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Bulletin No. 52, January 2008

Welcome

This news bulletin highlights innovation in AT service delivery and FAST welcomes contributions. The Disabled Living Foundation is pleased to sponsor the bulletin.

Contents

  1. News from the NHS Purchasing and Supply Agency
  2. Housing for Older and Disabled People
  3. The National Stroke Strategy
  4. The NHS Reforms
  5. Social Care Reform
  6. Local Government Reform
  7. Public Service Reform
  8. Services for Older People
  9. Services for Children and Young People
  10. Rights for Disabled People
  11. Vocational Rehabilitation
  12. Support for Carers
  13. Governance and Regulation
  14. The Third Sector
  15. News in Brief

1. News from the NHS Purchasing and Supply Agency 

The Centre for Evidence-based Purchasing (part of NHS PASA) has published the evidence review “Pain-free artificial lower limb patient interfaces”. The review finds that “there is little consistent agreement in the research literature regarding the most effective way of interfacing a prosthetic limb to an amputee’s stump” and that further research is required.  Further information is available via this link

The NHS Purchasing and Supply Agency has launched the NHS Procurement eEnablement Programme, which is tied into other initiatives, such as Coding for Success.  More details via this link

The NHS Purchasing and Supply Agency has published “Procuring for health and sustainability 2012”, a sustainable procurement action plan for the health and social care sector.  Read the details here

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2. Housing for Older and Disabled People

In a wide-ranging speech to the home improvement agencies’ annual conference, Communities Minister Baroness Andrews announced a 20 per cent increase in central government funding for Disabled Facilities Grant (DFG) in 2008/09, taking this to £146 million. DFG helps around 35,000 people a year to continue living independently in their own homes through the provision of adaptations. The Government will announce a package of changes to the DFG programme in the New Year, alongside a “housing strategy for an ageing society”. More information via this link.  

The Government also announced plans to strengthen home improvement agencies (HIAs), the locally based not-for-profit organisations that help homeowners and tenants renting private housing repair and maintain their homes, including a new three-year contract for a national co-ordinating body for HIAs.  Read more here

Foundations is the national co-ordinating body for home improvement agencies in England: http://www.foundations.uk.com/

The Supporting People programme, which provides housing-related support for independent living, is to receive £4.9 billion funding over the next three years.  Further details are here.  

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3. The National Stroke Strategy

The Department of Health has published a national stroke strategy for England, a “10 year vision for the delivery of world class stroke services, from prevention through to life long support”. Key points include: 

  • more emphasis on reducing risk factors
  • stroke should be treated as a medical emergency
  • better information, advice and support for people who experience stroke
  • individuals and their carers should be involved in developing and monitoring services
  • people with suspected stroke should be immediately transferred to a hospital providing hyperacute services throughout the day and night, should receive an early multidisciplinary assessment and have prompt access to a high-quality stroke unit
  • stroke-specialised multi-disciplinary rehabilitation should be provided within hospital, immediately after transfer to home or care home, and for as long as it continues to be of benefit
  • planning for the transfer of care from hospital to community needs to be improved, working closely with the voluntary sector
  • a range of services needs to be locally available to support the individual long-term needs of people who have had a stroke and their carers, including opportunities to participate in community life and to return to work.

The role of appropriate equipment and adaptations is highlighted at various stages, including rehabilitation, transfer of care and support in the community. The strategy sets out “quality markers” based on the National Service Framework for Long-term Conditions and other policy guidance. It can be downloaded via this link.  

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4. The NHS Reforms

NHS Chief Executive David Nicholson has published the “Operating Framework for the NHS in England 2008-09”, setting out the priorities, “levers for reform” and business processes for the NHS over the next year, together with the allocations to primary care trusts and guidance on Payment by Results.

While the aim is for local NHS organisations to have greater autonomy in determining their own priorities, the national priorities are: 

  • improving cleanliness and reducing healthcare associated infections
  • improving access through achievement of the 18-week referral to treatment pledge, and improving access (including at evenings and weekends) to GP services
  • keeping adults and children well, improving their health and reducing health inequalities
  • improving patient experience, staff satisfaction, and engagement
  • preparing to respond to emergencies. 

