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Bulletin No. 39, December 2006

Welcome

This news bulletin is provided as a resource for AT Forum members and to highlight innovation in AT service delivery for a wider audience. FAST welcomes contributions.

Disabled Children Miss Out on Equipment
Research and Development in Assistive Technology
Procurement and Supply of Assistive Technology
Developing Telecare Services
Outdoor Mobility
NICE/SCIE Guideline to Improve Care of People with Dementia
Musculoskeletal Services Framework
The NHS Reforms
Services for Older People
Services for Children and Young People
Rights for Disabled People
Independent Living
Governance and Regulation
The Third Sector
News in Brief

1. Disabled Children Miss Out on Equipment

A report by the charity BDF Newlife (formerly the Birth Defects Foundation) has revealed serious problems with the funding of equipment for sick, disabled and terminally ill children by primary care trusts and local authorities, based on information obtained under the Freedom of Information (FOI) Act. Some bodies reported not knowing what they spend.

“We started off making grants to support the state system paying out £37,000 in 2004, but this rose to half a million in 2005 and so far it stands in excess of three quarters of a million this year and rising. We are no longer supporting the system, we are replacing it in many cases as the statutory system is rapidly failing children,” said Sheila Brown OBE, founder and CEO of BDF Newlife.

BDF Newlife has also found a lack of coordination between agencies, delays in assessment and problems with the equipment supplied. The charity has launched a campaign – “It’s not too Much to Ask” – with the aim of raising awareness of the plight of thousands of children in need of millions of pounds worth of equipment. For more information go to: http://www.bdfnewlife.co.uk/docs/home/home_1.php

2. Research and Development in Assistive Technology

The Department of Health has published its annual report for Parliament on research and development relating to assistive technology in 2005-06. The reports, which are produced by FAST, cover research and development carried out by or on behalf of any Government department in relation to equipment that might increase the range of activities and independence or well being of disabled people.

The current report places such research in the context of Government policies and outlines the role of assistive technology in making independent living easier for older people and people with disabilities. The report describes the wide range of Government funded projects supporting the development, introduction and evaluation of assistive technology in relation to:

independent living for older people
support for dementia in older age
extra care housing to support older people
telecare and telehealth assistive technologies
telecare on the move
remote delivery of assistive technology services
management of long-term conditions
environment-sensing assistive technologies
technology to assist learning and communication
rehabilitation
electrical stimulation to enable fitness and control of function
tools to support inclusive design
technology evaluation.

The report can be downloaded by clicking on this link.

Full details of research and development projects in assistive technology funded by Government are also available on the FAST website, together with information on research funded by other sources such as business and voluntary sector organisations: http://www.fastuk.org/

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3. Procurement and Supply of Assistive Technology

The work of NHS Logistics and the associated procurement service provided by the NHS Purchasing and Supply Agency (NHS PASA) has been transferred to a new organisation, the NHS Supply Chain, and outsourced to private companies (see October bulletin). The NHS Supply Chain has now taken over responsibility for the national framework agreements (NFAs) for the following assistive technologies: audiology, prosthetics and orthotics, electronic assistive technology, special seating and wheelchairs and accessories (not telecare):
http://www.pasa.doh.gov.uk/rehabilitation/

NHS PASA has set up a decontamination equipment trading website for use by the NHS free of charge to advertise surplus decontamination equipment to other NHS organisations: http://www.pasa.doh.gov.uk/decontamination/

NHS PASA’s annual report for 2005/06 is at: http://www.pasa.nhs.uk/annualreport/

4. Developing Telecare Services

The Department of Health has published advance notification of the “whole system long-term conditions demonstrator programme”, which was proposed in the White Paper “Our health, our care, our say”. The programme aims to “support the independence of those with complex long term conditions through provision of integrated care with assistive technologies”.

The total resident population covered in up to three pilot projects will be at least one million, from a variety of demographic and geographical contexts and in areas with different health and social care configurations. The pilots will run for a minimum of two years and will be subject to a rigorous ‘real time’ evaluation process.

