Ray Hodgkinson, Director General of the British Healthcare Trades Association (BHTA), discusses the vital role of assistive technologies in today’s healthcare market.
An increasing number of people are living longer in the UK, but the future is stark for many elderly people. As mobility and other health problems develop, people worry that there may not be the help and support available to enable them to stay in their own homes. The population of over-50s is predicted to increase by 40% over the next 10 years. As age increases, so does the need for the products and services our member companies supply: ‘assistive technologies’.
Basically, these are any product or service designed to enable independence for disabled and older people, such as wheelchairs, stairlifts, hoists and continence products, special seating, orthotics and pressure care. They can range from simple products such as grab rails to complex pieces of electronic equipment such as speech aids and prosthetics. There are also some exciting developments coming from the nanotechnology sector that could have a big impact on the industry.
The Government is recognising the importance of caring for people in the community. Spiralling NHS costs have prompted it to carry out radical and comprehensive research into reforming services. As a result, it is now looking to shift much of the current 75% share of the total NHS spend that is focused on secondary (hospital) care to primary (GP and community) care. Our industry stands to benefit from this shift through recognition of the contribution our products and services can make to keeping people in the community.
Aids to independent living
The British Healthcare Trades Association is celebrating its 90th anniversary this year, and we are proud to be the oldest healthcare trade association in the country. We have over 350 company members, employing over 17,000 people and representing a £2 billion turnover in the healthcare market. Some of these businesses are very large and some are sole operators, but the majority are SMEs. The BHTA’s 14 sections include mobility (wheelchairs and scooters), services for the visually impaired, stoma and continence products and prosthetics and orthotics.
We are closely involved with developing industry and product standards to maintain and improve product choice, quality and, above all, safety. The BHTA works tirelessly to protect its members’ interests through close liaison with government departments and agencies (particularly the Department of Health and the Department for Transport), as well as charities and other bodies involved in delivering healthcare services. As an organisation, by working with government and the NHS, with social services and directly with consumers, our aim is to enable as many people as possible to live independently in their own homes, whatever their age or condition.
New Code of Practice
In our industry, ‘cowboys’ – people who sell unsuitable and expensive equipment to vulnerable people – are a serious concern. To address this problem, three years ago we developed a new Code of Practice to which all our members must sign up. The Code sets out the standards our members must meet and aims to identify best practice, eliminate cowboy behaviour and ensure that member businesses are ones that consumers can trust to give good service.
The Code has now achieved Stage 1 of the Office of Fair Trading Consumer Codes Approval System, and is backed by organisations such as Age Concern, Disabled Living Foundation, the Medicines and Healthcare products Regulatory Agency (MHRA), the NHS Purchasing & Supply Agency, the National Patient Safety Agency (NPSA) and Motability. Now the spotlight is on Internet selling and the pitfalls involved for unwary members of the public. We are preparing guidance on this topic.
The BHTA also has a Registrant’s Scheme for individuals who wish to sign up to the Code of Practice – they do not have to be BHTA members. This scheme is leading the medtech industry in promoting best practices.
Community equipment services
In the NHS, the current procurement model for assistive technologies is based on commodity procurement. The government is trying to aggregate these services in much the same way as in the pharmaceutical industry. This has worked well for that sector, where items are identical – but the BHTA and its members are trying to get across the idea that our products are not a ‘one size fits all’ prescription.
The needs of our customers are different, and we have to cope with the fact that these needs will change over time. A number of the products we deal with have a high input of training, servicing and education. Our members are dealing with the most vulnerable people in our communities. So we’re trying to safeguard the consumer’s right to choose the best option for their needs at any one time.
It is estimated that 7 million people in the UK could benefit from supportive equipment for independent living. Currently, the best estimate is that the state and private sector combined provide equipment to only around 2 million – a huge shortfall! We are currently working with the government to develop a model as to how this could be remedied across the country.
A recent pathfinder study on orthotics showed that for every £1 spent on assistive technology, approximately £4 is saved from that part of the NHS budget. It can be assumed that similar cost savings could be achieved in all areas of the NHS.
A shift in vision
The new system would represent the same fundamental shift in service provision that happened in the spectacles market over 30 years ago. The idea is to give people choices and help before they need to be treated in a hospital environment. If assistive technology is utilised before the patient requires medical intervention – for example, installing grab rails in an older person’s home to prevent falls – then the benefit to the person of preventing a hospital visit and being able to stay at home, coupled with the saving for community services, is immense.
The market that this new model needs to encompass ranges from people with severe disabilities caused by congenital problems or accidents through to people with chronic illnesses, and people with failing health who simply need assistance to prevent further accidents or deterioration. At first glance, there already appear to be a vast number of solutions, with the number of existing products being well over 6,000. There will be a variety of solutions to address any given problem – e.g. walking stick, walking frame or walker – each with several different manufacturers and suppliers, whose products will be suited to some individuals and not to others.
This could work via a prescription model. The client will be assessed and given a prescription they can then ‘cash in’ for a product that fulfils the prescription requirements and suits their tastes. For example, using the spectacles market comparison again, someone could walk in with a prescription for glasses and take a pair of NHS specs. Alternatively, they could use the prescription to fund the lenses and top up using their own funds to choose the frames they like best. We could see a Dolce & Gabbana product in our market yet! We’ll have to wait and see how it will work if this process goes forward.
The vulnerable nature of the end user means that extra support is needed in terms of advice, instruction, demonstration and installation or commissioning (e.g. grab rails need to be sited and installed properly; an electric wheelchair means driving tuition is essential). Advice must improve and be more widely available, as there is a very significant risk attached to self-help without appropriate guidance. This is why BHTA strongly supports the introduction of a regulatory framework.
Quality of life
To take these radical plans forward, we are working closely with healthcare professionals and the industry to shape the necessary changes. I am sure it will prove to be a challenging time, but our members who have signed up to the Code of Practice will be at the leading edge of all these changes. The BHTA believes this to be a ‘win-win-win’ situation for the consumer, the supplier and the taxpayer. This could be a huge opportunity for the industry, and we will see a great deal of growth over the next 10 to 20 years.
Ultimately, these changes will take pressure off long-term care facilities, and will offer a much more efficient way to spend the taxpayer’s money. Our members will be in a position to supply the best solutions and service to the public.
It is estimated that 7 million people in the UK could benefit from supportive equipment for independent living. Currently, the best estimate is that the state and private sector combined provide equipment to only around 2 million – a huge shortfall!
The popular stigma attached to assistive technologies is rapidly going away. Stairlifts are now being advertised on TV. The public will start to seek out these products in order to help them achieve a better quality of life, and BHTA members will be ready to meet their needs.
Ray Hodgkinson is Director General of the British Healthcare Trades Association (BHTA). For more information, visit www.bhta.com.