Areas where primary care trusts need to take action because performance is not meeting required standards or new national strategies are to be published include: learning disability services, services for people with dementia, end of life care and services for disabled children. Primary care trusts and NHS trusts should also set local priorities with local partners within the new-style Local Area Agreements (see item below on Local Government Reform).

The Framework includes a statement of the principles and rules governing co-operation and competition for NHS funded services. From April 2008 all patients who require an elective referral will be able to choose to be treated by any provider that meets NHS eligibility criteria, including a wide range of independent sector providers. Primary care trusts are also expected to roll out choice to people with long-term conditions and to support the personalisation of services for older and disabled people envisaged in the concordat “Putting People First” (see item below on Social Care Reform).

During 2008/09, all primary care trusts should “review their requirements for community services and use this process to consider all the options for models of provision. Whilst this is being undertaken, and from 1 April 2008, all primary care trusts should create an internal separation of their operational provider services and agree Service Level Agreements for these”.

The Operating Framework is available via this link.  

The Department of Health has published a “generic choice model for long term conditions” to support choice, control and personalised care for this client group. The “Our health, our care, our say” White Paper included the commitment for everyone with a long term condition, should they want one, to be offered a care plan by 2010.  More details are here.  

The Department of Health has published its “vision for world class commissioning” and a related set of eleven organisational competencies, to improve commissioning by primary care trusts and help them lead the NHS at local level. World class commissioning is seen as the key lever for NHS reform.  Read more here.

The Department of Health has announced £132 million funding for a new wave of NHS community hospitals and super-surgeries.  For more details, follow this link.

The Healthcare Commission has published its fourth annual “State of Healthcare” report, based on its ‘annual health check’ of NHS trusts’ performance. Significant improvements in health and healthcare, including on waiting times, are balanced by the need to reduce health inequalities, to offer more personalised care and to improve safety, particularly in relation to falls and healthcare-associated infection. The report criticises primary care trusts’ performance, including services for people with long-term conditions. Only 58% of NHS trusts complied with all the Government's nine core standards on safety, with infection control, decontamination of medical devices and medicines management the biggest areas of concern.  Further information is available here.

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5. Social Care Reform

Health Secretary Alan Johnson has announced an extra £520 million of ring fenced funding to reform adult social care and support for carers over the next three years through the introduction of “personal budgets”. In a new concordat "Putting People First", key central government departments, local government and the professional leadership of adult social care and the NHS have jointly committed to a radical transformation of care services. The aim is to create personalised services which support independent living and self-determination for older and disabled people. The £520 million will be allocated to councils as a Social Care Reform Grant from April 2008 on top of their mainstream core funding. The grant includes some NHS resources in recognition of the impact social care can have on improving people's health and well-being. Key elements of the reform programme will include: 

  • giving the vast majority of people who receive funded care their own personal budgets so they can choose the support services they want for themselves or a family member, with an increasing number supported to use direct payments
  • high quality care homes, home care and day services to be rewarded, poor performers failing to respect people's dignity no longer to be used by local councils and the NHS
  • initiatives such as first-stop shops becoming commonplace, so that everyone, including people who do not have support from social services, will have access to advice and advocacy about all relevant services
  • support for at least one local user led organisation and mechanisms to ensure people using services and their families have a collective voice, influencing policy and provision
  • investing in preventative support that keeps older people healthy and tackles isolation
  • closer collaboration between the NHS and local government through Joint Strategic Needs Assessments and Local Area Agreements, so that people receive more coordinated and efficient support in the community
  • “a transformed community equipment service, consistent with the retail market model”
  • telecare to be “integral not marginal".

