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Bulletin No. 100, January 2012

Welcome

In this month's bulletin: new assisted living projects compete for funding, the government announces more money for reablement services to support people to live independently and moves to implement telecare at scale in the UK and Ireland.


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

Contents

  1. Assisted Living
  2. Housing Services
  3. Innovation
  4. Long Term Conditions
  5. Medical Devices
  6. Mobility and Transport
  7. Information and Communications Technology
  8. Telecare and Telehealth
  9. Healthcare
  10. Social Care
  11. Services for Older People
  12. Rights for Disabled People
  13. Services for Children and Young People
  14. Third Sector
  15. News in Brief

1. Assisted Living 

The Technology Strategy Board (TSB) has announced that eight 'seed communities' have come through the preliminary rounds of the UK-wide Delivering Assisted Living Lifestyles at Scale (DALLAS) competition programme. These eight project consortia are now being invited to continue to develop their proposals at a workshop in early January. They are: 

  • Community Solutions (Lead: Torbay Care Trust/HIEC SW)
  • Feel Good Factory (Lead: Liverpool Primary Care Trust)
  • I-Focus (Lead: ADI)
  • Living It Up (Lead: NHS 24, Scotland)
  • MyPAL (Lead: Rotherham Foundation Trust)
  • WALES (Lead: Hywel Dda Health Board)
  • Wellness Partnership (Lead: Your Homes Newcastle)
  • Year Zero (Lead: Illumina Digital)

A total investment of up to £23 million is being made in DALLAS, made up of £18m from the Technology Strategy Board and the National Institute for Health Research, with a further £5m contribution from the Scottish Government, Highlands and Islands Enterprise and Scottish Enterprise. The aim of DALLAS is to establish three to five communities of 10,000 people each or more across the UK, of which one will be in Scotland. These will show how assisted living technologies and services can be used to promote wellbeing, and provide top quality health and care, enabling people to live independently – including a preventative approach.

The competition has been designed to grow the assisted living sector and position UK companies to take advantage of increasing global demand for assisted living goods and services. It opened in July 2011 and applicants have attended a number of events and workshops in order to develop collaborative approaches which will unlock new markets in social innovation, service innovation and wellness, enabled by technology, and show that technologies and services can be made available at a sufficient scale and cost to enable independent living. Successful projects will attract 100% of public funding and last up to 36 months. There is more about DALLAS here and details of the eight seed communities are here.

The European Commission has published a final report on the public consultation on the eHealth Action Plan 2012-2020.  The consultation, which involved a range of stakeholders including NGOs, academic institutions, enterprises, health and social care providers and public authorities from many member states, aimed to validate four proposed objectives and to explore possible actions to be undertaken in the coming years. The four objectives are:

  • to increase awareness of the benefits and opportunities of eHealth, and empower citizens, patients and healthcare professionals.
  • to address issues currently impeding eHealth interoperability
  • to improve legal certainty for eHealth
  • to support research and innovation in eHealth and development of a competitive European market

The report is here.  

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2. Housing Services

The Housing Learning and Improvement Network (LIN) and the Association of Directors of Adult Social Services (ADASS) have jointly published a new housing for older people resource pack. Called 'Strategic Housing for Older People: Planning, designing and delivering housing older people want (SHOP)', and written by the Institute of Public Care at Oxford Brookes University, the guide is intended to help local authorities develop their housing with care strategies. Set out in three sections, it contains briefings and tools on: 

  • The policy context across housing, social care, health and planning
  • Demand for and supply of specialist housing
  • How local authorities can encourage developers and investors by producing market position statements and clear commissioning plans
  • The potential for upgrading ageing sheltered housing to extra care housing
  • The need for an emphasis on design, location and quality, and
  • Provides a comprehensive bibliography.

To download a copy of SHOP, go here.

An independent evaluation of 19 extra care housing schemes that were part-funded by the Department of Health (DH) has concluded that such housing can improve older people's health and wellbeing and offer them improved choice and independence. It offers a potential viable alternative to residential care for some older people and can produce savings for both the NHS and social care services. The DH's £227m Extra Care Housing Fund helped produce more than 5,000 units of accommodation - the single largest investment in specialist housing for older people in England. Evaluation of the fund has been jointly published by the Housing Learning & Improvement Network and the Personal Social Services Research Unit (PSSRU) at the University of Kent and is available via this link

In a viewpoint article for the Housing Learning and Improvement network, Jeremy Porteus argues that the case for the connection between housing, health and social care is often poorly understood and the lack of any evidence base cited as an obstacle to closer integration. The article identifies a number of obstacles that have contributed to a 'silo' mentality and 'mono' culture across organisations, along with language barriers that prevent a truely holistic approach in meeting the housing, care and support needs of older people - whether as patients, clients or residents. 'Housing, prevention and early intervention at work: a summary of the evidence base' is available here.   

