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Market Context

The Integrated Community Equipment Loan Service (ICELS) provides, by way of loan, equipment to adults and children living in their own home to support them to maintain or increase their independence and support careers in their roles. Examples of community equipment include:

  • Toileting – commodes, shower seats, raised toilet seats
  • Mobility Equipment - mobile or fixed hoists, lifting aids and moving and handling equipment
  • Walking – walking frames, sticks, etc.
  • Beds – specialised beds, mattresses and accessories
  • Seating – standard and specialised chairs and seating
  • Hoists – including ceiling track hoists
  • Adaptations – including simple such as grab handles or rails, and complex such as door widening or concrete steps.
  • Medical/Surgical – disposable medical and surgical support equipment

Equipment can be provided to support an urgent and non-urgent hospital discharge or be provided following an assessment of need for someone in the community. Equipment is also provided to support children in education environments.

Essex County Council have established a contract for the provision of the equipment, with Medequip Assistive Technology, which commenced on 1st July 2023, and this includes the delivery, collection, cleaning, maintenance/testing and refurbishment of the equipment. The current contract runs to June 2028, with the option for an extension of up to 24 months.

This service is provided across ECC Adult Social Care, Family Ops and Education and through a number of Essex-based Health and Local Authority partners.

Market Rating

Having conducted a tender process for the community equipment service in 2022/2023, there were a very small number of high quality and motivated providers in the market. A review of the contract awards for community equipment in 2024 and 2025 has led to the view that one provider (Medequip) are being awarded a large majority of the most recent contracts. This along with reviews of the financial standing of the main competitors leads to concerns of potential monopolistic control in the near future, this will be monitored.

The Council anticipates that demand for the service will remain high as more people are supported to live in their own homes and with an aging population. It is thought that the staffing of the equipment service for the next five years will not represent a significant challenge, outside of occupational therapy resource which continues to be a challenge across many markets.

The quality of equipment providers in the main is generally good, ensuring reliable service delivery and the markets for both the manufacturing and distribution of equipment are strong and mature. The community equipment service is continually evolving to meet changing needs.

The concerns would be; the limited number of capable suppliers and also the dominance of one main provider; raising potential concerns over monopolistic control. The concentration of contracts may limit competition, potentially impacting innovation, pricing, and service quality. However, the public sector's involvement in commissioning these services ensures a degree of oversight and regulation to mitigate these risks.

Market Quality Market Supply ECC Demand
Good Good High
ECC Ambition Market Workforce Market Maturity
Increase Supply Good Evolving

ECC rating of the market, assessed on 31st March 2025.

The Community Equipment Service (CES) market in England is a significant segment of the healthcare industry, providing essential equipment to individuals with various health needs to support independent living.

ECC, with Medequip, are contracted with one of the leading organisations within this market. Medequip is a leading supplier, having achieved a £20m annual increase in turnover between 2022 and 2023. That being said, profit margins in the community equipment service industry have dropped significantly, Medequip’s profit has dropped from £2.7m in 2022 to 0.5m in 2023. This is reflected across the market with the other main market player NRS Healthcare Ltd having maintained a similar turnover in 2023 when compared to 2022, but their profit dropping from £6.4m in 2022 to £0.6m in 2023.

The industry as a whole has been navigating these economic pressures while trying to maintain service quality and secure new contracts. This has led to a focus on efficiency and cost management to sustain profitability. ECC have been affected by this via high level commercial discussions which led to a material contract variation and a collaborative joint action plan to benefit both parties.

Medequip have been awarded a significant proportion of the recent awarded contracts for community equipment across local authorities in England. NRS Healthcare Solutions Ltd are another leading provider in the Market and hold numerous live contracts but have not been awarded a significant number of contracts over the last couple of years.

Essex Market  
Total Spend £15m per annum*
No. Providers 1
No. Adults/Children per month Adults and Children ≈6,211
Adults ≈5,951
Children ≈261
No. Items per month Delivered ≈9,827
Collected ≈5,823
No. Standard Items in Catalogue ≈370
Core NHS and LA Service Partners 4
EPUT, MSE, Thurrock Council, ESNEFT

The information shown in the table(s) above is correct as of 31st March 2025.

*It is anticipated that the above figures will be subject to change over the next 12-24 months.

The contract with Medequip aims to evolve the service and achieve the vision through a detailed specification of requirements, clear social value and climate goals, and through continuous improvement and innovation with a market leading organisation. The scope for these improvements is vast due to the economies of scale the provider holds, and the expertise within the field.

Essex County Council and Medequip continue to work together to deliver the vision for the equipment service for Essex, ensuring that service users are at the heart of the service whilst ensuring best practice. The ICELS team at ECC continue to drive to ensure that the vision of the service and the specification is fulfilled, ensuring that the provider fully understands their obligations, but also provides their expertise and continuous improvements.

Over the next 6 – 12 months, it is expected that ECC will make considerable moves to ensuring the vision of the equipment service is achieved, and that the data and reporting is available to support this. The ICELS team continue to work with the provider and partners to identify savings, continuous improvement, and innovation, alongside reviewing current procedures for efficiency.

The collaborative nature of the relationship means that where issues and concerns do arise, these are addressed and resolved quickly and efficiently.

There are now very limited COVID risks and impacts, with the availability of staff within the equipment service no longer affected.

COVID-19 outbreaks have affected some elements of the supply chains in East Asia, by limiting throughput at the ports and creating an adverse supply-and-demand situation, but no noticeable impact on the overall availability of equipment, both domestically and internationally is being reported.

Current market risks:

  • The market is stable overall, but external factors such as shipping remain relevant. Medequip provide clear and frequent supplier analysis which advises the suppliers who may be affected by these issues.
  • Risks of failure of UK equipment service market, preventing ECC from effectively market testing future equipment contracts.
  • The dominance of contractual awards received by Medequip raises potential concerns over monopolistic control.
  • Provider profit margins tightening and the request for potential further funding.

Our current areas of focus are:

  • Aligning Medequip performance with the specification of requirements, including KPI’s, approved assessor, adaptations and ceiling track hoist requirements.
  • Working closely with clinical lead to ensure that service is in line with expectation.
  • Ensuring that charging mechanisms are accurately reflected on the invoicing.
  • Ensuring contract variation is implemented correctly.
  • Increased utilisation of recycled specials across the partnership.
  • Increasing collections across the partnership.
  • Review catalogue to identify rationalisation and savings.
  • Undertaking various tasks and projects under the umbrella of mutual action plan to benefit all parties, such as increased advertising of collection service, commencing drop off points at recycling centres and other locations and working with housing associations regarding void properties.
  • Working collaboratively with the provider to implement the increased scope of planned preventative maintenance under this contract in line with the material contract variation signed in February 2025.
  • Working with the provider and the ECC Data and Intelligence Manager to produce clear data and reporting which can be used to understand the current service, decipher areas of concern and improvement and provide evidence where required.
  • Ensuring performance data and narrative is provided regularly to senior stakeholders.
  • Engagement with other health organisations and local government organisations to determine current solutions and pursue best practice and innovation.
  • Engaging with commissioning to develop the lived experience forum.
  • Working towards innovations and continuous improvements
Last updated: 30/09/2024
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