Occupational Therapy News OTnews November 2019 | Page 21

•
‘‘
MOBILITY FEATURE
These are
Has the applicant put themselves at
Badge assessment. A robust code of practice
exciting times as allied
risk as a result of being unaware of the
provides an essential baseline that supports
dangers from traffic?
clinical reasoning, which is required to assess
health professionals
Does
the
applicant
require
continual
applications that often include complex
•
work collaboratively to
supervision while travelling in the
medical conditions.
influence the Blue
community (and in the case of children,
Each member of the working group has
Badge Scheme in
over and above that normally required
taken responsibility for an identified area and is
for children of that age)?
in the process of recruiting more local authorities
Scotland.
Can
the
applicant
deal
with
unexpected
to
assist
in the task, setting up work plans, activating
•
changes in their journey?
tests of change and adopting a quality improvement
methodology to any changes that are implemented.
• Does the applicant wander off when exiting a vehicle,
causing danger to themselves or others?
The group is heartened that the Scottish Government concurs
that the code of practice requires revision and the group welcome
• What coping strategies are currently in place to ensure the
applicant’s safety?
the opportunity to influence this.
There are prompts after each section to guide the professional in
Cabinet Secretary for Transport, Infrastructure and Connectivity,
completing the form, concluding with the professional being asked:
Michael Matheson, has said: ‘I am grateful for the holistic service
‘In your opinion, having considered the actual risk to this individual
that Scotland’s IMAs provide. They maintain the integrity of the Blue
applicant, not the potential risk associated with the condition, does
Badge scheme, but it’s about so much more than that. By adopting
the applicant regularly place themselves or others in danger?’
They are asked to tick ‘Yes’ or ‘No’ and to add further
comments to this declaration.
When addressing hidden disabilities it is vital that a Blue Badge is
issued so that it is beneficial to the applicant and is not detrimental
to a treatment or rehabilitation programme. This is particularly
important when considering psychiatric and psychological
conditions.
In cases where exercise is often recommended as treatment or
as a coping strategy, a Blue Badge would be contraindicated.
In Scotland there is a recently-established working group with
representatives from local authorities and health boards throughout
Scotland. The group is made up of independent mobility assessors
(IMAs) who are allied health professionals registered with the
Health and Care Professions Council (HCPC), with many years of
experience working in the Blue Badge scheme.
The group has identified areas within the current code of practice
and eligibility criteria that require updating; including the mobility and
the upper limb criteria.
For example, there are new methods of paying for parking,
such as ‘Ringo’, rather than use of a parking meter, and with the
introduction of the new gold Medical Research Council (MRC)
Dyspnoea scale, the impact on the current level of award of a Blue
Badge for shortness of breath needs to be addressed.
In addition, the working group plans to review the ‘Risk in Traffic’
criteria. With the introduction of the new eligibility criteria in England,
it is important to ensure that a consistent approach to badge award
is achieved throughout Scotland.
One potential way of doing this is to update section three of the
‘Risk in Traffic’ criteria and ensure that the questions asked provide
the necessary information. It is important to develop a method for
the professional to be able to provide accurate information, but avoid
threatening a therapeutic relationship or creating a conflict of interest.
The working group also intends to look at the training of IMAs
and develop training resources to facilitate consistency in the Blue
a person-centred approach, the Blue Badge service can identify
unmet need and help people live independently.
‘We have a record of listening and acting where legislation and
guidance needs to change to suit circumstances in Scotland. It’s
a testament to the professionalism of Scotland’s IMAs that they
are giving of their time and expertise in helping Transport Scotland
revise the code of practice. This will make sure best practice is
consistently spread throughout the country.’
In Scotland, there are no plans to change the legislation setting
out the eligibility criteria. However, we plan to develop our existing
code of practice and help Transport Scotland continually keep the
eligibility criteria and methods of application under review.
On 26 September 2019, there was a commitment from
Transport Scotland to use the code revision to explore a pilot of
alternative routes to access a Blue Badge for people who have
Motor Neurone Disease.
There is potential for this to be done using the resources of
existing multidisciplinary teams, members of which could certify that
the eligibility criteria are met. This method of working could reduce
waiting times for people who have a progressive condition. While
most of these people will be automatically eligible, this example
illustrates how the Scottish approach considers the views of users
and is open to adopting new approaches for the provision of a Blue
Badge.
These are exciting times as allied health professionals work
collaboratively to influence the Blue Badge Scheme in Scotland.
Sarah Sutton, team lead clinical assessment, SMART Centre,
Astley Ainslie Hospital, Edinburgh, email: sarah.sutton@
nhslothian.scot.nhs.uk, with members of the Scottish Blue
Badge Assessment Working Group: Elaine Wood, Claire Reid,
Aberdeenshire, Tina Poole, Edinburgh, Anne McConnell,
Lisa Caldwell, South Ayrshire, Gavin Alexander, East
Dunbartonshire, Alistair More, West Lothian, and Elaine Blair,
Fife
OTnews November 2019 21