The pilots will be on a scale significantly greater than anything undertaken in England to date: in the region of several thousand telehealth and telecare installations over the two year period across all of the sites. More details are available by clicking on this link.

Concern about this demonstrator programme has been noted on the Telecare Aware 'Soapbox' section at: http://www.telecareaware.com/soapbox

The Care Services Improvement Partnership’s telecare newsletter for November included items on suppliers of telecare technology, the evidence base for telecare, and telecare news from around the country: http://www.cat.csip.org.uk/telecare

Slides from the conferences organised by the NHS Purchasing and Supply Agency on building telecare through effective procurement using the national framework agreement are at: http://www.pasa.nhs.uk/eat/telecare.stm

Web links for the telecare initiatives in Scotland and Wales are at:
Scotland: http://www.jitscotland.org.uk/action-areas/themes/telecare.html
Wales : http://www.allwalesunit.gov.uk/index.cfm?articleid=1924

The November issue of the journal Critical Social Policy included an article on the emerging social policy implications of telecare:
http://www.changeagentteam.org.uk/index.cfm?pid=34&catalogueContentID=1807

5. Outdoor Mobility

A report commissioned by the Department for Transport has recommended compulsory third party insurance for motorised wheelchairs and scooters. For more information, click on this link.

According to Disability Now (November 2006) this proposal has been welcomed by mobility charities and the Department is likely to consult on it next year: www.disabilitynow.org.uk

The Forum of Mobility Centres has launched a new UK- wide assessment and tuition service for people with mobility impairment who require a vehicle that allows them to drive from their wheelchair: http://www.mobility-centres.org.uk/

The November issue of Disability Now (www.disabilitynow.org.uk) included an article on progress at Mobilise, the merged charity for disabled drivers: http://www.mobilise.info

6. NICE/SCIE Guideline to Improve Care of People with Dementia

The National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE) have published joint guidance on the treatment and care of people with dementia in health and social care (“Supporting people with dementia and their carers in health and social care”. Clinical guideline 042. November 2006).

It is estimated that there are 700,000 cases of dementia in the UK and approximately one million people caring for them.

The guideline covers the identification, treatment and care of people with dementia and the support that should be provided for carers within primary and secondary healthcare, and social care. For the first time, healthcare professionals working within the NHS will be following the same guidelines as social workers and care workers in nursing homes. The guideline incorporates the Institute's controversial recommendation that donepezil, galantamine and rivastigmine should normally only be prescribed for people with moderate Alzheimer's disease. Key recommendations include:

There should be a coordinated and integrated approach between health and social care to treat and care for people with dementia and their carers
The needs of carers should be assessed by health and social care professionals and support should be offered as part of a coordinated care plan
Memory assessment services should be the single point of referral for all people with a possible diagnosis of dementia
People with dementia should not be excluded from any recommended services because of their diagnosis, age (whether designated too young or too old) or coexisting learning disability.

Provision of assistive technology (including telecare) is mentioned in the sections on:

environmental design for people with dementia
integrated health and social care
promoting and maintaining independence of people with dementia

The guideline can be downloaded at: http://www.nice.org.uk/page.aspx?o=CG42

7. Musculoskeletal Services Framework

New plans for better care for people who suffer from bone and joint ailments such as arthritis, back pain and fractures have been announced by Health Minister Andy Burnham. The Musculoskeletal Services Framework provides the NHS with new guidance to help improve services for people who suffer from such conditions, helping patients to be seen sooner and closer to their homes. An estimated ten million people in England suffer from musculoskeletal problems.

The framework sets out how the NHS can use a wider range of health professionals including physiotherapists, nurses and pharmacists, in addition to GPs and hospital consultants. It has been endorsed by professional bodies and is seen as crucial in delivering the 18 week pathway for the maximum wait from GP referral to hospital treatment, as orthopaedic waiting times present one of the greatest challenges to meeting the target.

