

this market is not a cheap one to be in, the margin has to stretch a long way to cover some big costs, vans, diesel, rent soon add up.
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Re: Personal Wheelchair Budgets

Postby Burgerman » 02 Sep 2018, 21:15

spec a salsa up and itll cost you around 8k retail for a capable spec


£10,006.23 to be exact! Less some discount. As you know. NHS offered approx 2/3rds this.

Because a) based on THEIR trade prices.

And b) they won't cover extra cost for 6mph, only 4. Or the upgrade to the fancy colour joystick (now included - typical!) or the 120 Amp upgrade r-net over the 90A one included. Or the lights. So anything over 4mph spec, I had to add. I also had to pay for the black custom paint. They wont cover that. They did understand the 4 pole motors and did cover that, and the single post arms, and the wider P shaped jay tops, swingaway joystick munt (junk), etc. They understood the need fot tilt, recline (pressure sores) and the extra cost of a build for me centre power footplate to get the CG back, and the lift, to aid transfers to different heights. And a jay2 cushion, and a jay3 back. Quite reasonable really. But thats because I had a full page explaining the need for all the expensive options. And because she looked at all my home built lithium chairs, and I explained what that was all about, why the scheme existed, so that I CAN BUILD MY OWN or do whatever I choose. Complete with tubeless tyres explanations etc. And I told her it would be lithium powered, seat moved back, fat tubeless rims and tyres, reprogrammed etc. She just nodded. Once she handed over the money thats all my business.
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Re: Personal Wheelchair Budgets

Postby MichaelB » 03 Sep 2018, 13:43

rover220 wrote:the discount depends on the dealers deal with each manufacturer, can be up to 48% for top tier dealers but it varies from product to product even from one manufacturer.

this market is not a cheap one to be in, the margin has to stretch a long way to cover some big costs, vans, diesel, rent soon add up.


That is the same for most products, commit to carrying stock, sell more, be proactive marketing that brands products and your margin increases. Overheads won't be vastly different to a bike shop but I would think that value of stock would be less and they don't have the same amount of internet competition. I know from buying a joystick last year that some are taking liberties, bought at £950 and I couldn't sort sensitivity out so returned for refund, 1 year later asked another dealer for a quote £2k!! for an item they don't carry in stock so would order then despatch to me. I sent them original invoice and asked them to explain the price - silence...
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Re: Personal Wheelchair Budgets

Postby Burgerman » 03 Sep 2018, 13:52

I know from buying a joystick last year that some are taking liberties, bought at £950 and I couldn't sort sensitivity out so returned for refund


Bit you are the reason they charge a fortune for parts. And have high margins. You ordered a part that you didnt understand. When it needed the ability to understand it, and to program it with tools you dont own, and correct the issue you had, then you returned it for a refund! That wasnt the shops fault, and they shouldnt have taken it back. But they did. So you are surprized when they want to charge you a lot? Thousands do this sort of thing, day in and day out. So these dealers end up with parts they cant return as new, just sat on shelves indefinitely that cost them money, overheads, and time. They end up being sold to wheelchair breakers in bulk, and end up on ebay for 10% of their cost.
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Re: Personal Wheelchair Budgets

Postby MichaelB » 03 Sep 2018, 16:21

We contacted the manufacturer prior to purchase as we knew their could be problems because the DX system was using the SLM to move the steering system, the manufacturer wasn't certain that it could be made to work but was happy to do it via the dealer on a sale or return basis. Very few people have experience of the SLM steering system used on the Boma so even talking to Dynamic Controls wasn't much use, throw in the combination of the joystick mount arm and it was not easy to get it any better than the DX joystick. Plus the interface had switch problems which the manufacturer didn't know about, we told them, they replicated the fault but had to work on a fix.

The manufacturer was always aware that it might not work, hence why they offered SOR, as it didn't work I returned it and at the same time made them aware of a fault, for that they were grateful. Dealer had little to do, they didn't have it in stock and will of returned it to manufacturer as agreed.

When one makes assumptions without knowing the facts it is inevitable that you will get it wrong and I fail to see how I am the problem given that set of circumstances.

If I want other parts I contact manufacturer or the distributor as my experience of wheelchair dealers has not been good. I will check compatibility, part number and availability, if the manufacturer or distributor won't sell direct I'll get a dealer list and order via a dealer giving them all the information they need. I can guarantee that they won't have it in stock so all they will do is order, despatch to me when it arrives, pay invoice after 30 days but take my money prior to despatch. And for that they get anywhere up to 48% GP??

