Provision of Wigs Policy Senior Operational Group Date: 18.06.2014 Review date: November 2016 Page 1 of 14

Provision of Wigs Policy

Post holder responsible for Procedural Document

Lead Cancer Nurse

Author and post holder of Policy

Tina Grose, Lead Cancer Nurse

Division/Department responsible for Procedural Document

Cancer Services

Contact details x2896

Date of original policy 11/01/2013

Impact Assessment performed Yes/No

Ratifying body and date ratified Senior Operational Group (SOG) 18/06/2014

Review date (and frequency of further reviews)

01/11/2016 (every 3 years)

Expiry date 21/05/2017

Date document becomes live 03/09/2014

Please specify standard/criterion numbers and tick other boxes as appropriate

Monitoring Information Strategic Directions – Key Milestones

Patient Experience √ Waiting

Assurance Framework Privacy and Dignity

Monitor/Finance/Performance Efficiency and Effectiveness

CQC Regulations/Outcomes: Delivery of Care Closer to Home

Infection Control

Other (please specify):

Note: This policy has been assessed for any equality, diversity or human rights implications

Controlled document This document has been created following the Royal Devon and Exeter NHS Foundation Trust Development, Ratification & Management of Procedural Documents Policy. It should not be altered in any way without the

express permission of the author or their representative.

Provision of Wigs Policy Senior Operational Group Date: 18.06.2014 Review date: November 2016 Page 2 of 14

Full History

Status: Final

Version Date Author (Title not name)

Reason

1.0 11/01/2013

Health Records Manager

To confirm patients entitlement to the provision of a wig appliance

Associated Policies: Information Governance Policy

Health Records Policy

In consultation with and date: Cancer Patient Support Group: January 2013 Tina Grose, Lead Nurse Cancer Services: January 2013 and 06/03/2014 Patient Experience Group: 01/04/2014 Associate Director of Nursing: 06/03/2014 Governance Managers: 04/03/2014 Policy Expert Panel: 02/12/2013 Senior Operational Group 18/06/2014

Review Date

01/10/2016

Contact for Review:

Tina Grose, Lead Cancer Nurse

Executive Lead Signature:

Chief Nurse

Provision of Wigs Policy Senior Operational Group Date: 18.06.2014 Review date: November 2016 Page 3 of 14

CONTENTS

1. INTRODUCTION ........................................................................................................ 4

2. PURPOSE .................................................................................................................. 4

3. DEFINITIONS ............................................................................................................ 4

4. DUTIES AND RESPONSIBILITIES OF STAFF ......................................................... 5

5. PATIENTS REQUIRING A WIG ................................................................................. 5

6. ACRYLIC WIGS ........................................................................................................ 6

7. REAL HAIR WIGS ..................................................................................................... 6

8. ARCHIVING ARRANGEMENTS ................................................................................ 7

9. PROCESS FOR MONITORING COMPLIANCE WITH AND EFFECTIVENESS OF THE POLICY .............................................................................................................. 7

10. REFERENCES ........................................................................................................... 8

11. ASSOCIATED TRUST POLICIES ............................................................................. 8

APPENDIX 1: WIG APPLIANCE PRESCRIPTION FORM ................................................... 9

APPENDIX 2: THE PROVISION OF WIGS INFORMATION LEAFLET .............................. 10

APPENDIX 3: RAPID IMPACT ASSESSMENT SCREENING FORM ................................ 12

Provision of Wigs Policy Senior Operational Group Date: 18.06.2014 Review date: November 2016 Page 4 of 14

1. INTRODUCTION 1.1 The NHS makes provision for the supply of wigs to people who need them in order

to help with medical hair loss as a result of a condition or treatment. 1.2 The process of wig provision varies around the country. It is expected that Trusts

will manage their wig provision within a budget.

1.3 The Department of Health leaflet HC11 „Are you Entitled to Help with Health Costs‟, (DoH, 2012a) provides information on providing patients with a wig through the NHS.

1.4 Failure to comply with this policy could result in disciplinary action.

2. PURPOSE 2.1 The Royal Devon & Exeter NHS Foundation Trust (hereafter referred to as „the

Trust‟) provides wigs to NHS patients receiving their NHS treatment at the Trust. 2.2 This policy is to ensure the fair and equitable provision of wigs to patients where they

are needed in the course of treatment

2.3 The policy is for NHS patients who require a wig for temporary, long term and permanent hair loss. It does not include provision for patients who are being treated privately or by another NHS Provider for a condition that results in hair loss.

