Advances in European Assistive Technology service delivery and recommendations for further improvement

Abstract

Seventeen years ago the European Commission funded HEART (Line C) project released a report on rehabilitation technology service delivery, describing the processes from 16 countries and making recommendations for improvement by market stimulation and quality assurance. Service delivery of rehabilitation technology, now more commonly referred to as Assistive Technology (AT), has advanced since the 1994 report. Highlights include the establishment of the EASTIN network of AT databases, expansion of systems that facilitate user choice, and a stronger sector identity promoted through the AAATE. Policies and attitudes toward disability have also changed at a societal level over the intervening years, reflected in key documents such as the UN Standard Rules, the ICF, the UN CRPD and the European DisabilityStrategy 2010-2020. People with disabilities can expect to be provided with information about and access to technologies and services enabling their participation and integration in society. Yet discussion about issues including the ageing population, keeping up with technological advances and containing costs in health and social care budgets, is not new. The message is the same as it was in 1994; we need to work together to meet the challenges. The difference now is that, with progress slower than expected, the voices are more urgent. Aim: This paper reflects the advances in service delivery since the HEART study, the impact of European policy and strategy on development in the AT field, and the current challenges the sector faces. It is intended to stimulate further collaboration and improvements in European AT service delivery. Methods: National contacts from the AAATE were surveyed about the current status of AT service delivery in their respective countries, and asked to comment on the improvements since 1994 as well as the new and continuing challenges and priorities. Survey responses were analysed and recommendations made for further discussion. Results: 13 responses were received, all reporting improvements in elements of AT service delivery, differing in focus across countries. Users frequently have access to AT information but their involvement in decision-making varies. The seven essential steps and six quality criteria for service delivery from the HEART study retain relevance for most respondents, but their use in practice remains limited. The participation of AT practitioners and services in professional development and networking varies from individually organised activities to requisite programmes, and from local to international involvement. Conclusion: European countries have AT service delivery systems that vary in their structure and sophistication, but share some common challenges in meeting the needs of AT service users. Several recommendations are made to inform further discussion and encourage the various stakeholders in AT policy and practice to work collaboratively in improving service delivery across Europe.