Health Secretary Alan Johnson said:

"One of my top priorities is to develop a new care system which gives people maximum control over their own support services…Our commitment that the majority of social care funding will be controlled by individuals through personal budgets represents a radical transfer of power from the state to the public… Having announced our intention to produce a Green Paper on the long-term reform of social care funds, it is essential we also seek significant improvements to the existing care system." The press release is available here.

Speaking at the launch, Alan Johnson also supported the suggestion in Lord Darzi’s interim report on the NHS that in the future personal budgets for people with long-term conditions could include NHS resources.  More details via this link.   

The concordat “Putting People First” is available here

The concordat uses the term “personal budgets” rather than “individual budgets”. The piloting of individual budgets was announced in the 2006 White Paper, “Our health, our care, our say”. Individual budgets cover a range of services including community equipment, building on ‘direct payments’ for social care, which have been available for some years.  More information is available via this link.

The National Centre for Independent Living and In Control, the Government-backed body that promotes individual budgets and ‘self-directed support’, have published a joint statement saying that self-directed support is the key to independent living.  Read more here.  

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6. Local Government Reform

The Communities and Local Government department has published draft guidance on Local Strategic Partnerships and the new-style Local Area Agreements, based on the local government reform White Paper, “Strong and Prosperous Communities”, and the Local Government and Public Involvement in Health Act 2007.  For more details, follow this link.  

The Government has published a narrative for those working in the NHS, local authorities and the third and independent sectors to explain how the new local performance framework for local authorities should operate to drive improved outcomes in health and social care. “Joint Strategic Needs Assessments (JSNAs) and Local Area Agreements (LAAs) will be key tools in enabling local authorities and primary care trusts (PCTs)… to effectively identify and prioritise the health and well-being needs of local people”.  More information is available here.  

The Department of Health has also published specific guidance on Joint Strategic Needs Assessments.  Details are here.

The Communities and Local Government department and the Local Government Association have agreed a concordat to govern the relations between central and local government. This establishes “for the first time an agreement on the rights and responsibilities of local government, including its responsibilities to provide effective leadership of the local area and to empower local communities where possible”. Councils have responsibilities for service performance but also “for the prosperity and well-being of all citizens in their area and the overall cohesion of the community”. Central government will “progressively remove obstacles which prevent councils from pursuing their role”. Local Area Agreements will be “central to these new arrangements”.  More information via this link.

According to a report from the Audit Commission, councils need to use competition more effectively if they are to realise the £4.9 billion efficiency savings required by this year's Comprehensive Spending Review.  For more details, follow this link.  

The IdeA (the Improvement and Development Agency) and the Local Government Association have published the “Local Government Workforce Strategy 2007”. This is intended to support current local government reforms, including the forthcoming National Improvement and Efficiency Strategy.  The details are here.

Local Government Minister John Healey has announced that 66 local and 21 transitional authorities will receive a share of a new £1.5billion fund as part of the Government's drive to turn around long-term unemployment in the most disadvantaged communities.  More information here

Local Government Minister John Healey has approved proposals for five new unitary local authorities.  Details via this link.

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7. Public Service Reform

The Prime Minister has promised to deliver "wider and deeper" reform across public services. Competition in health, education and social care would intensify, with an expanding role for the private sector where that offered value for money, but based on local commissioning. Speaking to the cross-party Liaison Committee in Parliament, Mr Brown said the next stage was to combine “diversity of supply” with “diversity of demand”. Personalised services “tailored to people's needs” could include one-to-one support for service users and the voluntary sector could play a greater role in the future. More details here.

The Prime Minister has launched the Council on Social Action and asked it to focus, as its first key challenge, on the theme of one-to-one support.  Details via this link.

Business Secretary John Hutton has commissioned a review of the emerging 'public service industry' to examine the increasing contribution being made to the UK's economy by firms and other organisations contracted to deliver services in the public sector.  For more information, follow this link.

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8. Services for Older People

A survey from think-tank Demos has warned that older people who are not able to use the internet risk becoming increasingly isolated. For more information, follow this link.  

