Thank you to all who have let us know the impact of occupational therapy in their local area!
- Adaptations team within Adults, Housing and Communities, Unitary Authority, Southampton.
The specialist housing occupational therapist visits adults who have applied for re-housing and have need for wheelchair adapted accommodation or major adaptations. The occupational therapy adaptations team covers major adaptations in council-owned stock funded by Housing Revenue Account and in private tenure funded by Disabled Facilities Grant.
Archie required intervention from an specialist housing occupational therapist following a stroke that made him dependent on using a wheelchair. This made his second-floor flat, with no lift access, unsuitable accommodation – which resulted in him living temporarily in a nursing home. The occupational therapist scoped out a void ground-floor, 3-bedroom council flat in the next-door block for Archie, and worked with the structures team in adapting the property for him and his family’s needs. Work was completed on the property at a cost of £22,682.23. The nursing home fees were costing £1,088 per week and added up to £26,112 over 6 months (£56,576 a year). Archie and his family moved into the property which saved the cost of further nursing home accommodation while reducing the need for social care support.
- Specialist Palliative Care Team, The Rowan Hospice, Solent NHS Trust, Portsmouth
“I wanted to thank you personally for all the help and advice you gave to both my husband and myself. You were always so generous with your time and patiently listened to all our problems.”
Specialist occupational therapy supports people to manage their symptoms and maintain independence and social and family roles for as long as possible. This is achieved through providing essential equipment, supporting end of life wishes and preferred place of death. From May – July 2015, 48% of patients seen remained the same in two or more areas when using the TOMs outcome measure palliative care scale.
- Forensic CAMHS Hospital, Bluebird House, Southern Health NHS Foundation Trust, Southampton
As part of a multi-disciplinary team, occupational therapy supports young people to improve occupational performance in social interactions, productivity, leisure and self-care. Evening groups supporting regulation have led to a reduction in the use of PRN medication and a reduction in the use of prone restraint (Ulysses incident reporting system, 2015).
- Occupational Health and Wellbeing service, Bradford District Care NHS Foundation Trust, Bradford
“Thank you for your time yesterday…. I came away thinking I still had something to offer as a nurse.”
Occupational therapy provides occupation focussed strategies as an alternative to counselling. The occupational therapist, besides working with individuals, delivers stress management for managers and stress awareness and resilience training for staff. Occupational therapy health manager believes occupational therapy has opened up positive new pathways of support to staff.
- Emergency Department Therapy Team, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Surrey
From March 2015 – March 2016 on average 77% of patients seen per week by occupational therapists were discharged and avoided inpatient admission.
- Occupational Therapy Service, Ulster Hospital, South Eastern Health and Social Care Trust, Belfast
The occupational therapy team at the Ulster Hospital, Belfast provide a seven day service (including public holidays) to the Emergency Department, Observation Ward & Ambulatory Care. The focus is on preventing unnecessary and/or inappropriate hospital admissions, providing quality assessment and intervention to facilitate safe and effective patient discharge including collaborating with community and hospital outreach services in preparation for resettlement. As a result of this initiative an average of 68 admissions per month are avoided, resulting in significant savings for the South Eastern Trust.
- Gillis Memory Centre, Mullinure Health & Wellbeing Centre, St Luke’s hospital, Southern Health and Social Care Trust, Armagh
Occupational therapy transformed Mrs Z’s care, improving her overall health and wellbeing through understanding her cultural needs. This led to an estimated saving in her care of £126,794 over a one year period.
- Community Occupational Therapy Intervention, Richmond Memory Service, Barnes Hospital, South West London & St George’s Mental Health Trust, London
Through structured personal recovery goals, the occupational therapist, working with an 80 year old gentleman with dementia, delayed his move into residential care by three months and reduced incidents of wandering by 30%. This led to a saving of £6,508 in residential care fees, police involvement and hospital admission.
- Independent Living Centre, NHS Northern Devon and Devon County Council (joint funded), Devon
The Independent Living Centre is an occupational therapy equipment specialist service; providing assessment and equipment advice to people living in Devon. The occupational therapists’ train all equipment prescribing staff in Devon and work closely with manufacturers and retailers and the Community Equipment Service. The Independent Living Centre occupational therapy intervention in the community equipment service generates direct annual equipment budget savings of £1,875,000. The staffing cost for the service equates to £153,000 per year.
- Learning Disabilities Outreach Team, Derbyshire Community Health Services NHS Foundation Trust, Derbyshire
Adam’s incidents related to challenging behaviour were reduced from nine per week to one following an occupational therapy- led intervention. An acute admission to a specialist learning disability hospital or forensic unit was avoided and Adam was able to remain in his home. Adam’s self-esteem has improved and he is more actively engaged in activities, using communal areas in the house and his antipsychotic medication has been reduced. He is now able to access the community with the support of two support workers and his night staffing has been reduced. This has led to a total saving in preventing his placement breaking down of £129,409.65 annually.
- Bath Centre for Fatigue Services, Royal United Hospitals Bath NHS Foundation Trust, Bath
The Bath Centre for Fatigue Services (BCFS) has a national reputation for providing specialised fatigue management services for people with CFS/ME, cancer related fatigue and fatigue linked to other long-term conditions. The Centre is led clinically and operationally by two consultant occupational therapists. Between January 2015 and December 2015, 278 new patients were referred by their GPs to the consultant occupational therapist for confirmation of diagnosis of CFS/ME. The cost of an hour long assessment was £74, compared to the cost of an assessment with a consultant physician at £200. This lead to a saving in the primary care budget of £99,428.00.