The Department for Communities and Local Government commissioned the Centre for Housing Policy at York University to produce an independent research report on Lifetime Neighbourhoods. The report brings together existing writings and research and practice examples of Lifetime Neighbourhoods, ie places designed to be inclusive regardless of age or disability, and is available via this link.

Habinteg Housing Association and BRE IHS Press have published a new guide on how to make the design of new housing flexible enough to meet the needs of the widest range of people who may take up residence. The “Lifetime Homes Design Guide”, is a practical guide to the Lifetime Homes Standard and gives the technical specification and guidance on the Lifetime Homes Standard’s 16 design criteria, which follow underlying principles of inclusivity, accessibility, adaptability, sustainability and good value. The aim is to provide a practical tool to make future adaptation of housing quicker and simpler and provide resources for architects, designers, developers, housing associations, access consultants, social services professionals and home improvement agencies. Copies are available via this link.  

Keith Brown, Scottish government housing minister, has announced a new Older People's Housing Strategy which stresses the importance of supporting people to remain at home independently for as long as possible, rather than premature or inappropriate admissions to care homes or hospitals. Details are here

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3. Innovation

At the beginning of December, the government published the UK Strategy for Life Sciences describing how it aims to provide a better environment for life sciences, to improve the lives of patients and contribute to economic growth. Amongst the initiatives outlined in the report are the setting up of a number of Academic Health Science Networks (AHSNs) across the country, a higher profile for NHS Innovation Challenge Prizes, and plans to establish a Specialised Services Commissioning Innovation Fund as well as doubling investment in the Small Business Research Initiative.

The list of high impact innovations which the government is seeking to adopt includes:

  • rapid acceleration of the use of assistive technologies in the NHS, aiming to improve at least 3 million lives over the next five years
  • launch of a ‘child in a chair in a day’ programme to transform the delivery of wheelchair services throughout the NHS
  • NHS organisations required to explore opportunities to increase national and international healthcare activity, with plans for hosting a summit with UK trade and investment in the new year
  • NHS required to work towards reducing inappropriate face-to-face contacts and to switch to higher quality, more convenient, lower cost alternatives 
  • NHS required to commission services in line with NICE-SCIE guidance on supporting people with dementia

From April 2013, compliance with the high impact innovations will become a pre-qualification requirement for the Commissioning for Quality and Innovation (CQUIN) payment framework. More details here.

A prosthetist based at the NHS Exeter Mobility Centre has developed a new prosthetic arm with a smart phone docking point for a patient who has only one arm and who found that his existing prosthetic forearm did not allow him to use new generation phones with qwerty keypads. The new device allows him to secure his mobile phone within the prosthesis, so he can make calls and send texts using one hand. More here.

The Department for Business, Innovation and Skills has published a report 'Strength and Opportunity 2011' covering the landscape of the medical technology, medical biotechnology, industrial biotechnology and pharmaceutical sectors in the UK. The report suggests that assistive technology accounts for around £700 million turnover a year, and is the second largest source of employment. For more information, go here

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4. Long Term Conditions

The National Audit Office (NAO) has issued a report which says services for people with long-term neurological conditions are not as good as they ought to be, despite a large increase in spending. The report is critical of the National Service Framework for Long-term Conditions, introduced by the Department of Health in 2005. The NAO says that while people with neurological conditions have had better access to health services, key indicators of quality have worsened and the Department of Health does not know what the framework and additional spending of nearly 40 per cent have achieved. Progress in implementing the framework is described as 'poor', with considerable variation in services across the country. One constant, however, is a 'significant' increase in the number of emergency admissions to hospital.

The report notes that: 'There are still significant problems with current services. Many patients, following their diagnosis, are not given information on their condition, about local services or on available support. Ongoing care is fragmented and poorly coordinated and there is a pattern of patients being referred to hospital for treatment, then discharged and then referred to hospital again. The NAO also found that there is poor coordination between health and social services.' More information via this link.

