1. Transfer & Transport Simon Wells MSc DCR (R) Moving & Handling Advisor
Kings College Hospital NHS Foundation Trust, London &
Queen Victoria Hospital NHS Foundation Trust, Sussex

3. Aim Transfer – (non-emergency)
In/out of vehicles – client, equipment (wheelchair, hoist )
techniques
equipment
Transport – (routine)
guidance
Sources of information

4. Legislation & Regulation
• The European Bus Directive 2001/85/EC, Annex VII, Paragraphs
and
• European Directive 76/115/EEC, Anchorages for motor vehicle
safety belts.
• European Directive 77/541/EEC, Safety belts and restraint
systems of motor vehicles.
• UNECE Regulation 14.04, Safety belt anchorages.
• UNECE Regulation 16.06, Safety belts and restraint systems.
• UNECE Regulation , Approval of M2 and M3 vehicles,
general construction. Annex 8, Paragraphs and
• The Public Service Vehicles Accessibility Regulations 2000,
SI 1970.
• BS ISO Wheelchair tie-downs and occupant restraint
systems: Part 1 - Requirements and test methods for all systems.
systems: Part 2 - Four-point strap type tie-down systems.
• ISO Wheelchair tie-downs and occupant restraint systems:
Part 3 - Docking type tie-down systems.
• BS EN 1789: 2007 Medical vehicles and their equipment,
Road Ambulances.
• SAE J2249 Wheelchair tie-down and occupant restraint systems
for use in motor vehicles.
For other global standards, please contact our Engineering team

5. Legislation & Regulation
Wheelchair tie-downs & occupant restraints 'WTORS
Min. req - WTORS - ISO (parts 1-5). All WTORS are required to pass a simulated crash test at 20g/48kph using an 85kg surrogate wheelchair and 75kg ATD occupant.
ISO compliant WTORS satisfy req. - European Whole Vehicle Type Approval for Wheelchair Accessible Vehicles under the Special Purpose Category, The European Bus Directive 2001/85/EC, UNECE Regulation 107 and the UK Public Service Vehicles Accessibility Regulations (PSVAR) 2000.
ISO 7176 Part 19 - Wheeled Mobility devices for use as seats in motor vehicles ISO 7176 Part 19 wheelchair manufacturers with min. design performance req.& assoc., test methods for manual & powered wheelchairs intended for use as a forward-facing vehicle seat in a road passenger vehicle.
Vehicle Seat fixtures UNECE Regulation 14, or Directive 76/115/EC, as amended by 2005/47/EC. specify seatbelt anchorage load requirements by vehicle category:
M1 Vehicles: Vehicles for the carriage of passengers comprising no more than eight seats in addition to the driver.
M2 Vehicles: Vehicles for the carriage of passengers comprising more than eight seats in addition to the driver's seat and having a maximum mass not exceeding 5 tonnes.
M3 Vehicles: Vehicles used for the carriage of passengers comprising more than eight seats in addition to the driver' seat and having a maximum mass exceeding 5 tonnes
Seatbelts design and performance requirements of UNECE Regulation 16 and the Directive 77/541/EC, as amended by Directive 2005/40/EC.
Floor & Anchorage Systems requirements of UNECE Regulation 14 & Directive 76/115/EC as amended. .

6. Transfer & Transport: People & equipment
Independent
Mobile & requiring assistance
Wheelchair users
can transfer
can not transfer
Existing assessment - follow guidance
If no assessment ensure it is undertaken & documented to ensure a safe system of transfer for both client & carer

7. Transfer: in/out of vehicles
Options: -
Small handling aids (SHA)
Swivel Seats
Hoists
Wheelchair systems
Wheelchair accessible vehicle (WAV)
Increasing cost

8. Transfer: In/Out of vehicles: SHA
Dependant on assessment and design of car, height of transfer surfaces, size of individual, space, degree of mobility of individual etc
Equipment which may assist: –
Transfer boards
Turn tables
Rota stands
Slide sheets
Transfer bar…..