3. DEFINITIONS 3.1 Approved Wig Supplier – wig suppliers under contract to the NHS through a

framework agreement must supply a good standard of wig, offer choice along with a confidential and quality service. The suppliers are members of the Hairdressing and Beauty Suppliers Association and have subscribed to a code of conduct and practices which comply with British Standard ISO 9001.

3.2 Authorised Prescription Form – the Trust‟s approved prescription form for a

clinician to prescribe a wig appliance to a Trust patient receiving treatment at the Trust for a condition that results in temporary hair loss or where the patient has permanent hair loss.

3.3 Course of Treatment - a prescribed regime to be followed for a specific period of time. 3.4 National Set Prescription Charge – the Department of Health (DoH) review the wig appliance prescription charge on an annual basis every April. This is currently set at £64.95 for an acrylic wig and £245.40 for a real hair wig as at January 2014. 3.5 For the purpose of this policy a Specialist Clinician is – a consultant or senior nurse

from Oncology, Haematology, Radiotherapy or Dermatology who treat patients with permanent or temporary hair loss as a medical condition or as a result of treatment they are receiving.

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4. DUTIES AND RESPONSIBILITIES OF STAFF 4.1 The Chief Nurse/Chief Operating Officer is the Executive Trust Board Officer who has overall responsibility for patient care and provides assurance to the Board on any risks associated with patient care. 4.2 The Lead Cancer Nurse is responsible for reviewing the policy and managing the budget for the provision of wigs to NHS patients prescribed a wig by the Trust. 4.3 The Appliance Officer is responsible for following the operating procedures to support the issuing of wigs to patients, keeping up to date records to ensure payment to suppliers is accurate. 4.4 Staff with a role in the implementation of this policy are responsible for ensuring

they are familiar with and comply with the policy and their role in the implementation of the policy. This includes Oncology, Haematology, Radiotherapy and Dermatology Consultants, Senior Nurses, Matrons, Registered Nurses and the Force Cancer Charity.

4.5 The Senior Operational Group (SOG) is responsible for approving this policy.

5. PATIENTS REQUIRING A WIG 5.1 In order for a patient to receive a wig a prescription for a wig must be made by a

specialist clinician. 5.2 All patients being prescribed a wig will pay a nationally set prescription charge,

however, nationally set exemption criteria may apply to some patients who must complete a WF1 0403 form at:

http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Entitlemen

tsandcharges/NHScharges/DH_4049252 (DoH, 2010) and provide proof of continuing entitlement to benefits see HC11 Help with health

costs at:

http://www.nhs.uk/NHSEngland/Healthcosts/Documents/2012/HC11-oct12-approved.pdf (DoH, 2012b)

A person under 16 years of age

16-18 year olds in full time education

Has a valid War Pension Exemption Certificate and the items prescribed are the accepted disablement

Is named on a valid HC2 NHS low income scheme certificate

Is named on a valid HC3 Certificate for help with health costs

Get Income Support

Gets Pension Credit guarantee credit *

Gets income based Jobseeker‟s Allowance (JSA (IB))

Is entitled to, or named on, a valid NHS Tax Credit Exemption Certificate * Please note all pensioners will still be required to pay, as per government stipulations. Pensioners are not exempt.

- Prescription charges are revised each April by the DoH.

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5.3 Patients will be offered a wig by the supplier of a suitable quality and within a specified price range. Where a patient chooses a wig within this range they will only pay the prescription charge unless they are exempt.

5.4 In order to give patients choice, patients may choose to have a wig outside the specified price range but will pay the difference in cost directly to the supplier.

5.5 All patients will be provided with an information leaflet and asked to complete a

patient satisfaction questionnaire following the supply of a wig. 5.6 In order for the patient to make an informed choice on the wig and supplier, no order

for a wig can be made by the Approved Supplier until the authorised Wig Appliance Prescription Form Appendix 1 has been received by the Appliance Officer. The Appliance Officer will then issue an order number to the Supplier.

5.7 An appointment may be made for the patient with the Supplier prior to receipt of the

Prescription Form by the Appliance Officer but no order can be made or wig issued by the Supplier.

5.8 Wigs will only be supplied by companies on the Trust‟s list of approved wig suppliers Appendix 2.

6. ACRYLIC WIGS 6.1 The Trust will provide patients with an acrylic wig and will subsidise the cost up to £120 (inclusive of VAT) for each wig. 6.2 Patients experiencing temporary hair loss as a result of treatment they are receiving

i.e. Chemotherapy/Radiotherapy, will receive one acrylic wig per course of treatment. If treatment exceeds a 7 month continuous period a second wig may be supplied. This will be reviewed further if treatment exceeds 15 months.

