Welcome

In this month's bulletin: concerns about community equipment services, plans for wheelchair services, funding for children’s equipment services, and the new Assistive Technology Practitioners Society. Meanwhile, as the election approaches, the political parties clash bitterly over the funding of social care.

This news bulletin highlights innovation in AT service delivery and FAST welcomes contributions.

Contents

1. Community Equipment Services
2. Wheelchair Services
3. Children’s Equipment Services
4. Medical Devices
5. Information and Communications Technology
6. AT Education and Training
7. Public Services
8. Healthcare
9. Social Care
10. Services for Older People
11. Rights for Disabled People
12. Services for Children and Young People
13. Governance and Regulation
14. The Third Sector
15. News in Brief

1. Community Equipment Services

Replying to Parliamentary Questions, Care Services Minister Phil Hope confirmed that the Transforming Community Equipment Services (TCES) programme in England, which involves rolling out a retail model, is now in its “implementation phase”: The replies are available here and there is more about TCES here.
 
A report produced for the British Healthcare Trades Association (BHTA) by the Centre for Economics and Business Research (cebr) has found that the retail model could trigger costs of up to £13.4 million per annum. While the BHTA supports the intended objectives, it is worried the plans could backfire and has highlighted the following concerns:

• The retail model to date only considers simple, low value community equipment (simple aids for daily living). It therefore neglects the other three quarters of the community equipment spending which goes towards complex community equipment. By not recognising the relationship between complex and simple equipment, which are often prescribed in tandem, the government is likely to miss efficiency savings. An integrated approach is needed.
• The economic impact assessment shows that the proposed retail model is a less efficient way to provide community equipment. A nationwide adoption could trigger additional cost of up to £13.4 million for private households and public services providers.
• The many different ways in which community equipment services are provided – ranging from pure private sector to full public service approaches – means there is no common base case for a national impact assessment. This casts doubt on the cost savings claims made by the Department of Health.
• Additionally, the incentives of the new retail scheme are likely to lead to a sluggish take up among retailers with predominantly those with large outlets stocking the equipment. This may lead to an under-provision in less densely populated areas.

Phil Isherwood, Chairman of the BHTA commented: 'This report throws up real concerns about the Government's figures but provides an opportunity for the policy to be revised before it is too late. We are concerned that the new model, as it stands, could exacerbate the post code lottery, as a multitude of different approaches are being considered.' The BHTA press release is here. 

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2. Wheelchair Services

Replying to Parliamentary Questions, Phil Hope also gave information about plans for wheelchair services: 'The Department is in the process of refining the 2008 proposals for wheelchair services in partnership with the NHS, third sector organisations, service users and other key stakeholders. A multi-agency Wheelchair and Seating Services Advisory Group has been established to co-produce an updated model by April 2010 that reflects recent developments in health and care policy. This revised model will be placed in the Library. The first meeting of the Advisory Group is scheduled for 26 January 2010.' The replies are here.

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3. Children’s Equipment Services

Improvements in community equipment and wheelchair services for children form part of the Government’s Aiming High for Disabled Children programme. Funding within primary care trust allocations to improve services for disabled children includes funding for equipment services. Trusts have to publish their plans to improve services for disabled children.  

An independent consultant’s report on services delivering all types of children’s equipment, commissioned by the Government, has found fragmentation, waste and a postcode lottery in many areas. The report concludes that service transformation would require changes in governance, pathways, sourcing strategies and management of equipment once bought (equipment stores). The report describes options for improving services and sets out how Government departments could help regional or sub-regional partners identify models for pilot schemes. The Department of Health has written to strategic health authorities inviting them to submit proposals for funding for innovative activities within and across primary care trusts to transform children’s equipment services. The letter and report are here. There is more on the Aiming High for Disabled Children programme here.

Work to improve services for children and young people with speech, language and communication needs (SLCN), including local SLCN commissioning pathfinders and support for the alternative and augmentative communication (AAC) sector, is being carried out under the Better Communication Action Plan. For more details, follow this link. 

Jean Gross, the Government’s Communication Champion for children with SLCN, is inviting comments on her blog, which is available via this link. 

The Let’s All Talk website aims to share ideas about using assistive technology with young children with little or no speech. To find out more, go here.