The framework points out that “community equipment and telecare ….play a vital role in enabling people of all ages, including children, to maintain their health and independence, and to prevent inappropriate hospital admissions”:
http://www.18weeks.nhs.uk/public/default.aspx

Arthritis Care has published a patients’ guide to the framework, “Information for People with Bone and Joint Problems: Getting the most from your local health service”. For more information, click on this link.

8. The NHS Reforms

About a third of the NHS trusts in England are forecasting deficits totalling almost £1.2bn this year, although the Department of Health believes that the NHS as a whole "remains on track" to break even:
http://www.guardian.co.uk/uk_news/story/0,,1944273,00.html#article_continue

The Department of Health has published a set of “heat maps” giving an indication of NHS trusts likely to cause negative media coverage in each strategic health authority area. For more details, click on this link.

The NHS Chief Executive has written to English MPs warning of a wave of closures and fundamental changes to "much loved local services":
http://www.guardian.co.uk/uk_news/story/0,,1942807,00.html#article_continue

The Department of Health has endorsed a framework published by NHS Employers for NHS trusts on how they can provide all the necessary support for NHS staff whose jobs are at risk and for newly qualified healthcare professionals who are looking for work in health and social care. For more details, click on this link.

NHS Together brings together all the health service unions and staff associations together with the TUC in a campaign alliance to “raise the alarm at what is happening to the NHS and to press the government for honest and open discussion about its reform agenda”:
http://www.tuc.org.uk/theme/index.cfm?theme=nhstogether

The Department of Health has published the results of the first National Patient Choice survey commissioned to assess the implementation of choice at primary care trust level. Only 30% of patients recalled being offered a choice of hospital for their first outpatient appointment. For further information, click on this link.

The Department of Health has announced a new library pilot project alongside new choice booklets to help patients make more informed choices in their healthcare. There is more information available by clicking on this link.

NHS Direct Online, the health advice and information website for patients and the public, has been relaunched with a new look: http://www.nhsdirect.nhs.uk/

The Department of Health has published for consultation a self-regulatory code of practice on the promotion and marketing of NHS services. To read more, click on this link.

The newly published “Health Challenge England – next steps for Choosing Health” sets out public health achievements since 2004 along with plans for the next two years. A separate document,“Health profile of England”, complements this with a picture of the health status of the population in 2004. Profiles for each primary care trust and local authority area are also available. For more information, click on this link.

A letter from the Department of Health informs local authority chief executives with social services responsibilities about plans for improving service user and public engagement in health and social care, including Local Involvement Networks and the partnerships with local authorities in establishing them at local level:
http://www.info4local.gov.uk/searchreport.asp?id=31067&heading=e-mail+alert

9. Services for Older People

The Department of Health has launched a new campaign to stimulate a national debate about dignity in care, and prevent the abuse and disrespect of older people in care. The campaign will include all adult groups from next summer.
The campaign is backed up by:

£67 million for local authorities to improve the physical environment of care homes for older people and help older people living in care homes do so with dignity
the Dignity Challenge - a 10 point plan that lays out the national expectations of what constitutes a service that respects dignity
a new network of local champions of dignity - an army of volunteers working to raise the profile of dignity in care locally
a good practice guide: http://www.scie.org.uk/publications/practiceguides/practiceguide09/
a programme of service improvement support
more focus on dignity by inspectorates
a review of national policies.

The press release is available by clicking on this link.

For more information about the guidance, click on this link.

On 8 November the Safeguarding Vulnerable Groups Act received Royal Assent. The Act lays the foundation for a new vetting and barring scheme which will be phased in from Autumn 2008. Details are available by clicking on this link.

An article in the British Medical Journal of 15 November on the impact of the Evercare case management approach on frail elderly patients in nine primary care trusts reported no associated reduction in hospital admissions. Although employment of community matrons is now a key feature of case management policy in the NHS in England, the authors concluded that “without more radical system redesign this policy is unlikely to reduce hospital admissions”. An editorial also discussed the case management of older people in the community:
http://www.bmj.com/

The Department of Work and Pensions has published a baseline report on the independence and well-being of older people, alongside indicators which will be used to monitor the effect of the Government strategy for ageing and older people, Opportunity Age: http://www.dwp.gov.uk/opportunity_age/indicators/index.asp

Five research councils have launched a seven-year multidisciplinary research programme to improve the quality of life of older people. For more on the New Dynamics of Ageing programme, follow this link.