6.3 Patients experiencing permanent hair loss will be entitled to two acrylic wigs per year. 6.4 Only acrylic wigs will be supplied and no prescriptions will be accepted for a real hair

wig.

7. REAL HAIR WIGS 7.1 There may exceptional circumstances where the consultant prescribes a real hair wig

on the basis that the patient has a medical condition that excludes them from having an acrylic wig; or they are an existing patient with a prescription for a real hair wig.

7.2 The Trust will subsidise the cost of the real hair wig up to £500 (inclusive of VAT).

The patient may choose a wig of a higher price and pay the difference directly to the supplier.

7.3 Where a real hair wig has been prescribed the patient will be entitled to receive one real hair wig per year or two every two years. 7.4 Patients with a real hair wig may have them cleaned and redressed on a monthly basis through the approved supplier, following the issue of an order number by the Appliance Officer in order for the invoice to be raised which will be paid for by the Trust.

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7.5 Where a patient is medically unfit to attend the Approved Supplier for the provision of a wig or for cleaning and redressing, the Trust will provide a Domiciliary visit by the Approved Supplier in a patient‟s home up to twice a year.

8. ARCHIVING ARRANGEMENTS The original of this policy will remain with the Lead Cancer Nurse in the Cancer Cluster. An electronic copy will be maintained on the Trust Intranet (IaN), P – Policies W – Wigs. Archived copies will be stored on the Trust‟s “archived

policies” shared drive and will be held for 10 years.

9. PROCESS FOR MONITORING COMPLIANCE WITH AND EFFECTIVENESS OF THE POLICY

9.1 In order to monitor compliance with this policy, the auditable standards will be monitored as follows:

No Minimum Requirements Evidenced by

NHSLA standard

1. Correct entitlement on the Issuing of Wigs to patients

Authorised Prescription Forms

2. Correct number of wigs issued yearly against number of orders issues

Invoices and Order Numbers

3.

All patients will be provided with an information leaflet and asked to complete a patient satisfaction questionnaire following the supply of a wig. The Appliance Officer will process the questionnaires and forward any issues to the Lead Cancer Nurse who will contact the Supplier to address these.

Patient Satisfaction Questionnaire

4. Exemption criteria for prescription charge Copies of WF1 0403 form

5. Monthly Budget Reports Agresso

9.2 Frequency

In each financial year, the Lead Cancer Nurse will audit the above to ensure that this policy has been adhered to and monitored through the Performance Assurance Framework meetings.

9.3 Undertaken by Lead Cancer Nurse 9.4 Dissemination of Results

Through the Performance Assurance Framework. 9.5 Recommendations/ Action Plans

Implementation of the recommendations and action plan will be monitored by the Performance Assurance Framework meetings. The Board reviews the Framework quarterly.

9.6 Any barriers to implementation will be risk-assessed and added to the risk register.

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9.7 Any changes in practice needed will be highlighted to Trust staff via the Governance Managers‟ cascade system.

10. REFERENCES DoH (2012a). The Department of Health leaflet HC11 „Are you Entitled to Help with

Health Costs‟. London: Department of Health. Available at: http://www.nhs.uk/NHSEngland/Healthcosts/Documents/2012/HC11-oct12-approved.pdf DoH (2010). Department of Health WF1 0403 form. Available at: http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/NHScharges/DH_4049252 DoH (2012b). HC11 Help with Health Costs. London: Department of Health. http://www.nhs.uk/NHSEngland/Healthcosts/Documents/2012/HC11-oct12-approved.pdf The Hairdressing and Beauty Suppliers Association. Available at: http://www.thehbsa.co.uk/ British Standards Institution: British Standard ISO 9001 Available at: http://www.bsigroup.co.uk/en-GB/iso-9001-quality-management Veterans UK (undated). Pensions and Compensation - War Disablement Pensions. London: MOD. Available at: http://www.veterans-uk.info/pensions/wpd_question10.html NHS Choices (undated). NHS Low Income Scheme. (information on obtaining an HC2 NHS low income scheme certificate). Available at: http://www.nhs.uk/NHSEngland/Healthcosts/Pages/nhs-low-income-scheme.aspx NHS Business Services Authority (2012). : Low Income Scheme - what you need to know (information on obtaining an HCS Certificate for help with health costs). NHS BSA. Available at: http://www.nhsbsa.nhs.uk/HealthCosts/1136.aspx Wig Appliance Prescription form – see: Appendix 1