The Department of Health has published 'Long term health conditions 2011: research study', which presents the results of the third and final wave of a tracking study commissioned by the Department of Health with Ipsos MORI. The research programme aimed to explore attitudes towards ‘self-care’. In particular, researchers looked at the general public’s perceptions and behaviour with regard to both their own health and the NHS generally, and sought to capture the attitudes and behaviour of those people with a long term health condition with regard to the self treatment of their condition and their use of healthcare services. Details here.
 
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5. Medical Devices

The Medicine and Healthcare products Regulatory Agency (MHRA) has published medical device alerts for the following products:

  • Octopus 3 extension set with anti-reflux valves and clamps manufactured by Vygon (details here)
  • Specific model variants of Plum A+ infusion pumps manufactured by Hospira Inc (details here)
  • All Plum A+ infusion pumps manufactured by Hospira Inc (details here)

There has been a formal launch for a new Code of Practice for community and other disability equipment written by Brian Donnelly in response to a series of critical reviews identifying serious clinical and financial failings. The Code aims to support public sector organisations to help them commission and provide services more effectively. It will be administered by the Community Equipment Code of Practice Scheme (CECOPS), a not-for-profit social enterprise chaired by Sir Bert Massie. The CECOPS website is here.

The Code of Practice sets out standards, guidelines and best practice for each stage of the community equipment process and applies to all areas where community equipment is commissioned and provided by Health and Local Authorities. It covers all public sector commissioning, provision and the clinical and professional responsibilities. Organisations can register as working to the Code of Practice as a Full or Associate Registrant, depending on their level of involvement with community equipment. For more information, follow this link.

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6. Mobility and Transport

New measures to reduce Blue Badge fraud, which is estimated to cost £46 million a year, came into force on 1st January 2012. They include the introduction of an electronically printed badge, much like a driving licence, which has security features such as a unique hologram, digital photo and serial number allowing parking attendants to check for genuine badges more easily through the windscreen. 

Other measures include:

  • shared administration between authorities resulting in faster renewals, less abuse and operational efficiency savings of up to £20 million a year
  • online applications and renewals using Directgov, as well as access to a new national helpline number and the facility from April 2012 to report lost and stolen badges online
  • wider use of independent mobility assessments to determine eligibility, with local authorities given control of National Health Service spend on Blue Badge assessments
  • extending the scheme to more disabled children under three years of age and severely disabled Armed Forces personnel and veterans; and removing residency requirements for disabled service personnel and their families who are posted overseas on UK bases

Details of the reforms are here. The Department for Transport has produced a list of frequently asked questions about the Blue Badge scheme, which is here.

Rail Minister Norman Baker has announced more than £37.5m of government funding to make stations more easily accessible under a new Access for All Mid-Tier programme for projects requiring up to £1 million of government support. Upgrades to the stations will include new lifts, ramps and raised 'easy access humps' on platforms as well as new accessible toilets. The move forms part of the wider £370 million Access for All programme, which will deliver an accessible, step-free route at 148 key railway stations. Find out more via this link.    

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7. Information and Communications Technology

A new United Nations report on digital inclusion calls on decision makers to ensure that television and other digital media are fully accessible to people with disabilities. The report says that many of the 1 billion or so people who live with some form of disability are unable to enjoy the audiovisual content that comes to their homes and that accessible TV should be a fundamental tool in building inclusive societies. The report is here.

Professor Alan Newell, from the University of Dundee, has written "Design and the Digital Divide: Insights from 40 years in Computer Support for Older and Disabled People". The book argues that demographic trends and increasing support costs means that good design for older and disabled people is an economic necessity as well as a moral imperative. Details via this link.

Housing Minister Grant Shapps has pledged to end what he styles a 'digital apartheid' that has meant many social tenants in England are unable to get online. Current estimates suggest nearly half of council and housing association tenants in England, which Shapps said included older and disabled people, do not have access to the internet or have never gone online. More here.   

The Jodi Mattes Trust, a charity which promotes full cultural equality for disabled people, has announced the winners of its annual awards for the use of technology to improve accessibility. They include Bristol’s M Shed museum, which used the PenFriend audio labeller from RNIB to give visually impaired visitors audio access to hundreds of stories behind exhibits in the collection, and the ‘Touch Pods’ multisensory interpretation for learning disabled visitors to the National Wildflower Centre in Liverpool, which was developed by Mencap Liverpool. There is more about the awards here.