Urgent action and investment is needed to deliver better care and support for Britain’s ageing population, according to a report from the charity Counsel and Care. The “Fit for the Future” report calls for a national debate on a long-term strategy for better care and support for older people and how it can be fairly funded. It sets out a range of practical measures that Government can implement, including information, advice and advocacy, individual budgets and investment in early intervention and telecare: http://www.counselandcare.org.uk/influence/publications/

10. Services for Children and Young People

The Department for Education and Skills has published the resource pack “Implementing the Disability Discrimination Act (DDA) in schools and early years settings”. For more information, click on this link.

The Department for Education and Skills has also published guidance for schools on the Disability Equality Duty (see item below on Rights for Disabled People). Read more by following this link.

Ofsted has published its annual report into the state of education and care for children in England in 2005/06, finding that:

in about two thirds of schools the progress of pupils with learning difficulties and/or disabilities is good or outstanding and it is inadequate in only 3%
local partnerships between services were beginning to play an important role in ensuring that the needs of children with learning difficulties and/or disabilities were taken into account
there was inconsistency in the quality of provision to meet the health needs of children with learning difficulties and/or disabilities
there was better achievement among learners with learning difficulties and/or disabilities in colleges.

The report is at: http://www.ofsted.gov.uk/

Ofsted and the Commission for Social Care Inspection have published the second annual performance assessment of local authority schools and other children’s services for 2005/06, which showed some improvement. For more information, click on this link.

The Learning and Skills Council (LSC) has launched its first comprehensive strategy for learners with learning difficulties and/or disabilities, “Learning for Living and Work”: http://www.lsc.gov.uk/News/LatestNews/National_Strategy_for_LDD.htm

According to Community Care (2-8 November), the Government has agreed to amend the Education and Inspections Bill to include a new duty on schools to cooperate with other partners to improve pupils’ wellbeing, but this will not apply to academies and city technology colleges: www.communitycare.co.uk

The Government has launched an online survey for children and young people about their views and experiences of children's rights. The results will be included in the government's next report to the United Nations Committee on the Rights of the Child, to be submitted by July 2007:
http://www.everychildmatters.gov.uk/?asset=News&id=49248

The Children's Society has launched the world's first image-led information website for disabled children and young people: www.askability.org.uk

A major new research report commissioned by Carers UK and Contact a Family has revealed the difficulties of combining paid work and care for disabled children:
http://www.cafamily.org.uk/whatsnew.html

11. Rights for Disabled People

The new statutory duty on public bodies to promote disability equality (the Disability Equality Duty) comes into force on 4 December. Most public authorities have to:

publish a Disability Equality Scheme (including within it an Action Plan)
involve disabled people in producing the Scheme and Action Plan
demonstrate they have taken actions in the Scheme and achieved appropriate outcomes
report on progress
review and revise the Scheme.

Guidance from the Disability Rights Commission (DRC) is at: www.dotheduty.org

Department of Health advice on how NHS organisations might produce a Disability Equality Scheme is available by following this link.

The November issue of Disability Now (www.disabilitynow.org.uk) was guest-edited by Bert Massie, chair of the Disability Rights Commission, and included articles on:

the Disability Equality Duty
an interview with Trevor Phillips, newly appointed head of the Commission for Equality and Human Rights, the merged equalities body which will operate from October 2007
definitions of disability
the prices of stairlifts, with comments from suppliers and charities.

The Government's new Commission for Equality and Human Rights (CEHR) has a credibility gap among the groups it is meant to help, according to DRC Chairman Bert Massie. Read his speech by following this link.