Help the Aged has published an advice leaflet to help older people use computers and get online. More details here

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9. Services for Children and Young People

Ministers in the Department of Health and the Department for Children, Schools and Families have written to local authority and primary care trust chief executives setting out the full Comprehensive Spending Review settlement in relation to priorities for disabled children's services, including investment in short breaks, palliative care, transition support and access to childcare. These commitments support local implementation of Standard Eight of the Children’s National Service Framework and build on the plans in “Aiming High for Disabled Children”.  More information via this link

A £45million fund will help public, private and voluntary sector providers improve equipment, transport and facilities for short breaks and support more inclusive breaks, where severely disabled children and young people can take part in activities with their non-disabled peers. Read more here.

Ed Balls, Secretary of State for Children, Schools and Families, has launched the “Children's Plan”, a ten-year strategy to improve schools and other services and “make England the best place in the world for children and young people to grow up”.

The Plan builds on the White Paper “Every Child Matters” and sets out a series of ambitions to help children fulfil their potential at all stages and to support parents. It repeats the aim that child poverty will be halved by 2010 and eradicated by 2020. The Plan will require “a new leadership role for Children’s Trusts in every area, a new role for schools as the centre of their communities, and more effective links between schools, the NHS and other children’s services so that together they can engage parents and tackle all the barriers to the learning, health and happiness of every child”.

The Plan includes £90 million capital over three years to improve facilities for disabled children to take short breaks and £8.4million to extend Family Fund support for disabled young people up to age 18. A child health strategy will be published in spring 2008. £18 million will be spent over the next three years to improve the quality of teaching for children with special educational needs and Ofsted will be asked to review progress on special educational needs in 2009.

For more on the Children’s Plan, use this link.

The children’s mobility charity Whizz-Kidz has welcomed the commitments to disabled children in the Children's Plan and the NHS Operating Framework.  Read its response here.  

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10. Rights for Disabled People

The Government’s Office for Disability Issues (ODI) has published its second annual report to the Prime Minister on progress towards the Government's goal of equality for disabled people by 2025. Work in the past year has included:

  • setting up Equality 2025, a new advisory body to Government made up of 23 members who are all disabled people
  • leading the Independent Living Review which will publish shortly a cross-Government five-year strategy to give disabled people choice and control over the support they need
  • coordinating the signing of the UN Convention on Disability Rights on behalf of the UK
  • developing an initial set of measures of progress towards equality for disabled people, published as an annex to the report.

 For further details, follow this link.

The January issue of Disability Now launched its campaign on hate crime against disabled people and included detailed coverage of this topic. The campaign is based on an analysis of fifty cases, including several deaths. More details via this link. 

Earlier this year Ministers promised to “refresh” the 2001 White Paper, “Valuing People”, which set out the Government's vision for services for people with a learning disability. The Government is now consulting on the priorities for the learning disability agenda for adults over the next three years in the document, “Valuing People Now”. The main priorities are:

  • personalisation – people having choice and control over their lives and services, including direct payments, individual budgets and “an increased focus on the use of assistive technology to support people in their daily lives”
  • what people do during the day, evenings and weekends - with a particular focus on involvement in the community and paid work
  • better health - ensuring that the NHS provides full and equal access to good quality healthcare
  • access to housing
  • making sure that change happens and the policy is delivered (funding for learning disability social care services will transfer from the NHS to local government).

The press release is available here

Following the first audit of specialist inpatient healthcare services for people with learning difficulties, the Healthcare Commission called for “sweeping and sustained changes to neglected services”.  Read more here.  

RADAR’s Chief Executive Liz Sayce has been appointed to the new UK Commission for Employment and Skills.  Details are here.

