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Equipped for Inclusion: Report of the Strategy Forum: Equipment and Adaptations

Executive Summary

All too often, environmental barriers limit the potential of disabled and older people to take part in mainstream employment, educational, social and recreational opportunities. Equipment and adaptations help to overcome these barriers, they can have a significant and positive impact on people’s lives, and those of their carers, and can influence the need for other care services. They help people of all ages to carry out ordinary activities of daily life that have become difficult or impossible due to impairment, ill health, traumatic injury, the effects of ageing or a change in circumstances.

The current dislocation of the component parts of equipment and adaptations within a variety of sectors, organisations, departments, and professional specialisms has contributed to the inefficiencies, bureaucracy, and delay that blight the delivery of assistance to the very people who could benefit.

During exploration of the issues, a multifaceted and intricate picture was exposed, arising from a broad range of products, services and people. Consideration of the overall impact of equipment and adaptations is therefore required, so that informed policy and service decisions can be made. The Strategy Forum's analysis indicated that there is considerable scope for existing resources to be managed and organised more effectively. Status quo is therefore not an option.

It was considered imperative from the outset to promote a much wider and longer-term improvement agenda for the availability of equipment and adaptations within society. The recommendations are extensive and interconnected, and if addressed, will have a significant impact on raising awareness, increasing general availability, and improving and supporting service delivery. The development of a tasked agenda with the resources to support it is recommended to achieve this, and it is vital that this vision is revisited regularly to ensure that the changes instigated are realising what they actually seek to achieve. This does not mean that the vision cannot be adjusted, but this should be deliberate rather than accidental.

The strategic vision for equipment and adaptations goes beyond service provision and seeks to address the way in which issues of equality in relation to illness, disability and getting older are approached. Four key areas were identified:

1. Equipment and adaptations as part of very day life: the promotion of social justice through the mainstreaming of equipment and adaptations.

Equal rights and equality of opportunity for all demand that everyone should have the possibility to participate to their potential in all aspects of society as well as being able to have control over their own lives at every level. This vision for the future of equipment and adaptations recognises each individual as an expert in his or her own situation, and acknowledges that the changes and transitions that people experience require a lifetime approach.

In addition to providing people with the assistance that they need in accordance with current legislation, the following are important related tasks:

• raising awareness of equipment and adaptations within the general population
• increasing access to equipment and adaptations through commercial settings
• the inclusive design of products, housing and the environment
• harnessing the potential of emerging technologies

2. Extending and sharing knowledge: by improving the information available and improving how information is provided, supported by advice and demonstration.

The Joint Future Group acknowledged that information was key to the successful development of effective community care services. It is also fundamental to the process of change that is sought in relation to equipment and adaptations, and to empower people so that they can make informed choices. The Strategy Forum considers this to be central to creating modern and effective equipment and adaptation services.

The vision for extending and sharing knowledge about equipment and adaptations is:

• centred on the needs and preferences of people
• underpinned by the mainstreaming of equipment and adaptations as part of everyday life
• acknowledges that many people do not need professional expertise to achieve the best outcome for them, but that some people do

3. A joint future: equipment and adaptations integrated with one another, integrated within community care, and across care groups through joint resourcing and joint service management, single shared assessment and care management.

Where people require assistance that includes equipment and adaptations there should be simple processes to access integrated and holistic local information, advice, demonstration, support, products and services.

The Joint Future agenda provides mechanisms that offer an unparalleled opportunity to overcome the gaps, overlaps and unhelpful demarcations that hinder delivery of equipment and adaptation services. It supports person centred planning, enables decisions to be taken jointly over a wider use of resources and directs a broader range of services and resources to needs. It enables equipment and adaptations, together with habilitation and rehabilitation, to be fully incorporated within community care as valuable and intrinsic components of, and alternatives to, community care services.

4. Assuring quality and innovation: by auditing and improving service standards, a knowledge base evidencing and evaluating the impact on people’s lives and the impact on other care services, and by encouraging and supporting innovation.

People want and expect quality products and services, which offer a choice of modern, safe, functional equipment and adaptations, supported and provided by people with relevant and current expertise and experience. All of which should be regulated and inspected by the appropriate agencies.

Advice on equipment and adaptations should be based on a holistic assessment of the person, their environment and their care needs, and the application of knowledge from an established evidence base.

Credible research, audited outcomes and consumer opinion should inform equipment and adaptation development, innovation and service provision. Comprehensive and reliable data that can inform the quantity, quality and effectiveness of resources and services should be collected.

To achieve this a partnership is necessary between people who use equipment and adaptations, people and organisations that provide them, and designers, manufacturers, and the construction industry.

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