₤2.5 million package announced to help disabled people travel more confidently

THE Government has announced a ₤2.5 million package to support disabled people travel more confidently on our transport network as it reopens after Covid. The new funding will include ₤1.5m allocated to support all 13 Mobility Centres across England roll out a:- 'Hubs Mobility Service.' These vital services help people stay mobile after they have been advised to stop driving or if they are unable to learn to drive due to their disabilities, offering them advice on alternatives such as powered wheelchairs, community transport and local services.

The hubs have been successfully piloted at 7 of the Centres over the last 2 years and have already helped over 4,000 people regain and retain confidence to travel. The real life benefits of staying mobile were highlighted in the Inclusive Transport Strategy which sets out the link between reduced mobility and access to transport with loneliness and social isolation.

Ahead of the announcement, Accessibility Minister Wendy Morton visited Queen Elizabeth's Foundation for Disabled People's Mobility Centre in South London, on Thursday, 24 March 2022, where she met people who had benefitted from the Mobility Centre's services, to help them stay connected and independent.

Wendy Morton, Accessibility Minister, said:- "This funding will help people travel with confidence and comes just in time as our nation rebuilds from Covid. We want to help everyone to be mobile and these vital Hubs Mobility Services will provide life changing travel advice keeping people connected to their friends, work and support networks. I was delighted to meet people benefitting from this service, and to hear about the difference this important work has made to their lives."

The visit coincided with QEF's 40th Anniversary, celebrating opening the UK's 1st Mobility Centre and their 1st Mobility Open day since the Pandemic. The Minister was able to see and experience some of the DfT funded assessments carried out at Mobility Centres, including for people interested in using:- wheelchair accessible vehicles, adapted cars and powered wheelchairs.

Karen Deacon, QEF's Chief Executive, said:- "We were delighted to welcome Minister Wendy Morton to QEF's Mobility Service to discuss how important it is to support people to improve their independent mobility and access public transport, to enable people to live the life they choose. Whether that be for young children through the fantastic Bugzi powered wheelchair, or people with a life-long disability or who have had a life changing medical event. Independent mobility and public transport should be equally accessible to everyone, and it was great to see the Minister personally experiencing the challenges some face when re-learning to drive in an adapted car and listening to the day to day travel challenges disabled people face on public transport."

The department has also announced that it will provide ₤1 million to lifeline ferries and seaports serving the Isle of Wight and Isles of Scilly to improve accessibility. The funding will improve access to services for passengers with disabilities.

The Government has also confirmed that the 1000th accessibility audit has been conducted at Oban station in Scotland. As part of the Williams-Shapps Plan for Rail, the Government committed to audit all 2,565 rail stations in Great Britain. This 1000th audit is a huge milestone as we highlight existing areas of excellence and identify scope for improvements. They will help produce a new public database so people can better plan their journeys in advance, and along with input from disabled passengers will shape future investment in accessible rail travel.

The department has also published a number of reports on transport accessibility:-

► The Reference Wheelchair Standard research will inform the broader evidence base on design of new vehicles and transport infrastructure to meet mobility aid users' needs.

► The Wheelchair Accessible Taxi and Private Hire Vehicle Services research report was commissioned to understand current use and experience of wheelchair accessible taxi and private hire vehicles.

► The 2nd Inclusive Transport Strategy scorecard (2020 to 2021) monitors annual changes in metrics relating to disabled people's travel and forms part of the overall evaluation of delivery against the strategy.

► A report from the first Technology Research and Innovation Grant Accessibility (TRIG-A) programme which delivered a ₤600,000 investment to support SME's developing accessibility technology in 2021.

Study finds 'Traffic Light' tool used by GPs to assess seriously unwell children is 'unreliable'

A tool used by GPs to help identify seriously unwell children may not accurately detect or exclude acute illness, according to an evaluation using data from UK general practice. The study, led by Cardiff University, assessed data from more than 6,700 cases and concluded the widely used National Institute for Health and Care Excellence (NICE) Traffic Light system:- "cannot be relied upon" and is:- "unsuitable" for use as a clinical decision tool. The findings are published in the British Journal of General Practice.

Lead Author, Amy Clark, a final year medical student, at Cardiff University, said:- "Our study found the tool on its own cannot identify, with sufficient accuracy, those children who have a serious illness, nor those who can safely be managed at home. An accurate Primary Care tool is vital to help GPs make the right decision to ensure unwell children receive the care they need, while avoiding unnecessary Hospital admissions. Further research is now needed to update or replace this tool. The need has become even more pressing during the Covid19 Pandemic, especially following the relaxation of restrictions which has led to an increase in respiratory illness among young children and high demand for emergency care, despite many not being seriously ill."

Children account for around 40% of the average GP's workload, with under 5's being seen on average 6 times per year. More than 2 million children under 5 attend Hospital emergency departments every year. To help GPs assess children, NICE created the Traffic Light tool which groups symptoms into:- green, amber, or red, corresponding to low (manage at home), intermediate (can be referred to Hospital or sent home with advice), or high risk of serious illness (refer urgently to Hospital). The tool, used to assess unwell children under 5, has been in use for 15 years. Previous studies have evaluated its use in children already in Hospitals, but this is the first study to assess its accuracy using data from children consulting in UK general practice. The researchers linked data from GPs and Hospital admissions for 6,703 children, within England and Wales, to assess whether their traffic light category matched the severity of their illness. The primary outcome of interest was a Hospital diagnosed serious illness within 7 days of visiting the GP. The data found that:-

► Around 32% (2,116) of children were categorised as red, but only 0.5% (10) of these had a serious illness requiring hospitalisation.

► The majority of children were categorised as amber; about 63% (4,204) and only 6% (383) were labelled green.

► The tool's red category had a sensitivity (the ability of the tool to correctly identify children admitted to Hospital with serious illness) of 58.8% and specificity (the ability of the tool to correctly identify children without Hospital admission with serious illness) of 68.5%.

► Combining the red and amber categories improved the sensitivity to 100% (however did reduce specificity to just 5.7%).

► Overall, the incidence of serious illness in children presenting to general practice is low, at just 0.3%.

"Our research suggests that if GPs had followed the NICE Traffic Light tool, they would have referred a 3rd of all children (those categorised as 'red') urgently to Hospital, despite most of these children having a mild self limiting illness. Using 'red' or 'amber' as the threshold would ensure that no seriously ill children were missed, but at the cost of referring a substantial number of children to Hospital." said Ms Clark.

Dr Kathryn Hughes, Co-Author on the study and Senior Clinical Lecturer at Cardiff University's School of Medicine, said:- "It was really surprising to us that this tool has never been validated in UK general practice, despite being recommended by guidelines since 2007. Accurate assessment in general practice is also vital to ensure secondary care services can function effectively."

Ms Clark added:- "We believe our results are important not just for GPs, but also trainees and students who are often taught this assessment system during their training. A new, more accurate, system could help junior healthcare professionals gain confidence assessing unwell children."