I've had some very good service from distributors, sometimes small parts FOC but, in general, my experience with dealers is not what I would expect in a competitive environment in 2018. I could give some appalling examples whilst trying to find a better chair over the last 6 months, some just not interested in the sale of a £14k chair as I wanted it to my spec and that was too much hassle, incredible. But probably one of the reasons they struggle.
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Re: Personal Wheelchair Budgets

Postby Burgerman » 03 Sep 2018, 18:19

I've had some very good service from distributors, sometimes small parts FOC but, in general, my experience with dealers is not what I would expect in a competitive environment in 2018.


You need to find a better dealer. Theres good and bad. And its far from competitive yet. MOST powerchairs and wheelchairs are bought in socialist style medicines way. And if/when the Personal wheelchair budgets ever gets going in a sensible way, there will no longer be wheelchairs bought directly from manufacturers in bulk and handed out to all. From whichever dealer or manufacturer offeres the best italian weekends away to "promote a new model", by the WCS physios. Regardless of what you really needed. But thousands of END USERS that have the buying power. That is then capitalist free trade instead of socialist medicines corrupt or dont give a shit versions of purchasing. Think venuzuala.

The good dealers will get all the trade. The good chairs will sell. The bad will fall by the wayside. The consumer gets to choose. Based in part on personal experience, forums such a this, stories on social media, spinal injuries unit talk, disability magazine discusion, offers in advertising, with good and bad dealer reputations, good and bad chairs, etc doing the bulk of the sales. And real competition driving up the quality and down with prices. And on places like https://www.google.com/search?client=fi ... f051ad,1,,,
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Re: Personal Wheelchair Budgets

Postby MichaelB » 03 Sep 2018, 18:54

So far my experience has been the majority bad and I have tried a few. I've given feedback to distributors telling them that they should not be dealing with companies like this but not many listen.

Eventually it will change, communication methods mean that poor service will be publicised and dealers will adapt or close. Distributors will see this and think about who they supply. Or I would like to think so but know that many disabled don't use social media or forums so it might not happen, you just have to hope that it will.

Maybe a dealer review section on the forum would help :)
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Re: Personal Wheelchair Budgets

Postby rover220 » 03 Sep 2018, 19:04

MichaelB wrote:We contacted the manufacturer prior to purchase as we knew their could be problems because the DX system was using the SLM to move the steering system, the manufacturer wasn't certain that it could be made to work but was happy to do it via the dealer on a sale or return basis. Very few people have experience of the SLM steering system used on the Boma so even talking to Dynamic Controls wasn't much use, throw in the combination of the joystick mount arm and it was not easy to get it any better than the DX joystick. Plus the interface had switch problems which the manufacturer didn't know about, we told them, they replicated the fault but had to work on a fix.

The manufacturer was always aware that it might not work, hence why they offered SOR, as it didn't work I returned it and at the same time made them aware of a fault, for that they were grateful. Dealer had little to do, they didn't have it in stock and will of returned it to manufacturer as agreed.

When one makes assumptions without knowing the facts it is inevitable that you will get it wrong and I fail to see how I am the problem given that set of circumstances.

If I want other parts I contact manufacturer or the distributor as my experience of wheelchair dealers has not been good. I will check compatibility, part number and availability, if the manufacturer or distributor won't sell direct I'll get a dealer list and order via a dealer giving them all the information they need. I can guarantee that they won't have it in stock so all they will do is order, despatch to me when it arrives, pay invoice after 30 days but take my money prior to despatch. And for that they get anywhere up to 48% GP??

I've had some very good service from distributors, sometimes small parts FOC but, in general, my experience with dealers is not what I would expect in a competitive environment in 2018. I could give some appalling examples whilst trying to find a better chair over the last 6 months, some just not interested in the sale of a £14k chair as I wanted it to my spec and that was too much hassle, incredible. But probably one of the reasons they struggle.


you dont get that margin on parts, more usually 20% but sometimes as low as 10%

the argin on a new product has to cover the minimum 2 trips to assess and then deliver a chair and it also has to cover the potential warranty call outs that manufacturers dont cover the cost of.

rent alone on our unit is £30k pa, i think you need to re align your expectations
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Re: Personal Wheelchair Budgets

Postby rover220 » 03 Sep 2018, 19:06

MichaelB wrote:So far my experience has been the majority bad and I have tried a few. I've given feedback to distributors telling them that they should not be dealing with companies like this but not many listen.

Eventually it will change, communication methods mean that poor service will be publicised and dealers will adapt or close. Distributors will see this and think about who they supply. Or I would like to think so but know that many disabled don't use social media or forums so it might not happen, you just have to hope that it will.

Maybe a dealer review section on the forum would help :)


manufacturers once upon a time were selective to who they gave accounts, now it is about volume and supplying as many dealers as possible, there are 5 such dealers within 15 miles of us. they will not listen to one end user complaining if the dealer is shifting stock and hitting targets
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