There is an overwhelming sense of pride in what we do and what we can bring … that leaves me to strongly believe that it isn ’ t the profession that ’ s the problem , it ’ s the systems and the structures that we work within ...”
There is an overwhelming sense of pride in what we do and what we can bring … that leaves me to strongly believe that it isn ’ t the profession that ’ s the problem , it ’ s the systems and the structures that we work within ...”
‘ OTs should be at the forefront of clinical decisions for patients about their discharge and ongoing rehab needs ,’ she said . In essence , if a patient presents either at the front door or on to a ward , they should be seen by an OT , who is part of that decision making , based on assessment of functional needs to that patient .
‘ What is it that matters to that patient ? What ’ s required to turn that patient round as soon as their medical needs have been met to discharge them safely ? We shouldn ’ t be holding on to people for rehab if rehab can be done in a more appropriate setting in the community .’
Nikki George-Powell , HARA Service Manager Community Hub , Harrogate and District Foundation Trust was asked , based on her work in Harrogate , whether she felt more occupational therapy should be taking place in the community , rather than on hospital wards and how do we make that happen ?
She said that ‘ starting at the end ’ and thinking about ‘ Home First ’ at every opportunity in a patient ’ s journey is key . This helps improve patient outcomes , shortens length of stay and avoids hospital admissions .
Reflecting on previous RCOT work and the conversations that took place at the workforce summits , Karin added that while we know OTs are incredibly busy ensuring discharge , they are not really working as OTs . She asked : How do we address that ?
‘ We need to think about auditing what we do ’, she said , calling on people to ask : What is that only we can do ? She said we can ’ t ‘ suddenly just stop doing and pull out of our teams ’, but we can highlight the percentage of our time that is doing roles that are based on low value decisions for occupational therapy .
If we focus what we do on better value decisions , she went on , then we would be able to better demonstrate what we would be offering .
Emma Ashton , Hospital Patient Transfer Team Manager , Powys County Council , was asked to consider our role in encouraging and enabling positive risk taking and leadership .
‘ Education [ with wider multidisciplinary team colleagues ] is such a big part of this ,’ she said . ‘ As OTs we always analyse … it ’ s in our nature and we assume everyone else does it as well , and they don ’ t .
‘ What can we do is to look at alternative options ? Think outside the box . What can we do to get people home ? It ’ s about encouraging more of the multidisciplinary team to have those conversations and enabling them to have those thoughts .’
She urged that people ‘ work together and have those combined assessments ’; if we share our information a person has a meaningful hospital stay , she concluded .
Lauren ’ s final question , before taking delegate questions was : How do we move all this forward and what needs to be a priority ?
Jo Richardson , Therapies Improvement Manager ; Emergency Care Improvement Support Team , NHS England , framed her response around the risk appetite . ‘ For all this to work we have to embrace it and share it ,’ she said .
Karin added that OTs in acute settings need to reach out and establish relationships with occupational therapists in the community and social care , ‘ get into the room ’ and start to have the difficult ‘ what if ’ conversations .
Nikki went on : ‘ You need buy in and it needs to be at all levels .’ She urged people to come up with the solutions first , then get the buy in after . ‘ There ’ s currency around , “ if you aren ’ t there anymore , what would be missed ”?’
Workforce innovation and diversification : take home message
Our occupational therapy support workforce is a skilled , experienced , valued and vital part of our OT community and essential to delivering safe , effective services . But , the lack of national policies for support worker development , has led to inconsistent job design , access to education and career progression opportunities . OTs need to harness the motivation and commitment of their current staff and to create an environment where development opportunities become commonplace and common practice , for those that want them .
24 OTnews July 2023