9. Small Handling Aids (SHA)
No adaptations required for these options
Handy bar - acts as a grab bar, lightweight stainless steel bar with soft, non-slip hand grip
Non slip handle and simple to use
slides into car door latches - can be used on nearly any car door frame
Car Caddie
Provides an additional hand hold & loops over top part of door/window frame
Transfer board
Person can slide from seated surface in/out of vehicle seat
Soft turntable
Helps user swivel their bottom and move their legs into/out from the vehicle
‘slide aid’ – may need to be removed before driving

10. Swivel Seats
Whole seat swivels - Rotate 90º or Rotates coupled with a lifting & lowering function
Transfer from wheelchair in vehicle onto swivel seat
Transfer from wheelchair to seat
outside vehicle

11. Hoists Lifts person from wheelchair into the vehicle
Lifts & stores wheelchair during transport

12. Hoist

13. Autochair Lite Wheelchair Lift & Storage
System folds, lifts & locks away a manual wheelchair in less than 90 seconds
Wheelchair is enclosed during travel
Suitable for most manual folding wheelchair with removable footplates & some wheelchairs with fixed plates
In emergencies, door can be opened and the wheelchair unloaded manually
All operations are from the normal driving position
Operation achievable from the drivers’ seat
Can be transferred to your next vehicle

15. Wheelchair Systems Wheelchair seat replaces the vehicle seat
User stays in same seat
Wheels will need to be stored separately once safely transferred into vehicle (carer safety)
If specialist seating required, not be an option

16. Ex - Milford Person Lift - The Electric Person Hoist
Wheelchair Systems
Ex - Milford Person Lift - The Electric Person Hoist
Hoist designed for lifting people from wheelchair into/out of a vehicle
Fits most 4 door cars, all 2 door cars, people carriers & 4x4s
SWL – 111 – 148 kg
8kg, has emergency switches & optional manual operation
Fitted to the driver's side, passenger's side both front & rear
Hoist operation by a carer or disabled person using a small control box attached to a fly lead 

17. Autochair - Carony Wheelchair System
allows the seat in the vehicle to become your wheelchair seat
the seat in the vehicle becomes your wheelchair seat, eliminating the need to transfer from one seat to another
Carony base unit is then stowed in the boot of the vehicle
3 versions available:
‘transit’ wheelchair - wheelchair user is pushed by a carer
‘user propelled’ - wheelchair user can propels themselves
electric wheelchair option

18. Wheelchair Accessible Vehicles (WAV)
Wheelchair or mobility scooter driven onto vehicle
Remain in wheelchair as a passenger
Option - drive from wheelchair
Most expensive option
WAV from Motability…….
- guide providing info. on vehicles that allow you to travel in your wheelchair. Contact information reviewed 6 mthly, guidance 2 yrly (Oct 2011)

19. ….About Motability Motability national charity
Helps disabled people with their personal mobility
Oversee the Motability Scheme which includes the Car Scheme &the Powered Wheelchair & Scooter Scheme
Manages the Government’s Specialised Vehicles Fund, specifically to help people who need a heavily adapted vehicles
Raises money for own Charitable Grants Programme - provides additional financial help to those people whose allowance does not cover the cost of the mobility solution they need
Adaptations are available through Motability to make your driving, or travelling, experience as comfortable as possible.
Adaptations can help you drive, stow your wheelchair or scooter, or get in and out of the car

20. Transport: wheelchair users
Self transfer in / out of vehicle
Requires assistance to transfer into vehicle
Generally safer for person to be transported in the vehicle seat rather than their wheelchair
If there is an assessment of how transport should be facilitated – follow recommendations/plan
If No assessment – some guidance to assist …..

21. Transport Wheelchair & occupant restraints
Occupant Restraint System – passenger harness
Flooring systems
Seating systems
Accessories (head replacement)

22. …..Transport: Advice & Guidance
MHRA (insert contact info web)
Community Transport Association UK (
Dept. of Transport (
Wheelchair manufacturers (leaflets/instructions)

23. Transport: wheelchair users
Direction of travel
Code of Practice on the Safety of Passengers in Wheelchairs on buses VSE 87/1
Wheelchair users travel facing forwards, unless provided with a vertical bulkhead against which to travel rear-facing
Not advised for wheelchair user to travel rear facing against the back of a vehicle seat (since not vertical)
Wheelchair accessible taxis – if integral bulkheads & suitable bulkhead & restraints may offer rear facing facility (as do some accessible low floor buses
Use parked/braked position (front castors orientated forwards & brakes on)
User restraints fitted
Wheelchair tie downs