Simon Halsey, an engineer with BIME, is featured in the new book “Extraordinary You – Science in Healthcare”, which profiles the work of NHS healthcare scientists. Simon’s contribution highlights the Wizzbug project, a paediatric mobility solution for very young disabled children developed by BIME which is now a commercially available product. For more details, follow this link.

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4. Medical Devices

The Medicines and Healthcare products Regulatory Agency (MHRA) has published the following Medical Device Alerts: 

• Medical Device Alert MDA/2010/013 refers to Arjo Passive Clip sling and Arjo Passive Clip Flite slings manufactured by Medibo and is here. 
• Medical Device Alert MDA/2010/010 refers to C-Max U/2 stair climbers manufactured by Alber Antriebstechnik GmbH (AAT) and is here.

The latest Medical Device Alerts are here.

The MHRA has also posted Field Safety Notices covering Appollo bath aids from Reva Industries Limited, (details here) and and limb prostheses, modular lower: knee from Otto Bock Healthcare Products (details here).

One Liners issue 74 February 2010: Eye 2 Eye Ophthalmology Special highlights problems that can occur when using ophthalmic medical devices, and there is more information via this link.  

Device Bulletin DB 2010(01) provides guidance on the MHRA's voluntary adverse incident reporting system and encourages users to report adverse incidents. Details via this link.  

NHS chief executives have been reminded of their responsibility to ensure that actions arising from safety alerts from the MHRA, National Patient Safety Agency (http://www.npsa.nhs.uk/ ) and the Department of Health are implemented within deadline and that this is confirmed on the Central Alerting System (CAS). To find out more, go here.

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5. Information and Communications Technology

A sensor that switches on the lights when you get out of bed, a temperature detector and a flood detector were some of the assistive technologies on display at a ‘wise home’ visited by Care Services Minister Phil Hope in Harrogate. According to Department of Health estimates, telecare could prevent 160,000 people from entering residential care per year, with potential cost savings of £2 billion per year. However, 98 percent of UK adults are unaware that assistive technologies are an important part of social care, according to new research commissioned by the Department. 

The Department of Health has selected North Yorkshire County Council as an exemplar provider of innovative prevention services. The Council has saved over £1 million through telecare over the last year that would otherwise have been spent on domiciliary or residential care. Phil Hope commented: 'Telecare has an important role to play. North Yorkshire is a great example of innovative support that is breaking the mould and challenging perceptions of care. ..We will soon set out a blueprint for a new National Care Service that is fair, simple and affordable for all. Innovative, personalised services will be a central pillar of the new system.' The press release is here. 

The telecare systems and response service for North Yorkshire County Council are provided by Tunstall Healthcare. For more details, follow this link. For an overview of savings from telecare, go here. For an update on the Whole System Demonstrator programme (three large-scale telecare and telehealth pilots) including the PCT Google Map for telehealth, go to this link.

The service and workforce impact of installing more complex sensor networks has been highlighted by one of the Technology Strategy Board’s Assisted Living Innovation Platform (ALIP) projects, led by Tynetec, working with Aidcall, Your Homes Newcastle, Darlington Borough Council and Intrahealth.

This learning is to be captured by a short ALIP Knowledge Transfer Network project over the next couple of months working with the Foundation for Assistive Technology (FAST) who are leading on workforce development for the sector, with Hereward College and the Tynetec ALIP project team. The project's findings will be drafted as sector guidance and put forward for consideration by the sector as the basis for future workforce, career and education planning for installation practitioners. 

Further information and draft guidance will be circulated in this bulletin for comment and advice in two to three months' time. At this stage installation  service providers, practitioners or planners are invited to email comments and suggestions to Keren Down at FAST (keren@fastuk.org or phone 020 7264 8955).

The Department of Health's telecare enewsletter for February includes a round-up of telecare developments in local authorities and is available as a pdf (4.38Mb) here and as a Word document (5.62Mb) here. 

Age Concern and Help the Aged have announced their Internet Champions, who will act as role models to encourage older people to get online. More information via this link. 

Sponsored by AbilityNet, the OneVoice Coalition has published a report on the business case for accessible ICT which is available here.

