Current E-Bulletin - AT Policy News Bulletin No. 126, April 2014

Welcome

In this month's bulletin: concerns about the retail model for community equipment services, NHS Englandís plans to improve wheelchair services and extend telehealth and telecare, a guide to taking mobility scooters on public transport, new rights to personal health budgets, AT as part of integrated care, and AT provision is cut by social care rationing and set to be affected by changes to disabled studentsí allowances.

Contents

  1. Community Equipment Services
  2. Mobility and Transport
  3. Housing Services
  4. Connected Health and Care
  5. Information and Communications Technology
  6. Healthcare
  7. Integrated Care
  8. Social Care
  9. Services for Older People
  10. Rights for Disabled People
  11. Sport for Disabled People
  12. Welfare Reform
  13. Services for Children and Young People
  14. Events
  15. News in Brief

1. Community Equipment Services

The British Healthcare Trades Association (BHTA) has expressed concerns to the government about the national catalogue and tariff for TCES – the optional prescription-based retail model for community equipment services in England – as the contract for managing this ended in August 2013. BHTA has now received a letter from Earl Howe, Parliamentary Under Secretary of State for Quality (Lords), stating that officials have had discussions with the London Community Equipment Consortium to understand the scale of the catalogue’s current use, its effectiveness, and the impact of its not being available in the future. Earl Howe also said that ADL Smartcare Limited will continue to host the http://new.national-catalogue.org/ site until July to enable stakeholders to access the specifications, tariff and catalogue.

The Trading Standards Institute (TSI) has launched a new blog, explaining how members of Approved Codes similar to the BHTA Code help protect consumers. Youcan read the full story on the TSI blog.

BHTA’s Code of Practice was also praised in a recent TSI audit.

Delegate bookings are open for this year’s National Association Equipment Providers (NAEP) national annual conference for the community equipment sector on 17th-18th of June 2014.

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2. Mobility and Transport

Improving the experiences and outcomes of wheelchair users is an objective in the NHS England Business Plan for 2014/15. NHS England held a Wheelchair Summit on the 25th of February 2014 and a report on the RESMaG website includes a letter from retiring NHS England Chief Executive Sir David Nicholson and a draft action plan.

Shadow Cabinet members Ed Balls and Andy Burnham are running the London Marathon for children’s wheelchair charity Whizz-Kidz.

With more than 300,000 mobility scooters in the UK, more scooters are now allowed on public transport and some smaller mobility scooter models can now be taken on low-floor buses. An online guide from consumer charity Rica explains which scooters are suitable, which bus companies are taking part, and how to get permission and training. Permit schemes have been developed across the UK by the Confederation for Passenger Transport and in London by Transport for London's Mobility Aid Recognition Scheme.

Rica’s Quick scooter search gives a list of all scooters that meet the CPT criteria. If you want to specify other features and dimensions, please use the Advanced scooter search. More help from Rica on choosing a mobility scooter here.

Baroness Kramer, Minister of State for Transport, launched RNIB’s 'We're On Board' bus charter and film to improve travel for blind and partially sighted people. A Press release and a We're on board video is available. A transcript of Baroness Kramer's speech is also available to view.

Paralympian gold medallist Baroness Tanni Grey-Thompson, who is a member of Transport for London's (TfL) Board, has urged disabled Londoners to take advantage of its increasingly accessible network, although an independent survey has revealed that only around a fifth of the capital's one million disabled people are using the Tube. She was speaking as she launched the new 'Turn up and Go' assistance service on TfL's London Overground rail network. Baroness Grey-Thompson has produced a video which can be seen here. A BSL version is also available.

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3. Housing Services

Care & Repair England has launched a brochure highlighting the critical role of housing in achieving some of the key aims of the Better Care Fund and the Care Bill, to integrate services and enable older people to live independent, healthier lives. The brochure lists the practical steps which everyone can take to help to ensure housing is included in local commissioning plans. To view 'On the Cusp?' brochure click here.

At an event in the House of Lords, government members agreed that housing had a pivotal role to play in the reforms of health and social care. View the press release here.

Care & Repair England has published a brochure setting out the case for why 'Ageing Well at Home' needs to be the cornerstone of national policies concerning older people.

Consumer charity Rica has published a guide to choosing central heating controls.

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4. Connected Health and Care

At the recent NHS Innovations Expo, the government’s 3millionlives project had an exhibition stand and was part of the Dementia Village, which included a house demonstrating telecare and telehealth equipment. 3millionlives presented a summary of the potential cost savings that could be achieved, based on one of the key findings from the Whole System Demonstrators (WSD's) projects - a 20% reduction in emergency admissions.

Local case studies and other resources are available on the 3millionlives website.

A special supplement from the Telecare LIN on the NHS Innovations Expo is here.

