• This report concludes that AT can help to deliver many of the goals and targets set out in the NSFs and in the Public Service agreement for 2003/06.
  • ’In particular, the effective use of AT to keep people at home offers one very powerful way of reducing the pressure on most acute hospitals, both by preventing emergency admissions and reducing the number of delayed discharges.’
• Audit Commission, Fully Equipped, 2000
  • ‘Equipment for… disabled people provides the gateway to their independence, dignity and self- esteem… It improves quality of life; it enhances their life chances through education and employment… It is no exaggeration to say that these services have the potential to make

or break their quality of life of many… disabled people’

• Audit Commission report

• Minister’s Introduction:
  • “Similarly, the evidence in the NSF about the value of improving access to assistive technology and of opening up palliative care for people with neurological conditions can also apply to other people living with disabilities and persistent pain.”
• Quality requirement 7:
  • Providing equipment and accommodation People with longterm neurological conditions are to receive timely, appropriate assistive technology/equipment and adaptations to accommodation to support them to live independently, help them with their care, maintain their health and improve their quality of life.
• NSF for long term conditions

• Assistive Technology considered within the Specialised Services National Definition Set 5 – Assessment and provision of equipment for people with complex physical disabilities (all ages)
  • Includes: specialised wheelchair controls; communication aids; Environmental Control and other Electronic AT; Specialised Telecare
  • “it is the expertise of the patient assessment process that determines the specialised nature of the service.”
  • “it is essential that commissioners look at the whole model of equipment service provision”
• More information on commissioning specialised services

• Improving the life chances of disabled people, Prime Minister's Strategy Unit
  • “‘Disabled children risk developmental delay owing to lack of specialist equipment: Specialist equipment – including community equipment, communication aids, wheelchair services and prosthetics – can be delayed and may not be adequately adapted as the child grows. Waiting for equipment can mean it does not fit the child when it does arrive, with developmental implications for the child. This is important given the increase in numbers of technology-dependent children’”
  • Recommendation 5.6 Equipment: “DH should assess by 2006, whether integrated community equipment services, communication aids provision and wheelchair services are able to deliver the NSF recommendation on children’s equipment, and, if not, make recommendations for improvement. From 2006, the Joint Area Review should consider, in consultation with local authorities, using equipment services as a key performance indicator of local social care, education and health services. The indicator should be consistent with the National Service Framework recommendation on equipment. DfES and DH to lead.”

• The Children's Plan (2007) - DFES Site.
  • 3.117 We recognise that more needs to be done to improve outcomes and provision for children with SEN and disabled children to increase parental confidence that children’s individual needs are being met. Over the next three years, we will spend £18 millon to:
    • improve the workforce’s knowledge, skills and understanding of SEN and disability through better initial teacher training and continuing professional development by working with the Training and Development Agency for Schools and others. In initial teacher training, we want providers to offer specialist units on SEN and disability, which have been successfully piloted. For new teachers’ induction, we will promote further use of specialist materials and look for opportunities to extend and strengthen the knowledge and skills of newly qualified teachers as they take up posts in schools. We will also invest further in the Inclusion Development Programme (IDP), which aims to increase the skills of the whole early years and school workforce in dealing with children with speech, language and communication needs and dyslexia; autistic spectrum disorders; and behavioural, emotional and social difficulties. We will continue to work with key voluntary sector partners to develop specialist trusts in relation to dyslexia, communication needs and autism, which will encourage teachers to become specialists in these important areas;

• 3.118 The Bercow Review into the provision of services for children and young people with speech, language and communication needs was launched in September 2007. The Review will consider improving information to parents to help identify issues early and encourage them to seek support; improve the skills of the early years and school workforce; promote better partnership working between health and local authority services; and ensure clear accountability in all services. In spring 2008 it will publish its interim report, reflecting the outcomes of its consultation, with a final report in summer 2008.