11. ASSOCIATED TRUST POLICIES

Information Governance Policy Health Records Policy

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APPENDIX 1: WIG APPLIANCE PRESCRIPTION FORM

WIG APPLIANCE PRESCRIPTION FORM

CONSULTANT:

…………………………………….. WARD/CLINIC:

……………………………………

Is this patient receiving their treatment at the Royal Devon & Exeter Hospital? YES NO* (*IF NO, DO NOT COMPLETE THIS FORM PLEASE REFER THE PATIENT TO THE TREATMENT PROVIDER.) Will this treatment result in hair loss? YES NO Is the patient exempt from paying the prescription charge? YES* NO (If Yes, copy of exemption must be provided and attached) AUTHORISED SIGNATURE: ……………………………………….. PRINT NAME: ………………………………………... DESIGNATION: …………………………………………………………… DEPARTMENT: ……………………….……………… DATE: ………… DD/MM/YYYY ……………………………………………………….……..

DIAGNOSIS:

PLEASE STATE REQUIREMENT:

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APPENDIX 2: THE PROVISION OF WIGS INFORMATION LEAFLET

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APPENDIX 3: RAPID IMPACT ASSESSMENT SCREENING FORM

RAPID IMPACT ASSESSMENT SCREENING FORM

Name of procedural document Wig Appliance Policy

Directorate and Service Area Business and Finance

Name, job title and contact details of person completing the assessment

Sharon Collingwood, Health Records Manager

Date: 18 November 2013

EXECUTIVE SUMMARY No Impacts identified 1. What is the main purpose of this policy / plan / service?

To ensure that the provision of wigs by the RDE is managed fairly

2. Who does it affect? Please tick as appropriate.

Carers ☐ Staff ☐ Patients ☒ Other (please specify)

This Policy focuses mainly on patients.

3. What impact is it likely to have on different sections of the community / workforce, considering the “protected characteristics” below?

Please insert a tick in the appropriate box √

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In identifying the impact of your policy across these characteristics, please consider the following issues:

- Fairness - Does it treat everyone justly?

- Respect - Does it respect everyone as a person?

- Equality - Does it give everyone an equal chance to get whatever it is offering?

- Dignity - Does it treat everyone with dignity?

- Autonomy - Does it recognise everyone‟s freedom to make decisions for themselves?

If you have any negative impacts, you will need to progress to a full impact assessment.

In sections 4 and 5, please copy and repeat the tables below, for each “protected characteristic” considered. Alternatively, you can use one table for more than one “protected characteristic”, if the outcomes are similar.

4. If you have identified any positive impacts (see above), what will you do to make the most of them?

Protected Characteristics

Positive impact -- it

could benefit

Negative impact -- it treats them

less favourably or could do

Negative impact -- they could find it harder than others to benefit from it

or they could be disadvantaged by it

Non-impact – missed

opportunities to promote

equality

Neutral -- unlikely to

have a specific effect

Age ☐ ☐ ☐ ☐ ☒

Disability ☐ ☐ ☐ ☐ ☒

Sex including Transgender and Pregnancy / Maternity

☐ ☐ ☐ ☐ ☒

Race ☐ ☐ ☐ ☐ ☒

Religion / belief ☐ ☐ ☐ ☐ ☒

Sexual orientation including Marriage / Civil Partnership

☐ ☐ ☐ ☐ ☒

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“Protected characteristic” affected:

Issue

Who did you ask to understand the issues or whose work did you look at?

What did you find out about?

What did you learn or confirm?

Action as a result of above

Action By who? When?

5. If you have identified any missed opportunities (“non-impacts”), what will you do to take up any opportunities to promote equality?

“Protected characteristic” affected:

Issue

Who did you ask to understand the issues or whose work did you look at?

What did you find out about?

What did you learn or confirm?

Action as a result of above

Action By who? When?

6. If you have a identified a neutral impact, show who you have consulted or

asked to confirm that this is the case, in the table below:

Who did you ask or consult to confirm your neutral impacts? (Please list groups or individuals below. These may be internal or external and should include the groups approving the policy.)

Tony Williams, Equality and Diversity Manager

Policy Expert Panel

Cancer Patient Support Group

If you need help with any aspect of this assessment, please contact: Tony Williams Equality and Diversity Manager Ext: 6942 anthony.williams1@nhs.net

Please note: This impact assessment needs to be sent, with the policy, to the Equality & Diversity Manager at the following stages: as part of consultation, prior to final ratification of the policy and when final ratification has been given.