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6. AT Education and Training

The British Healthcare Trades Association (BHTA) has launched the Assistive Technology Practitioners Society (ATPS) to recognise job competences and raise standards for its members’ employees. The Society will aim to provide a professional career structure and status (including Continual Professional Development) for these employees and for other staff in the AT sector. Recognition of skills and competences through appropriate courses and qualifications will lead to certification and entry on a registration scheme. ATPS is currently vetting training courses provided by BHTA members and others, and any information about relevant courses should be sent to Ali Hussain at ali.hussain@bhta.com. The Society’s new website is here. 

A list of AT training and courses is available on the FAST website via this link.  There is more on FAST’s work to improve workforce development, education and training across the AT sector here.

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7. Public Services

Shadow Chancellor George Osborne has confirmed that a Conservative Government would 'start dealing with the deficit in 2010'. To find out the details, go here. 

Billed as 'the biggest shift of power from government to people since the right to buy your council house in the 1980s', the Conservatives have announced plans to give public sector workers the right to form employee-owned co-operatives to take over the services they deliver. More information via this link.

The Department of Health is promoting social enterprises in health and social care. For the details, go here.

The Local Government Association is calling for more autonomy for councils to shape the total amount of local public spending, including on health. Details via this link.

According to a BBC survey and the Local Government Association (LGA) English councils are facing cuts in jobs and services over the next few years. Read the BBC report here and the LGA assessment here.

The latest quarterly survey from the Chartered Institute of Personnel and Development (CIPD) predicts significant falls in public sector employment. To find out more, go here.

According to a new series of reports from the CIPD, it is not the impending fiscal crunch that poses the greatest threat to public service delivery, but a people management crisis on the front line. Details via this link.

The Cabinet Office has published the 'UK Government ICT Strategy' to improve the ICT infrastructure across all of the UK public sector. The press release is here.

Speaking at the King’s Fund, Gordon Brown set out his vision of how personalised health and social care services could meet rising aspirations and the needs of an ageing population. The NHS would offer guaranteed rights and focus more on prevention, early intervention and support for independence, in a shift from hospital to community care. Similarly in social care, the Personal Care at Home Bill and a new national care service would guarantee standards of care and offer reablement and rehabilitation services to help people live longer in their own homes. The video is here, and the transcript is here.

Liberal Democrat policies include a week's respite for carers working over 50 hours a week, replacing primary care trusts with locally elected health boards, and integration of health and social care. Their leader Nick Clegg spoke at the King’s Fund. His comments are available here.

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8. Healthcare

The first annual report of the Department of Health’s National Quality Board gives an overview of quality reforms in the NHS and some international healthcare quality comparisons. The report is here, and details of the organisation are here. 

From April 2010, all providers of acute, mental health, learning disability and ambulance services will be required to produce quality accounts. Work is also underway to develop quality accounts for primary care and community services by June 2011, including pilot schemes in 2010. More here.

The Department of Health has published the latest 'Code of Conduct for Payment by Results', which is available here. The department has also published information on standard contracts for NHS services (here), and a 'Guide to Values in the NHS' which is available here.

Proposals for the organisation of community services provided by primary care trusts have to be agreed by 31 March 2010 and implemented by 31 March 2011. Guidance is here.

Department of Health ministers have announced the expansion of the Integrated Care Pilots programme. Innovative projects within health or across health, social care and other sectors are welcome. To find out more, go here.

Interviewed about Conservative plans to prioritise public health, shadow health secretary Andrew Lansley said that local spending could include 'adaptations and assisted technology in the home for older people'. Read the article here.

A report from the Confederation of British Industry calls for a major shift in the way healthcare is delivered, moving away from hospital care to services at home and on the high street. Examples include making better use of technology such as telecare and telehealth. The report is here.

The NHS is to offer more dialysis at home and chemotherapy in the community in moves to provide more care at home. Other measures include more services at home for children and young people with acute or long-term conditions, disability or palliative care needs, and offering people the option to die at home. Find out more here.

According to a report by Dr Foster Intelligence, the NHS could save more than £1billion each year by increasing the number of patients it treats at home rather than in hospital. The report is based on service changes being introduced by the NHS in Birmingham and private provider Healthcare at Home, covering long-term conditions, end of life care, chemotherapy, and supported discharge. More details via this link.

Most people in England are not living as long as the best off and spend longer with ill-health or disability, according to a major report on health inequalities which was commissioned by the Government. Read the report here.

