Occupational Therapy News OTnews May 2020 | Page 26

FEATURE COVID-19
clients tell us. We are facilitators in the lives of our clients
– they are not victims and we are not rescuers,’ says Jonè
Vosloo, the assistant team manager.
They were necessary changes. Six years ago, the
team had lengthy waiting lists, an £85,000 annual bill for
outsourced assessments, and was supposed to focus its
work on a costly online assessment tool that was little used.
‘In order to survive we had to think outside the box
and adopt smarter ways of working,’ says Jonè. ‘We
took risks and acted on our ideas, even though they
were controversial. We had to adapt our services to
overcome the ever-changing challenges until eventually
we developed our five-step programme for referrals.
‘As a result, we have no waiting list and we are chasing
clients for information rather than them chasing us.’
The five-step process
The first three steps are handled by the duty occupational
therapy team. The first step is signposting. ‘We have a
strength-based conversation with the client to identify
what may help them and we give them the options of how
their needs can be met,’ says Jonè.
‘If they want something more glamorous than
what we can provide, they are usually happy to buy it
themselves. It is also at this stage where we consider
whether our service is the best service to meet the client’s
overall needs or whether we need to refer to our health
colleagues.’
If the client does need something from the adult social
care team, then the second step sees the occupational
therapist establishing a basic level of need via a telephone
conversation, and where possible, order the equipment
straight away.
The duty occupational therapist may ask the client or
their carer for photographs where needed. ‘This enables
us to meet the clients’ needs at the front door,’ she adds.
The third step is where the real innovation begins. If
the team is not fully confident that a piece of equipment
can just be ordered and they want more insight into the
environment, then they send out a special notebook
they have designed for a client or carer to fill out the
information.
The 27-page EQuip notebook is now on its ninth
version, and provides a way to gather information on the
client’s environment and needs. ‘It gives us better insight,
especially if there are multiple needs to enable us to
discuss the best intervention options with the client – and
it can all be done remotely,’ says Jonè.
After the client returns EQuip to the team, the duty
team contacts the client to discuss possible interventions.
It’s proving to be more time efficient, client-centred and
is freeing up time for more complex cases. And it also
means that clients are not sat on a waiting list, but instead
26 OTnews May 2020
are able to contribute to the solutions they need.
If the EQuip notebook isn’t quite enough support for the
client, then they instead can go to step four: attending the
MeAssured clinic, held in Mersham.
Jonè says that, although the processes are now firmly
embedded in the team, it took effort on her part to ensure
staff were referring people to the clinic, rather than expecting
that an occupational therapist would visit them.
And that is a cultural shift that affected clients too. Says
Jonè: ‘The majority of clients have had the mindset that an
occupational therapist needs to visit. However, we would ask
them if they can go to the shops or the GP – if they can, they
can come to the clinic. It’s a case of being firm, but friendly.’
She notes that finding a suitable venue and a confident
and experienced staff member to run it may be challenges
for other areas to follow this model. However, the clinic has
proven to be cost effective and time efficient.
By 2016, 206 clients were seen at the clinic in six
months, negating the need for outsourcing. ‘The feedback
from clients attending MeAssured has been overwhelmingly
positive,’ she says. ‘The venue has a positive atmosphere
and is conducive to a friendly and dynamic service, utilising
partner organisations.
‘EQuip and the work on duty have enabled us to
respond quickly and efficiently to the clients requiring less
complex intervention, giving the team capacity to give more
time to complex clients and pursue various projects.’
Developing virtual assessments
Those earlier steps now handle a huge proportion of clients,
meaning that only the most complex cases require step five:
occupational therapist allocation.
And, as elsewhere in the country, some of these are now
being handled via video call. The team actually had their first
virtual assessment a couple of months before COVID-19,
but the arrival of the virus meant the team received the
green light to roll them out more fully.
Kirsten Callander, a senior occupational therapist, is
delivering some of the virtual assessments. One recent call
was for a profiling bed and standing hoist for a lady who
had recently arrived in a supported living home after a long
stay in hospital.
‘I completed the virtual review of the standing hoist with
the client and carers, with an additional carer holding the
phone,’ she says.
‘I introduced myself to the client and gained their consent
with an explanation of what was going to happen. I ensured
that the client remained at the centre of the assessment.
Prior to trialing the standing hoist with the client, I asked
one carer to trial it on the second carer first, as I usually do
during face-to-face visits.
‘This enabled me to check the equipment was working,
assess the confidence and competence of the staff, as