The new Equality and Human Rights Commission has published its interim business plan.  Details are here

The Commission has also launched a grants programme worth up to £10 million aimed at funding grass roots organisations across all areas of equality.  More information via this link

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11. Vocational Rehabilitation 

A consultation aimed at improving the specialist employment support available to disabled people has been launched by Minister for Disabled People Anne McGuire. The aim is to provide a more bespoke service to disabled people, ensuring they have the opportunity not just to work, but to progress in work to their full potential. Proposals include developing the role of Disability Employment Advisers and moving away from separate programmes of support towards a single integrated programme. For more information, follow this link

The Government has welcomed the publication of “Work Matters: Vocational Navigation for Occupational Therapy Staff” by the College of Occupational Therapists.  Details are here

A new training programme designed to help nurses get their patients ready for work following an injury, disability or period of ill-health, has been launched by Lord McKenzie, Minister for Health and Work, and the Royal College of Nursing (RCN). The training will cover the relationship between work and health, focusing on rehabilitation and workplace adjustments. It has been written by the RCN, with input from the Department for Work and Pensions and Department of Health. It will be on the RCN website and available to nurses across all nursing specialties. More information here

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12. Support for Carers

Community Care published a special Carers Issue on 6 December, with coverage of current developments affecting carers of all ages, including the Government’s new National Carers Strategy planned for next year and campaigning by charities. Details are here.

The first National Carers Summit on 8th November gave a clear message to the Government that they expect the forthcoming National Carers Strategy to deliver real change that improves carers' lives. Prime Minister Gordon Brown sent a special message to the Summit.  Read the details here.  

Carers UK has published a free guide for carers to know their rights and entitlements. More information via this link

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13. Governance and Regulation

The Healthcare Commission is consulting on its proposals for its 2008/09 assessment of NHS trusts, the ‘annual health check’. These include a “concerted drive to promote compliance with the Government’s core standards on healthcare”, a strong emphasis on safety and quality (including inspections on infection control), and plans to score primary care trusts both for how they commission and provide services. From 2009 the new combined health and social care regulator, the Care Quality Commission, will develop a registration system for NHS trusts that provide services. The Healthcare Commission will work with the NHS to support trusts to reach compliance with standards for all patients by 2009, ready for this registration. Find out more here.

The National Institute for Health and Clinical Excellence (NICE) is consulting on revisions of its documents, “Social value judgements: principles for the development of NICE guidance” and “'Guide to the methods of technology appraisal”. More details via this link

NICE has published a “How to change practice” guide, to help healthcare professionals and managers change their practice in line with the latest evidence-based guidance. Details are here.

The Health Service Journal of 6 December included a supplement about the development and implementation of NICE guidance: www.hsj.co.uk 

In May 2005, Government departments and agencies agreed to reduce the cost of administering regulation in the private and third sectors by 25% – or £3.4billion – by 2010, and to publish a series of annual rolling Simplification Plans. According to a Government report, cuts to red tape are now saving UK businesses and third sector organisations more than £800 million per year.  More information here.  

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14. The Third Sector

The Government and the Charity Commission have jointly published for consultation a package of proposals to reduce red tape for charities by increasing financial thresholds. More information here
 
The Department of Health is reviewing all its arrangements for funding the voluntary sector, including the Section 64 scheme. The “third sector funding and investment review” is seeking to “turn the current piecemeal arrangements for funding third sector organisations into a strategic portfolio of investments that are explicity linked with DH priorities”. The consultation runs until March 2008 and details are here.

One year on from the publication of “Partnership in Public Services”¸ which set out the Government's plans for reducing the barriers to the third sector delivering public services, the Office of the Third Sector has published an update on progress to date. Read more here

The Government has published the report of the eighth annual meeting to review the Compact on relations between Government and the voluntary and community sector. Details via this link
 
The Compact Advocacy Programme, based at the National Council for Voluntary Organisations (NCVO), has produced its 2006/07 case report, which shows that disputes between charities and local public bodies have more than tripled. More information via this link.

Local authorities are piloting the use of social clauses in procurement. Social clauses are requirements within contracts or the procurement process which allow the contract to provide added social value by fulfilling a particular social aim, such as the need to train or give opportunities to the long term unemployed. The results of a survey to explore further information on the uses, benefits, constraints and barriers to social clauses have also been published and are available via this link.