Health and social care organisations considering commissioning a Telehealth, Telecare or Telecoaching service at scale will need to ensure service, technology, quality and commercial processes integrate to provide a safe, cost effective, and patient-centred service. A paper from 3millionlives details the basic requirements of such a service.

FAST has undertaken a review of the Technology Strategy Board's Assisted Living Innovation Platform (TSB ALIP) projects looking at economic and business models for assisted living. The aim of the research was to understand why, despite potentially high demand from an ageing population, AL technologies had not been adopted at scale. Download the summary or the full review. Following requests for the market area diagram from Keren Down's presentation on the 12th of March 2014, this can be downloaded here

Other presentations about the projects are here.

The Scottish Health Secretary has announced a further £10 million for telehealth and telecare projects that allow patients to better manage their health, care and wellbeing at home.

Writing in the Health Service Journal, Helen Crisp of the Health Foundation illustrates how everyday technology such as mobile phones and Skype can be used in telehealth monitoring.

A European Commission survey is seeking the views of patients and carers on telehealth monitoring for people with long-term conditions.

A pilot scheme which tested the use of digital technology in improving the quality of life of older people has proved a success. The Mindings App helps people keep in touch via a private social network.

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5. Information and Communications Technology

Recent items from the E-Access Bulletin:

  • a new technical standard to ensure so-called 'rich' web content - dynamic, interactive features of many modern web pages - can be made more accessible to disabled people has been published by the international World Wide Web Consortium (W3C) Web Accessibility Initiative (WAI): the Accessible Rich Internet Applications 1.0 specification (WAI-ARIA);
  • only a quarter of UK local authority websites are accessible to disabled people, significantly fewer than last year, according to this year's 'Better Connected' council website review by the public sector Society of IT Management (Socitm);
  • the world's leading database of information on the accessibility features of mobile phones and tablet computers (GARI -Global Accessibility Reporting Initiative) is set to be refreshed with extensive new information.

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6. Healthcare

NHS England has published a revised business plan for 2014/15 – 2016/17 which includes plans to improve specialised commissioning (which includes the commissioning of specialised equipment services), integrated care, and care for older people and people with long-term conditions. Specific deliverables include:

  • consult on an accessible information standard and begin its implementation;
  • extend Patient Led Assessments of the Care Environment (PLACE) assessments to cover disability issues by March 2015 as part of a programme to ‘consistently deliver disabled people’s rights’;
  • work with clinical commissioning groups to ensure children with special educational needs (SEN) have access to services in their care plan based on a single assessment across health, social care and education;
  • improve the lives of 3 million people through the use of technology enabled care services (telehealth and telecare) by 2017, with roadshows for stakeholders in 2014/15;
  • improve the experience and outcomes for wheelchair users by supporting the implementation of the action plan from the national Wheelchair Summit, piloting the wheelchair tariff, supporting improved commissioning, and developing an outcomes based specification for wheelchair services by December 2014;
  • continue to contribute to implementing ‘Innovation Health and Wealth: accelerating adoption and diffusion in the NHS’, including launching NHS Exchange, a new national innovation web portal, by July 2014.

The Specialised Healthcare Alliance (SHA) has published a review of the first year of specialised commissioning by NHS England. The report praises the development of national service specifications, but highlights the need to improve system leadership and links with local commissioners. The report is available on the Limbless Association website.

The Department of Health has updated Health Building Note 00-01, which gives general design guidance for healthcare buildings including accessibility issues.

The latest newsletter from the British Society of Rehabilitation Medicine highlights changes in prosthetics services in England and the development of major trauma centres.

The Department of Health has published a framework on patients’ rights to choice in the NHS, including expansion of rights to choice into the areas of general practice, mental health and personal health budgets.

From April 2014 people eligible for NHS Continuing Healthcare because they have on-going significant health needs outside hospital have the 'right to ask' for a personal health budget and from October 2014, they will have the 'right to have' one. Budgets can be used to provide therapies, personal care and equipment and managed as a notional budget, direct payments or a third party arrangement. They are not new money but a way of using NHS money differently. From April 2015 people with long term conditions who could benefit will also have this option. More on the NHS England website.

The charity In Control has been commissioned by NHS England to help the voluntary and community sector gear up for personal health budgets.

The process for commissioners who wish to procure services using the Any Qualified Provider (AQP) model of patient choice, which has been used for hearing and continence services, has changed. Supply2Health has closed and been replaced by Contracts Finder. More details on the AQP resource centre website.

A report from the Nuffield Trust and the Health Foundation, which assesses the performance of the NHS in all four UK countries since devolution, has found significant improvements in the performance of the health services across all four countries, with the performance gap between the NHS in England and the rest of the UK narrowing in recent years. This is despite considerable policy differences between each country, such as England’s greater emphasis on patient choice and the use of private sector providers, and the rejection of competition in Northern Ireland, Scotland and Wales.