• Independent Living Strategy (2006)
  • ‘someone who does not use speech needs an electronic communication aid to overcome disabling barriers’
• SEN & Disability Act (2001)
  • Duty of the local authorities to plan strategically and to ensure that pupils have access to the curriculum.
• Children’s Act (2004)
  • Use of multidisciplinary services across agencies when developing Children’s Services
• Human Right’s Act (2004)
  • The right to develop the most appropriate means of communication for their needs
• Minimum standards of Healthcare for children with CP (1999)
  • Services should be provided to maximise the child’s potential
  • Team approach is essential to provide a more integrated service
  • Parents should be encouraged to work in an effective partnership with the rest of the team
  • Parents should be given written record of decisions
  • Parents should have the opportunity to see all professional as at the same time, so that a holistic approach is adopted.
  • A problem-solving approach for each family should underpin service provision
• NHS Plan – Modernising Community Equipment Services (2000)
  • By March 2004, to increase number of people benefiting from community equipment services
• Schools Access Initiative (2001)
  • Part of Government’s Inclusion Policy; Improve access in mainstream schools
• NSF – Neurological Conditions (2005)
  • The Long-term (Neurological) Conditions National Service Framework (NSF) was launched in March 2005. The NSF aims to transform the way health and social care services support people to live with long-term neurological conditions. Key themes are independent living, care planned around the needs and choices of the individual, easier, timely access to services and joint working across all agencies and disciplines involved.
• NSF – Children (2005)
  • Standard 8 - Disabled children and young people and those with complex health needs
  • Complex disability exemplar
• Every Child Matters (2004)
  • Multi Agency Working
  • Common Assessment Framework
  • Pooled Budgets
  • Voluntary Sector involvement
• “Our Health, Our Care, Our Say” (2006)
• Q&A: House of Lords Debate - Responsibility for AAC assessment (March 2006)
  • Responsibility for assessing people’s communication aids needs rests with local health & social care agencies, using the increasing resources that the Gov. has made available. Lord Warner, Minister of state, DoH. DoH has commissioned research on communication therapy & aids.
• Supporting Self Care – a practical option (2006)
• Policy review of children and young people (2007)
• Transforming community equipment stores
• The Role of Assistive Technology in Alternative Models of Care for Older People.
• UN Convention on the Rights of Persons with Disabilities
  • Government sign up: 30th March 2007
  • Article 7 requires states to ensure that disabled children can express their views freely on all matters affecting them
  • Article 21 requires parties to accept and facilitate, amongst other forms of communication, the use of Alternative and Augmentative Communication.
• Removing Barriers to Achievement – DfES
  • “The Strategy sets out the Government’s vision for enabling children with special educational needs to realise their potential and a programme of sustained action and review over a number of years to support early years settings, schools and local authorities in improving provision for children with SEN. It builds on the proposals for integrating children’s services in the Green Paper Every Child Matters and includes a strategy for improving childcare for families of children with special educational needs and disabilities.”
  • “We will encourage through our ICT in Schools and E-learning strategies the wider use of ICT to improve access to education for children with SEN and disabilities, building on our Communication Aids Project.”
• Working together to safeguard children – DoH
• Managing complex health needs in schools and Early Years’ settings – Council for Disabled Children DfES

• NICE guidelines for Multiple Sclerosis

“any person with Multiple Sclerosis who cannot communicate effectively should be assessed by a specialist Speech and Language Therapist for an augmentative aid to communication, which should then be provided as soon as possible”.

• NICE guidelines for Parkinson’s Disease

Speech and Language Therapy should ensure “an effective means of communication is maintained throughout the course of the disease, including use of assistive technologies”.

• SCIE Research Briefing
  • The term ‘assistive technology’ incorporates a wide variety of devices.
  • Assistive technology can be supportive, preventive or responsive.
  • The increasing proportion of older people in the population makes the use of assistive technology an attractive option in social services.
  • Perceptions vary as to whether or not assistive technology has sufficient benefits.
  • Existing research supports the greater use of assistive technology but further evaluation and ‘local learning’ is needed.
  • The views and needs of people using assistive technology need to be taken into account.

• 10 Quick Wins
  • 6. Appoint practitioners3 with specialist expertise in neurological conditions (QR2)
  • 9. Improve quality in specialised home care and community services (QR8)
    • Benefits:
      • Appropriate care is likely to reduce health complications, which often result in hospital admission
    • How:
      • Care providers need to have training, knowledge and skills to deal with complex needs such as positioning, turning, spasticity, and overcoming communication difficulties. Commissioning care packages should specify this in contracts and should pay enhanced rates to more specialised providers.

• SCOPE- Communication Aid Provision, Review of the Literature (2007)
  • The scarcity of communication aids hinders people’s self-expression and limits their involvement in decision-making. In many cases without the provision and use of Augmentative & Alternative Communication (AAC) it is very difficult, if not impossible, to participate. If you cannot participate your views are not taken into account. For people with communication support needs, this is a vicious circle, with the government in one hand offering further opportunities to participate and silencing these same people with the other.
  • Effective provision of communication aids enables people to live independently and engage with their local community. In addition to the increased opportunities for independent living, access to facilitated methods of expression, aids the empowerment of disabled people in tackling the double disadvantage of poverty and disability. This is pertinent when they and their families are vulnerable to living in poverty.

• FAST R&D Publications

This report is published yearly and presents an overview of research and development into Assistive Technology within the UK.

• RCSLT - Position Paper: supporting children with speech, language and communication needs within integrated children's services (January 2006)
• Getting started.. Communication aids – Integrated Community Equipment Stores
• Research and Development Work Relating to Assistive Technology 2006-07 , (2007
• Self care in AT, (2007)
• British Society of Rehabilitation Medicine, Assistive Technology (2000)
• Specialist equipment services for disabled people, Royal College of Physicians
• Speak for yourself report (SCOPE – 2000)
  • Central government should set up central fund for provision of communication aids and training
  • DoH should conduct research to determine numbers of users
  • DoH should issue new national guidance on provision of communication aids, and clear national standards to avoid postcode lottery *“That Kind of Life” (2001)

• Monday, 21 July 2008
• Monday, 3 December 2007

“It is the responsibility of local health and social care organisations to prioritise and allocate funding for communication aids based on their assessment of the needs of their local populations. "

• You and Yours, 2007

— Simon Judge 2007/10/03 Updated 2008/10/02

— Credit: Some text reproduced from “Setting up an AAC Assessment Service – the pitfalls and the rewards.”, Communication Matters Journal, 2007, Sally Chan.