Equipment provision by local authority occupational therapy teams using the Fair Access to Care Services eligibility framework: A vignette and interview study

Purpose: In April 2003, the first national eligibility framework for adult services, Fair Access to Care Services (FACS), was implemented by local authorities in England. The intention was to ensure equity in the provision of adaptive equipment. This study examined how the criteria were being used by local authority occupational therapy teams and if equity was being achieved. Procedure: Five vignettes or hypothetical case histories were used to capture the experiences of a purposefully selected group of 12 employees from three local authority occupational therapy teams in the Midlands. Semi-structured interviews were then conducted to explore the themes raised by responses to the vignettes. Interviews were recorded and transcribed. Thematic analysis was independently conducted by two of the authors. Findings: There are inconsistencies in the access to services and the use of eligibility criteria, particularly at the point of entry to the service and for those people who are classified as having 'low' level needs. However, there is consistency within professional practice and evidence that staff prioritise client need. Conclusion: The implementation of FACS has been inconsistent and has not resulted in equity of provision. Some occupational therapy staff appear to prioritise the needs of clients above organisational policies.