Welcoming the report, Health Secretary Andy Burnham accepted that any strategy to deal with this would need to take full account of the different aspects of health inequalities as well as social class, including age and disability. His comments are available via this link.

Baroness Thornton has been appointed as a Parliamentary Under-Secretary of State at the Department of Health. Details here.

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9. Social Care

The Personal Care at Home Bill aims to provide free personal home care for 280,000 older and disabled people with the highest needs, as a first step towards the national care service proposed in last year’s Green Paper. The Bill will also help around 130,000 people who need short-term intensive support or 're-ablement', which could include help with equipment. Council leaders and social services directors have expressed concerns that the Bill is under-funded. Responding to Parliamentary Questions from David Cameron, Gordon Brown defended the Bill and refused to rule out an inheritance levy to fund the national care service (one form of the ‘comprehensive’ funding option in the Green Paper). Read the details here.

The Conservatives branded the inheritance levy a “death tax” and secret cross-party talks collapsed, as described in a Guardian article here. The Government then convened a meeting, which was attended by charities, other stakeholders and the Liberal Democrats, but not by the Conservatives. The meeting endorsed the vision of a national care service, expressed concern about using disability benefits to help fund the new system, and regretted that the option of general taxation had not been explored. The majority favoured the comprehensive funding option with an element of compulsion, based on ability to pay rather than a flat rate. The report is here.
 
The Personal Care at Home Bill is currently in the House of Lords. Details via this link.

A report commissioned by the Department of Health from the University of Birmingham concludes that without a radical rethink the cost of providing social care will double in the next twenty years. The report argues that spending on adult social care should be seen as a social and economic investment that could generate savings in other parts of the welfare state, by reducing hospital admissions and helping social care users into employment. The report is here.

The Joseph Rowntree Foundation (JRF) has launched a new equity release pilot scheme to help older people pay for additional support and allow them to stay in their own homes for longer. Details are here.

The Department of Health has published new guidance on eligibility criteria for adult social care in the context of personalisation (the Putting People First programme). This replaces 'Fair access to care services' and is available here.

Many councils in England are failing to provide potential service users with adequate information about personal budgets, according to a survey by the disability charity and service provider Livability. The survey is here.

The Scottish Government has launched a 10-year plan personalisation strategy for social care which promotes individual budgets and self-directed support, mirroring the Putting People First programme in England. Details via this link.
 
The Law Commission has published proposals for consultation on the reform of adult social care law through a 'single, clear and modern statute' and a single national eligibility framework. Read more here. 

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10. Services for Older People

The Government has published its response to a consultation on its strategy for older people, 'Building a Society for All Ages'. This provides an update on current initiatives, including a greater focus on 'measures to prevent ill-health and promote active ageing' and is available here. 

The Audit Commission has published the report 'Under Pressure - tackling the financial challenge for councils of an ageing population'. The report claims that most councils do not know enough about the costs of their ageing population or the potential savings from preventive services such as telecare. Read the details via this link.

Research has found that the benefits of home care reablement services may be significant and sustained, possibly delaying subsequent needs for social care services by up to two years. Two interim reports are here.

According to the Office for National Statistics, the number of pensioners living in poverty in the UK has fallen by nearly a third between 1997/8 and 2007/8, but it is still estimated at 2 million. More in chapters 13 and 14 of the ONS report ‘Pension Trends’ here.

Aid call is the Age Concern and Help the Aged personal alarm service‚ currently used by over 40‚000 frail older people. A survey of 620 Aid Call customers has found that almost eight out of ten rely on friends‚ family and paid support to help with basic tasks such as shopping‚ cleaning and DIY. Six out of ten respondents feel local councils are not doing enough to help older people stay in their own homes. More here.

According to a new report on the prevalence, economic costs and research funding of dementia, it affects 820,000 people (1.3% of the UK population) and costs the economy £23 billion per year. Each dementia patient costs five times more than the average cancer patient, while spending on dementia research is 12 times lower than on cancer research. Most of the cost of dementia – £12.4 billion per year – is met by unpaid carers. Social care costs (mainly long- term institutional care) are £9 billion, health care £1.2 billion and productivity losses £29 million. The Alzheimer’s Research Trust, which commissioned the report, believes that dementia is the greatest medical challenge of our time. The report is here.