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7. Integrated Care

According to a report from an independent commission set up by the King’s Fund, England needs a ‘new settlement for health and care’ - a single system with a ring-fenced singly-commissioned budget and more closely aligned entitlements. The report argues that the increase in the number of people with multiple conditions demands integrated care. It points out that medical advance and technology are starting to blur the lines between health and care, citing telehealth and telecare as examples of the arbitrary divide between the two sectors.

According to another report from the King’s Fund, a fundamental shift is urgently needed in the delivery of health and care to meet the challenges of a rapidly ageing society. Care for older people should be co-ordinated around individual needs rather than single diseases and should prioritise prevention and support for independence. Services should include aids and adaptations, as ‘providing adaptations to
support an older person to remain at home for just one year can save £28,000 on long-term care costs’.

More resources from the King’s Fund on integrated care and on lessons from the transformation of mental health services, are available.

Responding to the Royal College of General Practitioners’ Put patients first: back general practice campaign, the Department of Health stated that ‘NHS England is developing a strategic framework for commissioning GP services, to strengthen general practice and enable it to play an even more pivotal role at the heart of more integrated systems of out-of-hospital care for patients and local communities’. NHS England emerging findings report is available to download.

The government’s Better Care web site to support integrated care in England is now live.

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8. Social Care

According to the first of a series of reports on the adult care system from the National Audit Office, ‘the provision of adequate adult social care poses a significant public service challenge. Demand for care is rising while public spending is falling’. The report points out that government does not know if the limits of the capacity of the overall health and care system to absorb pressures are being approached and warns that changes to the system to improve outcomes and reduce costs alongside implementation of the Care Bill will be challenging to achieve. The report mentions the role of equipment, adaptations, telecare and telehealth in helping people live without formal support. To view the report go to

Care and Support Minister Norman Lamb has pledged the Department of Health’s full support for the Social Care Commitment, a sector-led initiative to improve care quality. To see which Care Quality Commission registered providers have made the commitment, go to NHS Choices.

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9. Services for Older People

A report from the Nuffield Trust, in partnership with The Health Foundation, examines the scale and scope of cuts to social services for older people in England from 2009/10 to 2012/13, revealing that most local authorities are tightly rationing social care for the over-65s, resulting in significant drops in the number of people receiving services. Some of the largest falls included equipment and adaptations – a reduction of 109,460 individuals or 28 per cent over this period. Download the report here.

‘Your Home Care and Human Rights’, a booklet published by the Equality and Human Rights Commission (EHRC) for older people who are receiving care at home, explains how human rights protect home care service users and explains their rights to home care. If you are interested in ordering copies please email EHRC.

Age UK has launched a new vision of a positive approach to ageing, Love later life, alongside research findings showing that more than three quarters of adults are looking forward to living longer:

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10. Rights for Disabled People

The government has confirmed that the Independent Living Fund (ILF) will close in June 2015. Support for disabled people to lead independent lives will be delivered through the mainstream adult social care system and funding will be transferred to local authorities and the devolved administrations. There are approximately 18,000 ILF users across the UK and it was closed to new applicants in December 2010.

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11. Sport for Disabled People

The Paralympic Winter Games were held in the Russian Black Sea resort of Sochi between the 7th and 16th of  March 2014, with the Russian team won the highest number of medals.

Great Britain competed in the alpine skiing (visually impaired) and in wheelchair curling. The British team achieved its best ever performance at a Paralympic Winter Games, securing six medals and the highest ever finish position in the medals table of tenth. Achievements included:

  • First ever gold medal for ParalympicsGB: won by Kelly Gallagher and her guide Charlotte Evans in the women’s visually impaired Super-G alpine skiing. This was also the first gold medal for any British alpine skier, in either the Olympic or Paralympic Games.
  • Most Paralympic medals won by any British winter athlete in a single Games: Jade Etherington and her guide Caroline Powell’s fourth medal in the women’s visually impaired Super-Combined. They now hold the record for most Paralympic medals won by any British female winter athlete ever.
  • The bronze in wheelchair curling.

More here on the British Paralympics Association website.

AT company Otto Bock provided a team of technicians to support the Games, as they had done at the Summer Paralympics in 2012.

Channel 4 provided extensive coverage, including the excitement of alpine skiing (sitting) and ice sledge hockey and a news item on the situation for disabled people in Russia.

A BBC investigation has found that only three Premier League football grounds provide the required number of wheelchair spaces and Minister of State for Disabled People Mike Penning has told the BBC that he will prosecute clubs which fail to provide appropriate facilities for disabled fans.

The BBC reports that Prince Harry has launched the Invictus Games, Paralympic-style games for soldiers, which will take place in London in September.

The English Federation of Disability Sport (EFDS) has published a guide to help disabled people in sport and physical activity through inclusive and accessible communications.

