Occupational Therapy News OTnews May 2020 | Page 51

COVID-19 FEATURE Guidance for the interview was given to the occupational therapists • Establish the time limit to ensure focus on the questions. • Explain the process, outlining the areas that will be covered, and the timeframe. • Start with a list of known information, for example the • • • © GettyImages/sturti clearly introducing themselves, their role and profession. As well as establishing protocols, the introduction needed to be a means for establishing a rapport with the applicant and this was done by the occupational therapist checking the applicant’s identity at this point.’ Further guidance to ‘control’ the interview was given to the occupational therapists (see box out). Prior to the telephone assessment, the applicant’s information is sent securely to the assessor by the local authority. The organisation worked with local authorities on the most secure ways to transmit information. This information provides the reason that the person is applying for the Blue Badge and an overview of medical conditions, their severity and symptoms, medication, treatments, medical intervention and documentary evidence of the medical conditions. This allows the assessor to select statements, together with the applicant, that would seem to best fit from the evidence provided. In accordance with the Department for Transport’s guidelines that ‘applicants who can walk more than 80 metres and do not demonstrate very considerable difficulty in walking through any other factors would not be deemed as eligible’, asking the applicant for a practical example of the distance they can walk without very great difficulty, for example to a bus stop from their home, allows the assessor to later check distance on Google Earth. Many people have little idea of the measured distance they can walk. The assessor must consider if the applicant walks this far regularly, or very rarely, and with some difficulty or with great difficulty. Knowledge of activities such as shopping, social visits and dog walking can also be useful. The after effects of the effort to mobilise and fluctuations in mobility are also a key consideration. For occupational therapists working with local councils and Access Independent during the COVID-19 government guidelines, the new telephone assessment tool includes a scoring section to help the occupational therapist consider all the nine aspects of mobility as set by DfT. The assessor and applicant will go through the questions together, covering the distance walked, manner of walking, the level applicant’s medical information and difficulties, so the applicant knows they don’t have to explain this. Guide the applicant through the assessment process at a steady pace and in an emphatic way collecting personal information but keeping the focus on all aspects of the mobility assessment. Remind the applicant when they are halfway through the appointment. End by summarising the applicant’s problems and medical conditions to be certain that the information is correct and reassuring the applicant that their voice has been heard. of pain, breathlessness, and the length of time they could walk for, the speed at which they can walk, walking outside and the use of walking aids, and if the effort to walk might endanger their life. This gives a full picture of the applicant’s mobility, with a score allocated to each question. Another useful source of information are questions around activities of daily living, for example do they get help from carers, spouse, or other people, and are they in receipt of any benefits? When the scores are tallied, the applicant will be approved or declined. The baseline scoring helps other professionals or the local authority to understand and evidence how the occupational therapist came to their decision. Two or three sentences acknowledging the applicant’s conditions, and their difficulties, are then written to provide the reason for the decision. The process takes into consideration that anyone with language difficulties, cognitive problems, or speech and hearing problems, who will need support from their family or others in the appointment, may require a face-to-face appointment at a later date. During the COVID-19 situation, additional questions have been added to the assessment to identify if the applicant is self-isolating, if they are currently feeling well with no new symptoms, and if their prescriptions, care and support needs are being met.  The occupational therapists are also able signpost the applicant to other services, should they have any concerns about the applicant. Many of the occupational therapy assessors are reporting that the applicants have been grateful for the telephone contact. The telephone assessments allow them an opportunity to talk about their situation with someone who can empathise, listen and care. Stephen Naylor, managing director, Access Independent, email: [email protected] OTnews May 2020 51