“The long awaited publication of the NHS Long Term Plan was warmly received by the team at the Royal College of Occupational Therapists as a sound roadmap for the future of health care in England.
It is reassuring to see the overall direction of the plan, and themes within it, reflect many of the key recommendations the Royal College has been making in recent years – supporting people at home, a focus on prevention, greater integration and use of primary care, and achieving parity of esteem for mental health.
This places the profession in a key role to help deliver the plan’s vision for the NHS.
Primary care, community health, prevention, technology and areas such as mental health and learning disabilities are areas where occupational therapists can make a real difference to people’s lives.
The plan therefore sits comfortably with the Royal College’s direction of travel for the occupational therapy profession. We are confident that our members can develop, lead and deliver cost-effective services to achieve it.
As the only healthcare profession trained at undergraduate level to deliver the Government’s “triple integration” agenda, we call on commissioners, leaders and managers to work with us to develop an innovative, new model of healthcare for the 21st Century – because, we are ready, willing and able to deliver it.”
Urgent community response and recovery support
The Plymouth Community Crisis Response Team is a multidisciplinary team operating seven days a week. Occupational therapists pick up referrals relating to activities of daily living, personal care and mobility.
Within two hours, an urgent care assessment is carried out and an intervention plan is put in place to provide advice, information and support, a care package and/or equipment. The occupational therapist can also assess a person’s moving and handling risk and put in place a falls management plan.
The Plymouth team sees an average of 1,200 referrals every year, with approximately 88% of referrals not resulting in admission into hospital. With the average cost of a non-elective hospital admission running at £2,888 per person, that success rate gives rise to potential savings of over £3m per year (£3,049,728) as well as freeing up capacity within the urgent care pathway.
Reducing pressure on emergency hospital services
In November 2016, over two years ago, the Royal College published a report called ‘Reducing the pressure on hospitals – the value of occupational therapy.’ The report identified occupational therapy services that effectively reduced admission to hospital, significantly shortened the duration of stay in hospital and effectively discharged patients and reduced the chance of re-admission.
In East Lancashire, a falls response service which partnered an occupational therapist with a paramedic prevented over 76% of people who had required an ambulance call out from hospital admission. The cost savings of preventing these admissions through this service were £200K in one year.
Supporting children with mental health concerns, including anxiety, to return to or remain in school
An occupational therapist has been employed by Devon County Council as an Education Well-being Advisor since November 2017, supporting students with medically unexplained symptoms (such as headaches, fatigue, anxiety, tummy ache) who are struggling to remain in or return to school.
Often these unexplained symptoms can be attributed to anxiety in young people. Occupational therapists are trained in physical and mental health so can recognise the links between physical ‘symptoms’ and the underlying mental health issues that can trigger these symptoms.
Occupational therapy input has enabled a number of students with persistent anxiety and other mental health needs to return to mainstream school after being out of education for up to 12 months.
The cost of providing an alternative educational provision is in the region of £18,000, while educating a child in a mainstream school costs £4-6,000. Enabling these children to remain in mainstream education represents a significant cost saving.
Personalised care and self- management – new report launching next month
The Royal College has long championed a person-centred approach to health care, and a core principle of our profession is to support self-management through enabling patients to undertake the daily occupations important to them. Our latest Improving Lives Saving Money report will be published next month with examples of how occupational therapy intervention is empowering self-management and enabling personalised care.
Until then this blog by Clinical Commissioning Lead and occupational therapist Patience Young highlights the importance of personalised care in helping people achieve their ambitions and live fulfilling lives.