SOCIAL CARE FEATURE balance , they can manage to prepare a light meal in their kitchen , shower without support , or manage their own domestic tasks .’
Mark says that , rather than being challenged , his practice has been complimented by working jointly with the local authority occupational therapy service .
‘ My treatment may , predominantly , involve exercise prescription , but working closely with an occupational therapist has helped me to look at their home environment in a new way and to see new possibilities for where our joint input can boost a person ’ s independence , or how a minor adaptation can fast forward a goal that the person has ,’ he reflects .
Kirti Gokal , the occupational therapist on the team , says of the initiative : ‘ Having worked in the occupational therapy service within the city council for several years , I was keen to be part of a new initiative for therapy to be based within the Health Transfers and Reablement teams to support hospital discharges .
‘ This also gave rise for an opportunity for me to work alongside a physiotherapist employed by the local authority , as a pilot for collaborative working . This was a new venture for the occupational therapy service and I was involved with the scoping of the job role .’ On the issue of keeping his professional identity , but supporting the occupational therapist ’ s clinical reasoning , Mark says : ‘ While we complement each other ’ s roles within the team , we have managed to keep our core duties , roles and responsibilities in ensuring the services are met for the person .
‘ This entails assessing the person ’ s ability , with input from both professional viewpoints . The physiotherapy role would be to improve their mobility , falls prevention , muscle strength and balance , whereas the occupational therapy role helps to tie all these together within the functional tasks that the person needs to complete to remain independent .’
During the COVID-19 lockdown in Leicester , and the subsequent local lockdown , the service switched to only urgent face-to-face appointments and remote consultations . This was a new way of working for both physiotherapy and occupational therapy staff .
The benefits described here that were identified prior to the pandemic were enhanced in this new working environment . In addition , less staff needed to access a shielding person ’ s home . With a more in-depth knowledge of each other ’ s roles , both therapists could gather the information the other professional needed , rather then the need for two visits .
Kirti says : ‘ Joint working with the physiotherapist has enhanced my practice markedly . During the assessment process , we discuss the presenting situation from our professional viewpoints and reach an outcome that is appropriate and timely for the people we are jointly working with .
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While we complement each other ’ s roles within the team , we have managed to keep our core duties , roles and responsibilities in ensuring the services are met for the person
‘ This has proved to be an invaluable learning opportunity for the both of us . For example , it has enabled me to focus on the person ’ s potential for rehabilitation , goal setting and better pain management to improve their independence , as well as considering equipment or adaptations to meet their needs .’
She adds : ‘ Prior to having an in-house physiotherapist , referrals were made to the Health Community Therapy team , particularly for mobility assessments , and their outcome was awaited before cases were progressed . One benefit of therapy working jointly is the seamless service that both professionals can offer .
As an example , Kirti reflects that : ’ The views of the physiotherapist are sought when assessing the persons ’ stair climbing ability . This is to ascertain the benefits of maintaining their mobility versus the need for recommending major adaptations ( such as lifts ) and the long-term impact on their health and functional ability .
‘ Occupational therapy in the local authority setting is traditionally seen as an equipment an adaptations service , and by having physiotherapy onboard , it feels that we are returning to our core values of holistically assessing the persons ’ ability and maintaining their independence .’ This collaboration between occupational therapy and physiotherapy has also provided opportunities for both therapists to share their knowledge of activity analysis , assessing their home environment and using models of occupation .
But what of the impact of joint working on service delivery ? Positive feedback has come from from people referred via the Health Transfers Team and the Reablement Team for therapy input . This has meant that discharges have been better supported once in the community from the various pathways , such as Discharge to Assess and assessment beds .
There is no doubt that having both occupational therapy and physiotherapy professionals as part of the team means that any issues that arise once a person returns home are picked up and dealt with in their home environment urgently , to prevent hospital readmission and ensures their rehab continues at home .
Cases are often joint worked to problem-solve manual handling difficulties , essential transfers , decline in mobility , or issues with the packages of care , and are resolved with the provision of equipment and demonstration of correct techniques .
This has negated the need for referrals to the community therapy teams for urgent physiotherapy input , resulting in swifter outcomes for the person and their carers .
Mark Adams , physiotherapist , Kirti Gokal , occupational therapist , Kerry Tobin , occupational therapy team leader , and Miral Joshi , principal occupational therapist , Leicester City Council For further information email : Miral . Joshi @ leicester . gov . uk . * Mark has recently returned to live in New Zealand , but the council hopes to recruit another physiotherapist to the team in due course
OTnews December 2020 21