Primary care
Feature
Enhancing patient care through effective partnership working
Lisa Greer and Karen Symington look at how a small test of change to assess the impact of occupational therapy in GP surgeries was grown into a successful service .
I
n October 2017 , NHS Lanarkshire ’ s occupational therapy service launched a test of change to implement and assess the impact of occupational therapy service provision in primary care . This initiative was part of a Scotland-wide programme to redesign primary care services by improving access to a range of health and social care professionals , through the development of primary care multidisciplinary teams .
This change was driven by recognition that reform was required to manage the changing health needs of Scotland ’ s population and the increasing demands facing GPs . It was supported and funded by NHS Lanarkshire ’ s mental health and primary care transformation programme .
The first phase of the primary care occupational therapy service test of change involved two advanced occupational therapist practitioners working in two GP surgeries , with a varied caseload that supported adults with mild to moderate mental health and wellbeing issues , pain and fatigue related issues , long-term conditions , falls and frailty , employment retention issues and mild cognitive impairment .
We were able to successfully demonstrate that , by using an early intervention for prevention approach , occupational therapy could make an effective contribution to patient care , by improving their ability to carry out day-to-day roles and activities that are important to them and enhance their quality of life and mental wellbeing .
Feedback from GPs highlighted that they highly valued primary care occupational therapy input , reporting that it was responsive , supportive and flexible , enabling patients ’ needs to be met by the right person , at the right time and in the right place .
Subsequent provision of funding to test the effectiveness of the model on a larger scale has resulted in phase two , with the recruitment of 11 additional occupational therapy staff and the extension of our service to 21 GP practices across two NHS Lanarkshire localities ( Bellshill and Hamilton ).
This article will focus on how a small test was grown into a successful service . Factors in relation to workforce planning and team development were critical to the success of our service , as well as strategies used to develop effective relationships with GP colleagues and practice staff .
We will also summarise how the challenges of the COVID-19 pandemic provided opportunities to embrace new ways of working for our team , while being responsive and agile to the demands placed on primary care throughout this challenging time .
Workforce planning and development
Analysis of the clinical caseload in phase one highlighted that service needs could be met by a range of registered occupational therapy staff . This witnessed a departure from the advanced practitioner model to a more sustainable and costeffective skills mix model in phase two , with band five , six and seven practitioners carrying caseloads ranging from routine to more complex cases .
Key to establishing an effective workforce was the development of staff knowledge , skills and confidence , to support clinicians to manage the wider breadth and scope of cases that are managed at a primary care level .
To meet the demands , a service-wide continuing professional development ( CPD ) and training programme was developed , alongside tailored individual learning opportunities .
This learning was further enhanced through the development of effective partnership working with allied health professions colleagues across mental and physical health , which provided opportunities to participate in peer support forums , seek informal advice regarding referrals and more complex cases , as well as carry out joint assessments .
A stepped approach to the roll-out of the service was utilised , which not only allowed service expansion to 21 GP surgeries incrementally over
28 OTnews April 2022