OTnews August 2020 | Page 19

© GettyImages/Geber86
Response
and recovery
Julie Blake looks at the fast paced initiatives
the Isle of Wight community occupational
therapy service introduced during the pandemic
There are currently over 100 clinical staff in the NRS
Healthcare Clinical Division. At the start of the coronavirus
pandemic, it was keen to ensure services were kept
running smoothly and that it acted as a trail blazer and
pioneer for new initiatives to help overcome any damage that
COVID-19 would have on services and ultimately service users.
NRS Healthcare has managed the Isle of Wight community
occupational therapy service since August 2018, on behalf of the
Isle of Wight Council. Having initially reduced the number of service
users waiting for a community occupational therapy assessment
from 38 weeks to 11 weeks, the service was keen to maintain this
standard and to not see numbers of referrals and waiting times
creeping up to unacceptable levels during the pandemic.
It was felt the key to managing the COVID-19 situation was to
act fast. Usually, with significant changes in systems and processes,
standard procedure would be to set up strategy groups, steering
committees, project management, ratification committees, working
groups and team meetings, in order to ensure a fully involved
process change. However, as time was not on our side, local team
management was given full authority to make the changes they
considered necessary to provide a quality and speedy service at the
start of the pandemic.
Within a couple of days the managers had set up ‘Red’ and ‘Blue’
teams to come into the office on alternate weeks, in order to prevent
cross infection. They ensured there was sufficient management and
clinical cover in each team to keep the service running smoothly.
While one team was in the office managing duty phone calls and
visits, the other team worked from home on their own caseloads.
The team set about triaging the service users who were waiting for
COVID-19 FEATURE
home visits and, through robust clinical reasoning, service users were
either fast-tracked to service provision, signposted to other services or
offered a self-funding option.
This resulted in half of service users who were awaiting home visits
receiving an early assessment and provision, while over 50 Disabled
Facilities Grants were progressed through virtual assessments.
All service users remaining on the waiting list for an assessment
were regularly reviewed, ensuring the right people were waiting for the
right service at the right time. Government guidelines for the use of
Personal Protective Equipment (PPE) were immediately applied. The
Care Act 2014 easements were also considered and applied where
necessary.
One of the successful initiatives on the Isle of Wight has been the
use of Attendanywhere/Near Me, the virtual platform for secure online
assessments. Within days of the lockdown, a nominated lead on the
island was identified to undertake the initial webinar training to see if
this platform would be suitable for service users.
It was then tested and piloted with suitable service users,
training rolled out to the team, and engagement with the internal IT
department was gained for laptop access. The bulk of this work was
completed in two weeks. Team members then started to identify
service users who were suitable to assess using this tool and, either
working from their home or the office, assessments and reviews
continued and the throughput of work progressed.
Another initiative was in the Blue Badge service, where the mobility
clinics had been postponed. In order to progress work and ensure
applicants were not disadvantaged by the pandemic in terms of their
community access, a tool was developed and applied to support
desk-based assessments, including invisible disability, which resulted
in these assessments continuing via a desk-based service from within
the office or from the occupational therapist’s home.
Throughout the pandemic NRS needed to think and operate
flexibly. It had to act quickly, think fast and apply new techniques
and strategies at speed, in order to keep supporting it’s clients and
meeting the needs of vulnerable people.
A willingness to change was paramount in achieving this and
where normal systems, culture and processes would have applied
in the management of change, a new way of collaborative thinking,
trust and transparency has overtaken the traditional set of rules and
compliances.
NRS moved quickly to seven-day working to enable hospital
discharges through the provision of required equipment in people’s
homes. It kept service users informed of what it was doing to keep
them safe and it introduced new technology enabled care products to
help people stay safe at home.
The aim was to introduce service initiatives that were sustainable
and enduring, and that can be embedded into the organisation’s core
set of vision and values, so that all the new learning will not only be
used in the short term, but will result in improved outcomes in the long
term.
Julie Blake, clinical manager, NRS Healthcare www.nrshealthcare.
co.uk
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