24. Transport: Equip. attached to wheelchair
assess how attachments would move if a collision
bags removed from wheelchair
remove trays/tables, communication boards – fit foam block if they remain in position
do not remove footrests as may support posture
respiratory equipment, firmly secured

25. Transport: Wheelchair – raised backs/head restraints
Leave support in position to prevent whiplash
Shoulder straps of the occupant restraint - slotted beneath raised back rather than placed over the top of the raised back; sudden brake straps may break the raised back
If raised back of wheelchair prevents shoulder straps from wheelchair occupant restraint being fitted it should be removed & stored
If possible replace raised back with a detachable head restraint correctly positioned / secured (screw thread so backward force compresses rather than loosens restraint)

26. Transport: Narrow wheelchairs
For certain models – Not possible to follow manufacturers instructions since clamps have an inwards orientation
If this does not allow for secure restraint – use 4 point webbing restraint in preference

27. Transport: Powered Wheelchairs
Powered off
Firmly secured
Batteries – secured
Manual brakes applied
If no manual brakes clutch engaged – this may prevent ratchet clamps from proper safe fitting
Not to be secured with ratchet clamps – use 4 point webbing to be used and user secured
If central mounted joystick – reposition to one side or remove

28. Transport: Seating inserts
Insert secured to wheelchair
MHRA – advises postural straps supplied with a seat should be used during travel
Special seats will need to be secured following manufacturers instructions, generally with straps additional to & separate from passengers safety restraint system
Lightweight cushions do not need to be secured

29. Transport: Pommels & knee blocks
Assess risk of groin injury
If possible – remove (but only if users medical advisor approves)
If not possible –
travel rear facing
ensure user wears travel harness & lap strap
consider padding around the pommel

30. Tracking in minibuses
Most mini buses have floor tracking - Low profile tracking is recommended for floor tracking
Surface mounted tracking for walls to secure folded wheelchairs, other equip.
Wheelchair clamps - Widely used & suitable – for manual wheelchairs weighing
< 38 kgs
Lockable ratchet clamps are preferable, to hook type & more secure
Ratchet clamps – fit vertically
Adjustable bar- which rests on wheelchair chair frame and onto which lockable wheelchair clamps can be fitted, position bar so cannot damage spokes

31. Wheelchair restraints
Wheelchair 4 point webbing tie downs
Suitable - man/powered wheelchairs < 85 kgs (106 kgs for heavy duty types)
Attach wheelchair (at set points/manufacture) at/below seat height; 2 at front, 2 at rear
Fixed design
Restraints mounted on fixed base which fits into floor tracking
Floor tracking fitted and in good repair
Seat restraint systems which are not track compatible but can be slotted into predetermined access points in vehicle floor and ceiling

32. Safety Restraints Seat belts – offer protection, law
Exemption certificate from GP
If exempt must inform Insurance company
Wheelchair user posture belts are not passenger safety belts – have No connection to the floor or body of vehicle

33. Passenger Safety Belts
ONLY use as manufacture specifies
Vehicles to carry seat belt cutters for use in emergency
Must be
tight across pelvis
fitting inside not outside framework of seat or wheelchair
lap belt – must not ‘ride up’ over abdomen (risk of internal injury if collision or user slides out)
Shoulder traps fit across collar bone, not neck/throat
Safety belts should be in good order & easy to apply
Passenger safety lap belt (not wheelchair lap belt) is min. requirement for forward facing travel
Single diagonal strap of double straps secure upper body gives additional protection to head
2 Point Safety Belts (most common type)
2 points of attachment to vehicle floor/track system
3 designs:
lap belt (are min. req. but little upper body security
inertia reel belt (are comfortable with good muscle tone/upper body control
fixed harness with 2 shoulder straps (preferable if low muscle tone)

