As the focus of healthcare moves to the community, new technologies are increasingly being used to support access to education and training. We look at how advanced assistive technologies are being used to help young people develop their vocational skills.

The growth in the assistive technologies (AT) market can be attributed to two general causes. Firstly, the focus of healthcare is shifting from clinical environments to the community - which means a shift from acute care to long-term support for independence. Secondly, the shift in decision-making from clinical professionals to the patient within a network of carers and service providers is resulting in an increasingly consumer-driven market for products to support mobility and independence.

As the market for disability products grows, manufacturers are increasingly aware of opportunities for AT development. A major component of the AT market is the world of training and education, where new technologies can be used to support access to skills development and qualifications. This article looks at one example of an institution that is not only purchasing new technologies to support access to education, but helping companies to design them.

Meeting complex needs

Hereward College in Coventry is a specialist residential college of further education that welcomes all learners, including those with diverse and complex support requirements. It has over 100 residential learners as well as day learners, both disabled and non-disabled. Many of its students suffer from conditions that mean they have complex support needs, such as cerebral palsy, spina bifida, muscular dystrophy, brain and spinal injuries, autism and learning difficulties.

The college uses technology in a wide range of contexts: communication, mobility, telecare, environmental control, handling and residential life. As Paul Doyle, Head of Access, Research and Development at Hereward College, explains, it is important to have technologies available that any staff member can use: "Assistive technology is wonderful, but only when it works and when it works when you need it, first time, every time."

Hereward College was developed in the 1970s to help integrate special education into the community, being situated on a municipal estate and offering vocational links to local industry. The college's access centre was developed through seed funding to develop access strategies for physical and cognitive impairment. It combines assessment of students moving into further education with R&D into significant technology.

The college procures ATs through funding from the Learning and Skills Council (LSC), capturing the complex needs of the student (clinical, personal and access) and making an individual funding application. The initial needs assessment report suggests human and technological interventions. The college has a bank of technologies to draw on - from wheelchairs to voice recognition software - and develops a bespoke solution for each student, including IT training.

Training for staff is also a priority - as Paul Doyle explains, it is often necessary to bridge the gap between the people skills and the IT skills of staff members. The college is involved in the ATVET (Assistive Technology Vocational Education and Training) project funded by the EU.

Many of the ATs used in the college have been developed through work with suppliers. The TSB project i-Deal developed models for AT, feeding back to suppliers and manufacturers. The college is partnered with the Health Design and Technology Institute (HDTI) at Coventry University, and both organisations support medtech R&D by giving companies exposure to users and carers.

The role of IT in delivering healthcare is increasingly fundamental, but there is a high rate of 'technology abandonment' because solutions do not transfer readily between users, carers or institutions. Hereward College has developed an in-house training programme for people who support AT users. To ensure that there is a continuity of care within and beyond the college, it needs to adapt mainstream devices that can be replaced and transferred.

Paul Doyle comments: "The amount of hidden support that students receive here is often not visible from the outside. When a student starts working at 9am, their journey to the classroom may already have taken two hours."

Supporting further education

Hereward College's educational facilities integrate ATs with mainstream technologies for education and vocational training. For example:

• The IT centre has the latest versions of industry-standard software, so that the students are up to date when they enter the world of work. The room also features a range of mobility and sensory aids.

• The performing arts centre is fully accessible, and is used for drama and dance as well as experience of handling lighting and sound.

• The media studio enables students to work with sound, video and animation towards BTEC, HND and NVQ qualifications.

• The art and design studio supports work in multimedia, painting and sculpture, and is used for degree-level work in fine arts.

• The TV and music studios provide facilities for students to record, develop and edit work to broadcast quality.

• The business studies centre enables students to gain an NVQ in business administration and gain work experience with embedded businesses.

• The multi-use sports environment provides space and support for competitive games such as boccia and wheelchair football.

Alongside its study facilities, the college provides background support for access to education, including speech and language therapy and physiotherapy. Products recently acquired by the college include the Thera Live trainer from MedicoTech Ltd, a postural management device that supports forward, backward and sideways movement.

The canteen also features a range of ATs, including the Neater Eater from Neater Solutions - a device that helps to reduce tremors from handling - as well as adapted mats and variable-height tables.

Residential independence

Hereward College has the capacity for 120 residential students, for whom it develops comprehensive personal care solutions. The agenda is 'transition to independence': the students are provided with the support they need to live independent lives, carrying out their own laundry, cooking and so on.

The communal kitchen features a height-adjustable work surface and a smart control system from Halliday James, which uses a fingerprint reader to control access to the elements of the kitchen and gives feedback to the user where needed.

The students' rooms are fitted with environmental controls for off-the-shelf building management technologies that enable the occupier to control their personal space with regard to door access, lighting and electrical appliances.

Medtech and the education market

Suppliers of assistive technologies for the educational market need to be aware of the real human context of social life and activity in which they will be used. Products need to be assessed in terms of how they fit into the user's life, not just the therapeutic context or the procurement context.

Paul Doyle is keen to pursue dialogue with industry about building educational solutions (see contact details below). He notes that the economic situation is changing. At present, LSC funding enables Hereward College to offer guidance to suppliers and manufacturers, developing solutions through partnership and consultation. However, financial pressure will soon force the college to seek tangible benefits from sharing its expertise and market information with suppliers.

The following pointers are worth keeping in mind if you are diversifying into the AT market:

• You need to view AT use in the context of individual patient needs. Don't just talk to early adopters.

• The technologies will need to be embedded in the context of use. Without appropriate training, they will be used in a vacuum and soon abandoned.

• The 'transition to independence' agenda is fundamental. Users of ATs should be encouraged to use technology, but not led to fear that they will be adrift without it. Their knowledge of the technology needs to be grounded in real-life experience and to include risk management.

Hereward College has no preferred suppliers: the individual disciplines call in relevant companies, and the students make the choices. The supplier needs to start by demonstrating the accessibility of the product: how inclusive is the technology? The formal trial process that follows positions the user at its heart - thus setting an example of patient-centred treatment.

In the past, a lot of ATS happened to users, with the decisions being made by carers and therapists. In the future, especially in the educational context where the user's capability is at a premium, that will not be the case. Paul Doyle concludes:

"There is a new generation of consumers who judge technology on personal grounds, challenging the healthcare provider. Maintaining the role of expertise will be a challenge for therapists in the future. The best way forward is to make the end user part of a multi-disciplinary team that trials and chooses technologies."

To find out more about how Hereward College works with companies to develop assistive technology solutions for education, contact: Paul Doyle, Head of Access, Research and Development, Hereward College, Bramston Crescent, Coventry, CV4 9SW. Tel. 0247 642 6100. E-mail: paul.doyle@hereward.ac.uk