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8. Telecare and telehealth

December saw significant national media comment on the Department of Health's report on the initial findings from the Whole System Demonstrator projects, and the subsequent announcement of a 'Three Million Lives' campaign to identify at least three million people with long term conditions and/or social care needs who could benefit from using telehealth and telecare (see FAST December AT Policy Bulletin). The Department of Health press release is here and there is a round-up of the coverage in the Telecare Learning and Improvement Network's December newsletter, which is available here.

Management consultants from Ernst & Young are warning that while the Department of Health's commitment to accelerate the use of telecare is to be welcomed, there are significant operational and organisational issues which still need to be addressed. In an article in Public Finance magazine, they argue that implementing assistive technologies to three million people over five years is likely to cost £0.5billion and says it is difficult to see where this money will come from, given the current economic climate. Incentive schemes will be needed to fund a local enhanced service or pay the difference in the quality and outcomes framework. The authors note that some commissioners and providers are already moving towards a 'shared savings formula', but caution that 'the construction of a commercial deal that allows telehealth providers to benefit from downstream revenue savings is very problematic'. Read more here.

The Department of Health in Northern Ireland has formally launched an £18m telehealth initiative. The service will be rolled out to 3,500 patients across the country each year for a period of six years and will be developed by the Centre for Connected Health and Social Care (CCHSC) in partnership with the business consortium TF3. There is media coverage of the plans here and here

Business advisors FMC have published a top tips guide to breaking into the UK telehealth market, which is available via this link.  

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9. Healthcare

The NHS Confederation, the body which represents health service trusts, has issued a statement saying the NHS in England must end the 'hospital-or-bust' attitude to medical care, claiming that at least one in four patients would be better off being treated by NHS staff at home. The Confederation also wants to see more done to look after frail older people at home and to minimise hospital stays, although its comments do not cite assistive technology as the means to do so. A BBC report is here.

The College of Occupational Therapists (COT) has launched a new online edition of the Professional Standards for Occupational Therapy Practice (2011). The standards are here.

The Allied Health Professions (AHP) Referral To Treatment (RTT) Revised Guide has been update to include a framework of rules to reduce waiting times and is available here

An article in the Guardian newspaper highlighted the trend for local government to becoming involved in delivery healthcare, under the new NHS reforms, citing Kent County Council's adoption of telecare as an example of such services. Details are here

The health secretary Andrew Lansley, has launched more than 60 'outcome measures' for the NHS. The NHS Choices website is to provide user-friendly maps indicating which GP practices have specialised knowledge of particular health issues so that people with long term conditions can pick a doctor with specialised knowledge. Patients will also be able to see who in their area can offer them services under the 'any qualified provider' policy, which starts in April. There will be a choice of at least three providers of services such as wheelchairs and hearing aids. The NHS Outcomes Framework is here and there is a Guardian article here.

The NHS is accused of causing or contributing to the deaths of at least 74 patients with a learning disability because of poor care that reveals enduring 'institutional discrimination' among doctors and nurses. Guardian article is here and Mencap's response is here.

The Office of Fair Trading (OFT) is consulting on plans to refer the market for private healthcare to the Competition Commission for investigation after an OFT review identified a number of features that were preventing, restricting or distorting competition in the £5 billion market. More here

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10. Social Care

The Care Quality Commission (CQC) has published the first five reports from a targeted programme of 150 inspections of hospitals and care homes that care for people with learning disabilities. Among the issues raised are a lack of person-centred care and failure to meet all government-agreed health and safety guidelines. Read more here

Details of the proposed social security benefits rates for 2012 are here.  

The Department of Health has announced an additional £300 million for primary care trusts to fund reablement services to help provide community care for people to allow them to be more independent following stays in hospital. This is double the £150 million invested in 2011/12. Health Secretary Andrew Lansley has also announced another £20 million will be made available for the disabled facilities grant, to enabled disabled people to live more independently at home. Care services minister Paul Burstow said the reablement money 'will help cut the delays in getting the equipment and adaptations that people can need to enable them to live independently at home – saving them from an unnecessary stay in hospital or going into residential care' (details here). More information here and here and the Department of Health notice is here and the press release is here.

Emergency admissions for dementia patients were up by 12% according to a report by  MHP Health Mandate and the Alzheimer's Society which says some admissions could be avoided 'through high quality community support’. More here.

NHS and social care staff who have concerns about patient care will be able to access a new, free whistleblowing helpline from 1st January 2012. Details here.  