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12. Welfare Reform

According to a report from the Commons Work and Pensions Committee, reforms to support for housing costs, including the bedroom tax (spare room subsidy) and the household benefit cap, are causing financial hardship to vulnerable people who were not the intended targets of the reforms and are unlikely to be able to change their circumstances in response. Finding that the bedroom tax is having a particular impact on disabled people, especially those living in adapted accommodation, or who need an extra room as a result of their disability, and who are unlikely to be able to move house or enter work, the Committee calls for the government to take steps to mitigate its impact on disabled people. The report is here with an analysis by Disability Rights UK.

The report ‘Beyond the Barriers’, on employment and support allowance and the Work Programme, from the Spartacus network of disability campaigners argues that the current approach is preventing disabled people getting into work and should be replaced by a system based on listening to disabled people. Clients should control their own back to work support budgets, which might include aids and adaptations. The report praises the Access to Work scheme and disabled student allowances, both of which can be used to provide aids and adaptations (although the latter is about to be radically changed – see below).

A report from the Commons Work and Pensions Committee on the implementation of universal credit has highlighted the support that vulnerable people will need to adjust to the new system, as well as ongoing problems with IT.

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13. Services for Children and Young People

The Children and Families Act has been given the Royal Assent. Changes to the law include a new system to help children with special educational needs and disabilities (SEND), which aims to give children, young people and their parents greater control and choice up to age 25 through better co-ordination of services. Guidance about the new system, which comes into force in September, is here and here

The final version of the SEN code of practice will be published shortly ahead of implementation.

The government has published two progress reports on the special educational needs and disability (SEND) pathfinder programme:
https://www.gov.uk/government/publications/the-send-pathfinder-programme-evaluation and
https://www.gov.uk/government/publications/the-send-pathfinder-programme-evaluation-pathfinder-champions 

Cuts to disabled students’ allowances (DSAs) may reduce government funds available to disabled students in England by two thirds and make it more difficult for them to complete their courses, according to a report in Ability Magazine

DSAs cover the purchase of computers, laptops and specialist equipment, provision of support workers and assistance with travel costs. The scheme provided some £120 million of support for around 50,000 full-time undergraduate higher education students in England in the financial year 2012/2013. The government wants to see a ‘rebalancing’ of the funding with universities taking more responsibility for supporting students. Students going to university from September 2015 will no longer receive grants for standard specification computers or related warranties and insurance and grants will only cover a more expensive or higher powered machine if a student needs one because of their disability. Ian Litterick of the British Assistive Technology Association and founder of supplier Iansyst commented: ‘I would suggest it represents a drop of about 70% of DSA equipment by numbers and much the same by amount... It will decimate much of the AT industry in the UK, not just DSAs AT solutions providers: DSA assessors, AT trainers and one-to-one support workers will also be severely affected’. 

The Department of Business Innovation and Skills will also introduce a requirement for registration for providers offering DSA study needs assessments and for DSAs AT service providers.

David Willetts, Minister for Universities and Science, announced changes to the scheme in a written statement to the Commons.

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14. Events

Communication Matters National AAC Conference, the UK’s leading annual AAC (augmentative and alternative communication) event, takes place on th14-16th of September 2014 at the University of Leeds.

Communication Matters Roadshows are free to attend and run throughout the year.

RAatE 2014 is the only UK conference focused on the latest innovations and developments in assistive technology (AT). This conference will be of interest to anyone who uses, works with, develops or conducts research on or into AT and takes place on the 24th of November 2014. The conference organisers have issued a Call for Papers which closes on the 14th of July 2014.

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15. News in Brief

The British Association of Prosthetists and Orthotists has published three guides: Prosthetics and Orthotics Career Framework, Education and Preceptorship Guides.

The Medicines and Healthcare products Regulatory Agency (MHRA) and NHS England have jointly issued two patient safety alerts and supporting guidance to improve incident reporting involving medication errors and medical devices. Links to the medical device alerts and guidance are here:

Action for Hearing Loss has launched a new and improved version of Locate and Rate, its online tool to find and review hearing services including NHS providers and private providers involved in the Department of Health’s Any Qualified Provider (AQP) scheme.

April's ‘forward’ magazine from the Spinal Injuries Association features its new service, SIA Healthcare,

Press release: http://www.actiononhearingloss.org.uk/news-and-events/all-regions/news/improved-locate-and-rate-service-gives-patients-more-choice.aspx

Although the economy is growing faster than predicted, the Chancellor explained in his Budget speech that austerity will continue. Further public spending cuts will be needed to reduce the deficit and debt, with the aim of a small surplus in 2018/19. The government will cap the welfare budget (endorsed by Labour), ensure that employers are meeting the full costs of public service pension schemes, and limit public sector pay increases. The Budget also included measures to help savers and give people greater freedom over how they access their pension savings.

A briefing by the Institute for Fiscal Studies is here.

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