New practical guidelines to ensure the rights of disabled people are effectively met throughout Europe were launched on 21 November in Brussels. Disability charity Leonard Cheshire coordinated the work, drawing on the expertise of policy makers, researchers and disabled people across Europe.

EDAMAT (the European Disability Action Mainstream Assessment Tool) will be used to measure how far policies, laws and programmes in areas such as transport, health and education include the needs and rights of disabled people. Co-financed by the EU Commission, EDAMAT will be freely available to anyone involved in the development and monitoring of policy at European, national or local level:
http://www.leonard-cheshire.org/?lid=4434

The new book “Disability Rights and Wrongs” by Tom Shakespeare, published by Routledge, discusses key ideas and current issues affecting disabled people, including a critical look at the social model: http://www.routledge.com/

New guidance for the NHS in Scotland has been issued by Fair for All - Disability, a partnership between the DRC and the Scottish Executive Health Department: www.drc.org.uk/fair4all/.

The Department for Work and Pensions has published draft regulations and supporting material relating to the Welfare Reform Bill:
http://www.dwp.gov.uk/welfarereform/welfare-reform-bill-draft-regs.pdf

Directenquiries.com, the nationwide access register, now receives over 1.3 million hits each month from people looking for businesses, organisations and services with the disabled access they require:
http://www.directenquiries.com/content/tabid/55/news.aspx

RADAR has appointed Liz Sayce as its new Chief Executive from 1 February 2007. Liz is currently the Director of Policy and Communications at the Disability Rights Commission:
http://www.radar.org.uk/

12. Independent Living

For an update on the Government’s review of independent living for disabled people and a call for information about independent living initiatives, go to:
http://www.officefordisability.gov.uk/independent/#initiatives

For more information on direct payments and independent living, go to the National Centre for Independent Living website: www.ncil.org.uk

The Liberal Democrat Party has published “Independent Living – a policy development paper on disability”: www.libdems.org.uk

The 9 November issue of Community Care included an article by Bob Hudson and Melanie Henwood on issues raised by the various “cash for care” programmes for disabled people such as direct payments, individual budgets and the Independent Living Fund: www.communitycare.co.uk

For information about the Government's individual budget pilot programme, go to:
http://individualbudgets.csip.org.uk/index.jsp

The Department of Health is also funding 11 pilot projects on self-assessment by people with long-term conditions for home care and community equipment. For more information, click on this link.

The 16 November issue of Community Care included an article on the self-assessment project in Nottinghamshire, which is focused on the provision of less expensive equipment for the home: www.communitycare.co.uk

The 30 November issue of Community Care included an article on the issues around service users’ exposure to risk: www.communitycare.co.uk

The Department of Health is developing a risk and choice framework for social care and welcomes comments. For more details, follow this link.

The Better Regulation Commission has published the report, “Risk, Responsibility, Regulation: Whose Risk Is It Anyway?”, which recommends a public debate about the management of risk, with individuals empowered to take more personal responsibility for risk and state regulation as a last resort:
http://www.brc.gov.uk/news/2006/061018.asp

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13. Governance and Regulation

The Department of Health has published for consultation a paper on “The future regulation of health and adult social care in England”. This confirms the commitment to merge the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission, sets out the likely roles and functions of the new regulator and aims to provide “a clearer and refocused approach to regulation set within the wider context of the health reform programme”. For more information, follow this link.

The National Institute for Health and Clinical Excellence (NICE) is consulting on the scope of a clinical guideline to be developed on rheumatoid arthritis in adults:
http://www.nice.org.uk/page.aspx?o=360017

The Healthcare Commission will be carrying out a national audit of learning disabilities services in the early part of 2007. More details are available by following this link.