A study for the Association of Chief Executives of Voluntary Organisations (acevo) into the state of governance in the third sector has revealed a worrying gap between knowledge and implementation of best practice. Details are here.

Acevo’s best selling “Guide to Full Cost Recovery” is now available for free download via this link.  

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15. News In Brief

Transforming Community Equipment Services
The proposed new community equipment retail model, which is being piloted in the North West, is in line with the Putting People First concordat for social care reform (see item above). The latest update on the community equipment project sets out the opportunities for third sector organisations and is available here

Implementing Telecare
The December 2007 telecare eNewsletter from the Care Services Improvement Partnership included a detailed analysis of the Putting People First concordat and the issues arising for telecare and telehealth services, with links to other key policy documents. The information is available in pdf form here  (614 Kb) and as a Word document here (2.31 Mb). 

For a briefing on the implications for telecare and telehealth of Lord Darzi’s interim report on the NHS (see November bulletin), go to this link.

Electronic Tagging
The Alzheimer's Society has launched a new policy on electronic tagging and “safer walking technology” for people with dementia who wander. The charity believes people should have access to devices if it is appropriate and they want them. Details are here.

Hearing Aid Waiting Times
Hearing aid waiting times of up to two and a half years have been revealed by charity RNID in the most comprehensive and up to date survey on this topic. Details are here.

Website Accessibility
The www.journalism.co.uk website is carrying a series of articles looking at the accessibility of UK newspaper websites. Details are here.

National computing and disability charity, AbilityNet, was the expert accessibility judge at the British Computer Society’s first MP website awards. More information here.

Medical Device Alert
The Medicines and Healthcare products Regulatory Agency has published Medical Device Alert MDA/2007/096 - Kimba Spring paediatric buggies manufactured by Otto Bock.  Details via this link.

Healthcare Associated Infections
The Health Service Journal of 20 December included a supplement on reducing infections, which summarises current requirements, activities and resources. Details from this link.  Information and tools for healthcare staff are available via this link

Patient Safety
The National Patient Safety Agency has published the report “Safety First: One Year On”, an update on multi-agency progress against the recommendations set out in “Safety First”, published by the Department of Health in December 2006. Read more here.   

Self-referral to Physiotherapy

The Department of Health has published an information pack on its self-referral to physiotherapy pilot projects. For more information, follow this link.

The NHS in Scotland
The Scottish Government has published an Action Plan to deliver a healthier Scotland. Details are here

Science and Innovation
The Department for Innovation, Universities and Skills has published the allocations of the Science Budget for 2008-9 to 2010-11. The aim is to “drive up the economic impact of our world-class research by fostering ever stronger links between the research base and business”. There will be inter-disciplinary programmes on ageing (life long health and wellbeing), the digital economy and nanoscience (through engineering to application). More information via this link.  

The Department for Innovation, Universities and Skills is seeking views on “ways to encourage and foster innovation across the UK”. More information here.

Poverty and Social Exclusion
The Government’s strategy against poverty and social exclusion has lost momentum and is in urgent need of a major rethink, according to the tenth annual Monitoring poverty and social exclusion report from the New Policy Institute, published by the Joseph Rowntree Foundation. Read the details by following this link.

AAC Special Interest Groups
Communication Matters is looking to map details of any Special Interest Groups (SIGs) or meetings to do with AAC or AT in the UK. Email simon.judge@nhs.net for more information or to provide details of  local events or meetings.

Digital TV Products
Ricability has produced new test reports on a range of digital TVs and set top boxes in the run up to the digital switchover. The reports cover issues such as ease of use and access to audio description services. More details via this link

Electronic Tagging
The Alzheimer's Society has launched a new policy on electronic tagging and “safer walking technology” for people with dementia who wander. The charity believes people should have access to devices if it is appropriate and they want them. More information here

Hearing Aid Waiting Times

Hearing aid waiting times of up to two and a half years have been revealed by charity RNID in the most comprehensive and up to date survey on this topic. For more details, follow this link.

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