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150 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

the body, impaired by disease, injury or congenital condition, some AT is aimed at com-
pensating for, or substituting for functional limitations and thereby enabling individuals
to fulfil at least some of their daily living functions.
For the control of functions in the built environment, the term ‘environmental con-
trols’ (EC) is used, but in the context of this chapter, the term is applied specifically where
they are intended to alleviate difficulty or inability to undertake the control function by
‘normal means’ or using ‘standard controls’ due to physical impairment. The means to
achieve this is based on the available technology at any given time and therefore is pro-
gressively evolving.
The impetus for the development and provision of EC comes from the United Nations
Convention on the Rights of Persons with Disabilities (CRPD), which requires nation
states to ensure means to facilitate access to AT for those who need it to improve indepen-
dence in daily life and to enable participation in society on an equal basis (Andrich et al.,
2013). Although neither a cure nor a control for disease, AT compensates for the functional
limitations and is therefore associated with the rehabilitation or health benefits. It is also
driven by the personal need and desire of those with such limitations to achieve greater
function, autonomy and independence in life.
EC equipment provision has been commissioned on a national basis in the United
Kingdom initially by the Department of Health and transferred to the NHS in 1995 follow-
ing recommendations for the establishment of a network of regional services with a model
of interworking with community services and social care (BSRM, 1994, 2000). Since 2013
this national commissioning was again re-established with the transfer to NHS England
Specialised Commissioning following its creation under the Health and Social Care Act
(2012). The associated service specification for EC services in England (NHS England, 2013)
sets out the model of provision by multidisciplinary teams at specialist level and provides
EC equipment on a free-of-charge loan basis to individuals of all ages who meet the cri-
teria for provision. Furthermore, the provision is to include access to computer technolo-
gies separately or in conjunction with conventional EC functions of home control (NHS
England, 2013).
In the United Kingdom, EC equipment provision is also supported by a national
framework agreement for the procurement of the equipment and support services
from suppliers (NHS Supply Chain, 2014). Formerly, a very detailed specification for
the equipment attracted other manufacturers and gave an ‘assured market’ for suppli-
ers, leading to development of comprehensive products. However, it also leads to some
development inertia and potentially dated product functionality. Although altered in
more recent years it is more difficult for dedicated products to keep pace with main-
stream technologies.
NHS provision in England originated when only specialist devices were available to
achieve EC provision and has resulted in the procurement framework, supplier network
and equipment support service packages described. Now that some EC functionality is