34. 3 - point safety belts
3 - point belt; 2 Attachments - floor, plus to framework of vehicle above height of seated passengers shoulders
Preferable to 2 - point safety belts where shoulder straps run over passengers shoulder & directly down to floor
3rd attach takes a single diagonal fixed belt or inertia reel extension but not a harness with straps over both shoulders
Very few vehicles are adapted to take 3 point systems
Future - Consider for replacement vehicles

35. Transport: travel in a Mobility scooter on a bus
Certain smaller mobility scooter’s are compatible with low-floor buses, if: -
your local bus company is running a scooter permit scheme
your scooter is a Class 2 type & meets certain size limits
bus company has assessed you in safely using your scooter on the bus
Permit schemes developed across the UK - Confederation for Passenger Transport (CPT) & in London by Transport for London (TfL).
If bus company part of CPT – issue permits which confirm you/your scooter are allowed to travel
ricability website - info. on bus companies running the scheme & list of mobility scooters that meet the criteria

36. Vehicle Ramps
Generally aluminium fixed or telescopic ramps provide safe access even where there are significant height differences
wear-free non-skid surface providing grip in wet or dry conditions
Light weight & compact
Smooth nylon glide adjustment (telescopic)
Consider noise if rattle in the vehicle during transport
Ideally soft end profiles - no sharp corners
Soft rounded carry handles

37. Seating systems
Seating systems can greatly improve a vehicle layout by offering flexible seat configuration.
Flexibility
easily modified from fully seated to wheelchair accessible
Seat Fixtures
Fitted to the seat legs to provide an easy way of moving the seat within the vehicle
removable seat fixtures, designed for ease of operation and safety
single hand operated lockable systems
an alternative, the Standard Removable Seat
Bolt systems
Functions as a non-removable fixing for semi-permanent seat positions.
Combined Seat & Wheelchair Restraint
Provides either a seat or wheelchair restraint, is easy to move within the vehicle and combines a small footprint as an optimal space saving design.
The locking foot operation and adjustable reaction bar ensure the wheelchair is kept securely in place. A modular system for PTS or the Ambulance sector, it enables multiple and quick solutions for the driver as well as security for the passenger

38. Training Proper training for staff and helpers and carers
Transport providers regular risk assessments
Some training organisations…..

39. Training Organisations
AJS Training Tel: Website:
The Community Transport Association Tel: Website:
Specialised Transport Advisory Network Tel: Website:
Mark's Specialised Transport Tel: Website:
Nu-Track Ltd Tel: Website:
Community Transport Training Tel: website:
Phoenix Training Tel: Website:
Karen Gibson Ltd Tel: Website:
 Promobility Tel:  website:
Puwertec Ltd Tel: Website:

40. If you can’t use your own vehicle – Supported transport/travel
Advice on Supported Travel is available from your local SPoC (Single Point of Contact)
Limited service - priority is given to vulnerable people in isolated & rural areas. You may qualify if you: -
Do not have or are unable for medical reasons to travel in your own transport
Cannot be driven to your healthcare appointment with friends, neighbours or relatives
Are medically unable to use public transport, or this is not practical due to your isolated/rural address
It would be detrimental to your immediate health if you were not to attend your appointment on the day in question
You have 3 or more appointments in any consecutive 4 week period and do not have access to alternative means of travel due to any of the above
If a community voluntary car is provided, normally a nominal mileage charge is made towards this service, check this with your SPoC prior to travelling
 If you qualify under the guidelines above please contact your nearest SPoC

41. Ricability research and information for older and disabled people
independent consumer research charity providing free, practical & unbiased reports for older & disabled people
scooters_on_buses
getting_in_and_out_of_a_car
reports/address list
wheelchair_accessible_vehicles

43. Sources of Information 1
Motability
DLF
Ricability
Queen Elizabeth Foundation
Independent Living

44. Sources of Information 2
 Medicines and Healthcare products Regulatory Agency (MHRA) for Technical enquiries - 
Wheeled Mobility & Seating Centre, Blackpool   
Telephone
MHRA – Other enquiries- Business Services, Hannibal House, Elephant & Castle, London SE1 6TQ.
Tel:
The Community Transport Association (UK)
Tel/Fax:   / 
The Community Transport Association (Wales)
Tel:
Department for Transport  Mobility & Inclusion Unit
Tel:    Fax:
CTA – Community Transport Association -