FEATURE PRIMARY CARE
The right support , at the right time
Amy Smith reflects on the first six months of setting up a primary care occupational therapy service , with a focus on student mental health
I
began working in my current role at a GP surgery based on a university campus in September 2020 . There had been no occupational therapy provision prior to this . I had a two-week induction , which allowed me to spend time with various members of staff and gain a good insight into how the practice worked . I sat in with administration staff , GPs , nurses , reception staff and the mental health nurse practitioner who had already been in post for a year . I also met with various services that provided additional support to the patients .
This time was invaluable in terms of gaining an understanding of how primary care works and helped me to begin to see how I might work within this new system , which has a very different culture , focus and ethos to the various secondary care systems I had previously worked in . It also allowed me to see the kinds of difficulties patients were presenting with .
I was given a near blank slate in terms of setting up this new service – the only boundary put in place was that I would need to work within 20-minute appointment slots . I have kept to this , for the most part , with the only deviation being when further occupational therapy assessment is needed beyond the initial screening appointment – this takes place within a 40-minute appointment .
I am aware that this model is unlikely to work in GP surgeries that have a more diverse population , but the majority of work I do in this role is signposting , brief psycho-education and advising on coping strategies .
For the most part , the short appointment times tend to work well here as most patients can self-manage after being directed to resources that are appropriate to their individual needs .
Initially I decided to use the Occupational Self Assessment – Short Form ( OSA SF ) as an assessment measure when the initial screening appointment highlighted occupational needs that warranted deeper exploration .
This decision came in part from me being comfortable using Model of Human Occupation ( MOHO ) tools , but also because the sections reflect many of the difficulties patients were presenting with and it is quick and easy to use .
I have since looked into other assessment methods , but for various reasons they do not quite ‘ hit the mark ’, so I have continued to use OSA SF . It seems to be generally well received and gets people thinking about their day-today functioning , which is a novel approach for many that have had all their health needs met through primary care . I quickly began seeing a lot of patients with similar occupational dysfunctions ; mainly issues with maintaining occupational balance through developing a healthy routine and having anxiety symptoms that caused disengagement from or avoidance of occupations .
I have always thought highly of using group work in my practice and saw these patterns as an opportunity to develop groups to help provide support for some of the common issues I was seeing .
I developed a ‘ healthy routines ’ group , in partnership with the health and wellbeing coach , that we plan to run
26 OTnews October 2021