The report is released a year after the publication of the National Dementia Strategy for England, which is available here. An article in Community Care described improvements in dementia care in Croydon, including plans to extend assistive technology support, and is available here. 

An article in Community Care highlighted the work of the Hertfordshire falls prevention project, which helps older people avoid unnecessary trips to A&E. A council social worker and an emergency care practitioner respond to 999 calls in an ambulance response car and, if treatment at home is appropriate, this can include provision of equipment. The article is here.

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11. Rights for Disabled People

The Government has announced the eight local authority ‘trailblazers’ that will test the ‘right to control’ (personal budgets) for disabled people. For more details, follow this link. 

The Equality and Human Rights Commission would welcome views on how the UN Disability Convention is being implemented in Britain. There is more information on their website here, or contact UNCRPD@equalityhumanrights.com.

The Commission is consulting on the terms of reference for an inquiry into disability-related harassment. To find out more, follow this link.

The Department of Health has written to the NHS and social services setting out actions needed to respond to the recommendations of the Ombudsman’s 'Six Lives' report, which highlighted failings that led to premature and avoidable deaths of people with learning disabilities. Read the advice here.

The Director of Public Prosecutions has published his policy on prosecution in cases of assisted suicide, which is available via this link. 

The Department for Work and Pensions has published information for GPs, employers, employees and patients on the fit note, which aims to help people stay in work and replaces the sick note from 6 April 2010. Details via this link.
 
Dame Tanni Grey-Thompson, Britain's most successful ever paralympian, is to become a cross-bench peer in the House of Lords. For more information, follow this link and this link.

Shadow minister for disabled people Mark Harper has told Community Care, 'We have a good record and I don't think disabled people have anything to fear from a Conservative government.' The interview is here.

The Department of Health's strategy for stroke care has increased the priority and awareness of the condition and started to improve patients' care and outcomes, according to a report by the National Audit Office. However, improvements in rehabilitation and follow-up care have not matched those of acute care services, and health and social care services are not working as well together as they could. Regional reforms highlighted in the report include development of telemedicine and community rehabilitation and better speech and language support. To find out more, go here.

A report from the Public Accounts Committee has criticised NHS services for people with rheumatoid arthritis. Details via this link.

The Department of Health has published 'Six years on: delivering the Diabetes National Service Framework', documenting progress in diabetes care since the NSF was published. Areas for improvement include the detection and management of long-term complications through better foot care and diabetic retinopathy screening. For more information, follow this link.

The Department of Health is consulting on a strategy for services for chronic obstructive pulmonary disease (COPD) in England. Details are here.

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12. Services for Children and Young People

The Government has published its action plan to implement all the recommendations in Brian Lamb’s review on special educational needs. For more information, follow this link. 

Family Information Direct is a £60 million programme from the Department for Children, Schools and Families to improve the quality of national parental information and support services in England, working with key third sector and private sector organisations, including ACE and Contact a Family. It has a particular focus on meeting the needs of parents who are not well served by current services, including parents of disabled children. More here.

The Department for Children, Schools and Families is consulting on regulations for local authorities in England to provide short breaks for carers of disabled children and young people. To find out more, go here.

Research commissioned by the National Deaf Children’s Society has revealed that social care and child protection services are failing deaf children and their families. Read the details here. 

The Equality Challenge Unit has published a report about access to higher education for people with sensory impairments in response to concerns that they are disadvantaged by their campus environment. The report looks at the issues and solutions, including the use of assistive technology, and is available here.

The new national Vetting and Barring scheme will register all people doing certain work with children or vulnerable adults. More information on the Independent Safeguarding Authority website via this link. The Department for Children, Schools and Families’ 'vetting and barring myth buster' website is here.

According to a new study by the Audit Commission, Government policies and programmes have not significantly improved the health of the under-fives in the past decade. The report, which does not cover the needs of disabled children, is here.

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13. Governance and Regulation

The Care Quality Commission (CQC) has published its first annual report on the state of health care and adult social care in England. While services have improved overall, including support for more people to live independently at home, unacceptable variations remain and a small number of services do not meet minimum standards of safety and quality. The report calls for 'real acceleration in joining up health and social care', a shift to community services, and more choice and control for users. The report is here. 

These issues are reflected in the CQC’s strategy for 2010–2015. Priorities include 'making sure that care is centred on people’s needs' and 'championing joined-up care'. The strategy - and an overview of the CQC’s work -  are here.

