Occupational Therapy News OTNews March 2020 | Page 14

NEWS FEATURE
‘We are going to be part of the best rehabilitation services in
the world, but you still need to have a focus on living as healthy a
life as possible and making good choices,’ she says.
Any changes that are brought about need to be evidence
based and provide value for money, and Ruth praises RCOT’s
Improving Lives, Saving Money reports (available at www.rcot.
co.uk/ilsm) as doing just that.
And that also means challenging past practice. ‘If we have
evidence for something new and innovative but we’re still
holding on to what we’ve done before, then we don’t release the
resource,’ she says.
‘But what are we basing that decision on? Good evidence, or
are we basing it on comfort and security and that sense that it’s
always worked in the past? That’s my challenge: to look as hard
at the things we’ve done for a long time as the new things.’
Building resilience in the population
The framework builds on A healthier Wales’s plan to rebalance
the work of AHPs to promote wellbeing, prevention and early
intervention – all agendas that occupational therapists have a clear
role in, and which are intended to help reduce how much people
need to access health and social care services.
Says Ruth: ‘We need to be helping people make the best
choices they can, giving them the skills, capacity and confidence
to use community resources, and to be empowering people to
take control of their own health.’
Key for that, says Ruth, is the social model of health, so there
is again a clear sense that occupational therapists will be on home
territory with it.
‘This is all about making sure that our environments,
workplaces and communities are robust, and that individuals
know where to get the support they need to stay robust,’ she
says.
The framework has also embodied all the actions from the
UK-wide public health framework (read more in August 2019’s
Occupational Therapy News).
Accessibility and responsiveness
The framework builds on A healthier Wales’s plans to shift
focus into primary care, and part of that will mean ensuring that
occupational therapists are highly accessible.
‘This is probably the biggest cultural one for me,’ says Ruth.
‘If we are truly going to achieve the first two principles, then
people need to be able to get to us directly, at the right time and
without needing to go through long pathways of care before they
reach us. That is a very different way of working than being about
inclusion and exclusion criteria and written referrals.’
That means making sure that people access the right care
at the right time – and that will pose fresh challenges as more
occupational therapists are employed in primary care.
‘If a GP has got someone who they are looking to avoid an
admission for, they can’t be waiting for an occupational therapist
to come along later in the week, as the response would have
14 OTnews March 2020
Leading the change
Occupational therapy services are already delivering on the
strategy’s principles, including:
• The Ysbyty Glan Clwyd Home First Team in Denbighshire
has helped patients get back home after time in hospital.
• The Cwm Taf Morgannwg Memory Reablement team is
helping people with dementia return home and live well as
independently as possible.
• The ‘virtual ward’ model deployed by occupational therapist
Alex Gigg at a GP practice in Aberdare is helping adults with
functional difficulties at home to use strategies to help them
stay independent.
• The Hywel Dda team in south Pembrokeshire were praised
by a GP in the Improving Lives, Saving Money report
on cutting hospital admissions as ‘greatly underused by
primary care’ for their fast turnaround to see patients.
• The Healthy Prestatyn primary care team have helped
people to better manage their own conditions and lead
active lives (read more in OTnews, August 2018, p18-20).
• Occupational therapists in the integrated service with
Monmouthshire County Council and the Aneurin Bevan
Health Board work together in multi professional teams to
deliver place-based care.
to be calling an ambulance, and that won’t be an avoided
admission,’ says Ruth.
‘If we want to be in primary and community care, people need
to be able to find us. We need receptionists and one-stop shop
services to be directing people to the right person.’
Strong identity and presence
Ruth sees the last three principles as focusing on professionals:
how they can act collectively and individually to apply their skills,
experience and professional values to lead in evidence-based
care.
And the need for a strong identity applies both for AHPs
collectively and as individual professions. ‘At no stage at any point
of this framework is there any indication, nor will you ever hear me
say, that there should be a generic AHP,’ says Ruth.
‘I’m very pleased by the sentence that says ‘we are 13
professions allied by our belief in enabling citizens to live the life
they want to live’. The collective vision of AHPs – of being problem
solving and solution focused, practical and focused on outcomes
to help people live the life they want – is what draws us together
as a group.
‘I don’t think that we make the most of that. That is not about
changing what we do to some sort of generic blur, but about
working more collectively. We AHPs collectively need to be much
sharper and clearer in terms of selling our offer.’
Visible and transformational leadership
The plans for leadership will build on work done by Health