14. The Third Sector

The Charities Bill was passed by both Houses of Parliament and became law on 8th November 2006. The Charities Act 2006 is now law but, except for some technical provisions, it has not yet come into force. The Act provides a more modern framework for charities, including a new test of “public benefit” to be applied by the Charities Commission:
http://www.charity-commission.gov.uk/news/charbillnews.asp

The Government’s Social Enterprise Action plan, launched on Social Enterprise Day by Chancellor Gordon Brown, social exclusion secretary Hilary Armstrong and Minister for the Third Sector Ed Miliband, aims to encourage the growth of social enterprise and remove barriers for further participation of the sector: http://www.cabinetoffice.gov.uk/third_sector/

The Department of Health's Social Enterprise Unit has invited bids for funding for social enterprise pathfinder projects. For more details, click on this link.

The Association of Chief Executives of Voluntary Organisations has published a report on performance management in the voluntary sector, “Doing Good, and Doing Well?”, and a survey on leadership, governance and professional development, “Raising Our Game”: www.acevo.org.uk

15. News in Brief

Incontinence and Stoma Appliances: The Department of Health is consulting on:

proposed product reclassification and price reimbursement reductions for incontinence and stoma appliances supplied under Part IX of the Drug Tariff and
changes in remuneration arrangements for related services:
http://www.dh.gov.uk/Consultations/LiveConsultations/fs/en

Safety of Medical Electrical Equipment: The British Standards Institution has published the third revised edition of “BS EN 60601-1:2006 Medical electrical equipment: general requirements for basic safety and essential performance”, covering medical electrical equipment that comes into contact with patients:
http://www.bsonline.bsi-global.com/server/index.jsp

IT for People with Learning and Communication Difficulties: The book “Getting It” from Jessica Kingsley Publishers looks at how IT can help solve some of the common problems faced by people with learning and communication difficulties, including those on the autism spectrum and people with dementia:
http://www.jkp.com/catalogue/book.php/isbn/9781843103752

News from AbilityNet: AbilityNet has been piloting remote assessments in information and communication technology for disabled clients in their own homes since January 2006, and is now offering this as a paid service to employers, schools, colleges as well as the public and voluntary sectors: http://www.abilitynet.org.uk/

News from DLF: The Disabled Living Foundation has published its annual report for 2005/06 and its programme of training courses for 2007: http://www.dlf.org.uk/news/latest/index.html

News from Assist UK: Newly available from Assist UK - its annual report for 2005/06 and presentations from its recent annual conference: http://www.assist-uk.org/

News from the MHRA: The Medicines and Healthcare products Regulatory Agency is consulting on proposals to change the regulatory fees for medical devices. For more information, click on this link.

Number of People with Visual Impairments: The Information Centre has published a report on the number of people registered with councils as severely sighted (blind) or sight impaired (partially sighted): http://www.ic.nhs.uk/pubs/blindeng06

Diabetes Care: The Department of Health has published a diabetes commissioning toolkit. This describes how to carry out a health needs assessment for a local diabetes population and provides a generic specification for diabetes care, signposting recognised quality markers and suggesting key outcomes for the service. More information is available by clicking on this link.

Stroke Services: Stroke survivors are not getting the vital information they need on leaving hospital, including signposting to rehabilitation services, according to a new study from The Stroke Association:
http://www.stroke.org.uk/media_centre/press_releases/information_gap.html

User Involvement: The Joseph Rowntree Foundation has published the report, “Making user involvement work: supporting service user networking and knowledge”: http://www.jrf.org.uk/knowledge/findings/socialcare/1966.asp

Local Government Funding: The Government has confirmed that local authorities in England will receive more than £65 billion in 2007/08, a 4.9 per cent increase on 2006/07:
http://www.communities.gov.uk/index.asp?d=1002882&PressNoticeID=2303

2007 Comprehensive Spending Review: The Treasury has published a report on the “long-term opportunities and challenges facing the UK”, as background to the 2007 Comprehensive Spending Review. Key challenges include:

demographic and socio-economic change, with a rapid increase in the old age dependency ratio, with a 38 per cent increase in the numbers of people aged over 85 expected in the next 10 years, and rising expectations of public services
the rapid pace of innovation and technological diffusion, which will continue to transform the way people live and open up new possibilities for public services such as transport, education and health.

The report is available by clicking on this link.

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