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11. Services for Older People 

In a letter published in the Daily Telegraph a group of more than 60 government advisers, charity directors and independent experts said failure to meet the challenge of an ageing population was resulting in 'terrible examples of abuse and neglect'. The writers urge the government to overhaul England's 'failing' social care system, which they say is leaving 800,000 elderly people 'lonely, isolated and at risk' and which means disabled people cannot get the support they need to live independently. The signatories, who include representatives from the British Medical Association, Age UK and the TUC, called for cross-party support to secure 'urgent, fundamental and lasting reform'.  The letter is here and a Guardian article is here.

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12. Rights for Disabled People

The Office for Disability Issues (ODI) is asking disabled people to contribute to a new cross-government disability strategy which aims to enable disabled people to fulfil their potential and have opportunities to play a full role in society. The new strategy will build on previous discussions with disabled people, including the Independent Living Strategy, the Roadmap and the UK’s report to the UN on implementation of the Convention on the Rights of Disabled People. The ODI says the strategy needs to tackle barriers to realising aspirations and individual control, as well as change attitudes and behaviour towards disabled people, and has published a discussion document 'Fulfilling Potential'  which outlines key issues. The deadline for responses is 9th March 2012.

The discussion details and background information are here. The ODI has also produced a facilitation guide to help organisations run their own engagement activities, and will be providing some funding to support such events. Any applications for funding must be made by 20th January 2012 and there are details on the ODI website. The facilitation guide is here.                               

Inclusion Scotland has launched a human rights toolkit which has been developed in consultation with disabled people from around Scotland. Its key purpose is to provide disabled people and their advocates with the tools they need to realise their human right to live independently. The toolkit is freely available from Inclusion Scotland’s website here

Commenting on the planned closure of the Independent Living Fund to new applicants, Minister for Disabled People Maria Miller said that the government was committed to a formal consultation in 2011 on how existing users would be supported in the future. She said that consultation should be placed in the wider context of the reform of the care and support system and will therefore now take place in spring 2012, alongside the publication of the planned White Paper on the future of care and support in England. Details here.

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13. Services for Children and Young People

Contact a Family has said it is concerned that unless NHS reforms make substantial changes to the way patients and the public are able to feedback their views about their local health services, the voices of parents with disabled children will continue to be lost in the system. The charity is funded by the Department of Health to support the involvement of parents of disabled children in commissioning and improving health services, and has carried out a survey of parent carer forums about their experience of working with Local Involvement Networks (LINks) and their involvement with health services. The results showed that nearly a quarter had not heard of LINks, or had been told they did not work with children's services, and 40% had not found them helpful in improving services for disabled children. Contact a Family is now recommending ways in which the new HealthWatch organisations, which come into being later this year, could co-ordinate local patient and community groups to ensure the voices of different patient groups, including parents and disabled children, are heard by service commissioners and managers. More information here.

Young Ambassadors from the Council for Disabled Children (CDC) have held a parliamentary launch of their film 'Young, Disabled and In Control' and briefed MPs on the issues facing young disabled people. Sarah Teather, Minister for Children and Families, who attended the event, said she will be looking to the Young Ambassadors and other disabled young people for feedback on the Government's response to the SEND Green Paper consultation when it is published later this year. More here.

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14. New Year Honours List

Amongst the people named in the New Year Honours list 2012 are Jean Gross, England's Communication Champion for Children, who has been awarded a CBE in recognition of her work to improve services for children and young people who have speech, language and communication needs (details here). Professor Lionel Tarassenko, who is chair of electrical engineering at the University of Oxford, is also made a CBE, as is Jim Mansell who is Emeritus Professor of Learning Disability in the Tizard Centre at the University of Kent (details here). Professor Tarassenko specialises in biomedical signal processing and e-health (more here) and has worked on a project looking at the self management of chronic conditions using telemedicine (details here). 

Other awards include an OBE for Joyce Cook, the chair of Level Playing Field (formerly the National Association of Disabled Supporters), for services to disability sports. Neil Robinson, national coach of the Paralympics GB table tennis team received an MBE, as did Rhona Roy of Capability Scotland and Madeleine Starr, head of innovation at Carers UK.

The full honours list is here.

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15. News in Brief

Alvolution website
MedilinkWM has re-launched its Alvolution product comparison website, which its says is the largest and most up-to-date directory of assisted living technology and which provides information and purchase details for a wide range of items to support independent living. The site allows registered users can search by condition, equipment area, technical area, or scenario, then compare and contrast individual products on screen. More here.

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