A new registration system for providers of health and adult social care services in England comes into force on 1 April. All NHS trusts (including primary care trusts as providers) must be registered with the CQC from April 2010, most adult social care and independent healthcare providers from October 2010, and primary medical care services from April 2012.

The CQC has published guidance on how it will enforce the new regulations and the new quality and safety standards which will apply across health and social care. These include requirements on the cleanliness, safety, availability and suitability of equipment and medical devices, and compliance with the Department of Health’s statutory 'Code of Practice for health and adult social care on the prevention and control of infections and related guidance'. The guidance is here.

The Code of Practice, which includes requirements on the cleaning and decontamination of equipment and medical devices, is here.

The CQC is consulting separately on a quality assessment programme, which will complement the registration programme and assess the performance of commissioners as well as providers. Proposals for special national reviews include the pathways for dementia and long-term conditions, and unmet need for social care. For more details, follow this link.

The NHS National Leadership Council has published 'The Healthy NHS Board: Principles for Good Governance', which is available here.

The National Institute for Health and Clinical Excellence (NICE) has published 'How to Use NICE Guidance to Commission High Quality Services'. For more information, follow this link.

The six inspectorates responsible for assessing local public services in England have published the 'Oneplace national overview report'. This looks at the findings from the first year of Comprehensive Area Assessment (CAA) and complements local reporting of CAA through the Oneplace website, which is here. The report is here.

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14. The Third Sector

The Government has launched new web pages to help the third sector keep up to date with charity law and regulation. The information is here.

Communities Secretary John Denham has urged councils not to 'cut out' the third sector in the current efficiency drive. To find out more, follow this link.

The first round of Access to Volunteering grants have been announced. Access to Volunteering aims to increase the number of disabled people volunteering by providing grants to supporting organisations. Money is provided by the Office of the Third Sector with funds being offered in three test areas - Greater London, North West and West Midlands. The first round of funding awarded grants of up to £5,000 to 40 organisations. The Access to Volunteering website has details of the 40 awards and information on how to apply for grants and is here. Enquiries can also be made via the helpline: 03000 123 346 or by e-mailing enquiries@accesstovolunteering.org.

The Government has published a report on the role of the third sector in the personalisation of health and social care, which is available via this link.

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15. News in Brief

Naidex 2010
Registration is now open for Naidex 2010, the UK's largest event for homecare, disability and rehabilitation. Featuring over 360 exhibitors and a full seminar programme, Naidex 2010 takes place from 20-22 April at the NEC Birmingham. New features this year include the Communication Village, the Car Zone and the Sensory Garden. More details here.

The Disabled Living Foundation
The Disabled Living Foundation has added a new kitchen and household products section to its impartial advice site 'Living made easy. For more information, follow thislink.

The Limbless Association
The Limbless Association is moving office in a bid to cut costs. From 3 March the charity will be based at 3The Drive, Jubilee House, Warley Hill, Brentwood CM13 3FR for the next 18 months, and will review the situation after that time. More details are available on the Association's relaunched website, via this link.

Augmentative and Alternative Communication (AAC)
The charity Communication Matters has won Big Lottery funding for an 'AAC Evidence Base' covering needs, provision and best practice in AAC. More about Communication Matters, including its small grants programme, here.

Support for Veterans
The British Association of Prosthetists and Orthotists (BAPO) and the trade union UNISON have welcomed the Government’s commitment to increase NHS capacity for injured military personnel, but warned that without more funding, other NHS patients would suffer. More details via this link.

Housing Services
Care Services Minister Phil Hope has announced a £3.5 million innovation fund to help councils develop extra care housing, which provides the best housing design features for older people alongside personal care. For more information, go here.

Support for Carers
A new report from the Association of Directors of Adult Social Services argues for better support for carers of people being discharged from hospital. Details via this link.

Support for Business
The Office of Government Commerce has launched an awareness-raising campaign to promote greater access for smaller firms to the £220 billion worth of contract opportunities awarded by the public sector each year. Details are here.

The Government’s Office for Life Sciences has published a progress report on steps to ensure the life sciences industry, working with the NHS and academia, is 'in the best possible position to drive future growth and prosperity as well as continuing improvements in healthcare'. For more information, follow this link.

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