- Independent Review Pilot Team, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Newcastle-under-Lyme
Through occupational therapists’ completing annual reviews over a six month period of care packages for 41 people, weekly savings of £2,903.50 were achieved in care costs.
- Wellbeing through Work, Abertawe Bro Morgannwg University Health Board, Wales
The wellbeing through work service provides support to people with or at risk of developing health conditions that will affect their ability to remain in employment. People referred to the service are assessed via a phone call within seven working days. The assessment focuses on understanding the strengths of the individual, their support network and the difficulties they are experiencing in undertaking their work role. An action plan is developed with the person, which includes further telephone support, face to face sessions or attending the five week Managing Your Wellbeing course. EQ5D-L is used as an outcome measure. A six month evaluation demonstrated statistically significant improvements in EQ5D-L domains such as improvements in self-care and the ability to manage pain and discomfort. These improvements were generally sustained for six months after first contact with the service with greatest health gains for those on sick leave.
- Community Occupational Therapy Service, Wrexham County Council, Wales
This service provides rehabilitation, end of life care, equipment, advice on seating and positioning and support for families and carers. Following changes to palliative care screening, people are contacted by phone within 24 hours, whereas before it took an average of 18.6 days.
- Early Intervention and Prevention Team, Conwy County Borough Council, Wales
The early intervention and prevention team works with children, young people and adults who have a physical, sensory or learning disability. An occupational therapist working with an adolescent child with autism organised a level access shower enabling the teenager to become independent in personal care. This had a dramatic effect in increasing his life opportunities in terms of where and how he will live in the future. The total cost of the occupational therapists time and the disabled facilities grant adaptation came to £6492.09 which, compared to an ongoing annual cost of support with personal care, led to potential savings of between £14,404 and £20,332.
- Occupational Therapy Learning Disability Team, Belfast Health and Social Care Trust, Northern Ireland
The occupational therapy management team runs postural management clinics to review people’s needs and the effectiveness of their current equipment. By offering annual reviews through monthly clinics at local day centres, the service has reduced the number of new referrals from 60 to 38 in 2016. Good postural management decreases the need for medical interventions for bowel, bladder and respiratory issues. For example, improved posture and comfort at night through a sleep system has removed the need for 1:1 staff as the person is no longer exhibiting behaviour the staff find challenging. This has saved the Trust £24 a night with an annual saving of £4380.
- Housing Occupational Therapy Service, St Leger Homes of Doncaster, Doncaster
The occupational therapy service assesses housing needs and makes property recommendations for housing adaptations and rehousing. The occupational therapist liaises with the community equipment service and the local authority. An in-house occupational therapist has bought greater efficiency to the allocation of available housing stock, whilst recognising an opportunity to support colleagues in the local authority in managing the demands on their service. The average waiting time for an occupational therapy assessment through the local authority was 197 days. The in-house occupational therapist has reduced this to 34 days.
- Bristol Community Learning Disabilities Team, Bristol Community Health, Bristol
The occupational therapist and assistant working on the Bristol central learning disabilities team supported a young man who wanted to improve his fitness through boxing. After carefully considering the risks involved, following a road awareness assessment and liaison with the gym instructors, he has now completed 20 personal sessions and has joined a box-fit group session.
- Social Care Reablement, Devon County Council, Devon
The Social Care Reablement service offers up to 4 weeks of social care support. Most people are referred following admission to hospital with services available 7 days per week, 365 days per year. The 3.5 fte occupational therapists screen people referred with principally moderate to complex needs and complete home assessments/goal planning and reviews where occupational therapy can support improved outcomes. On completion of reablement interventions, approximately 75% of clients have no ongoing needs. Evaluating 10 cases with occupational therapy involvement, the savings to Devon County Council (based on 12 months with no additional social care intervention): £115,137 saved – where no ongoing care package required, £19,688 saved – through use of a strength based approach so people sourced their own equipment/minor/major adaptation, £32,656 of avoided costs through the prevention of admission to residential care and approximately £2,000 saved through a reduction in need for mental health and or NHS services.
- Yorkshire Fatigue Clinic, York
The clinic was set up in 2012 by a former Consultant Occupational Therapist as an independent provider for rehabilitation for adults with Chronic Fatigue Syndrome /Myalgic Encephalomyelitis (CFS/ME). Within the first year the single handed service had seen 105 patients, including NHS patients funded individually through the local CCGs. By April 2014 the clinic demonstrated a saving to the NHS of £99,357 in comparison to existing service provision. The service was chosen as the preferred provider and went on in 2014 to win an NHS Contract. A national study of NHS services demonstrated that 40% of patients reported being very much/much better after attending the clinic, which compared to the national average of 27.5%. Since it opened nearly 950 patients have been referred to the small team of three OTs and a physiotherapist, including those very severely affected.
- Adult Learning Disability Services, Dorset Healthcare University NHS Foundation Trust, Dorset
Tracey required an occupational therapy assessment to review her needs after the death of her main carer, her aunt. Initially her family were asking for Tracey to be put into care or to have 24 hour support as Tracey has never been supported to develop life skills. Following occupational therapy intervention, Tracey now lives in a warden assisted bungalow and attends a local authority centre two days a week and receives 21 hours per week in home support. This has led to a saving of £52,708 per year compared to the cost of 24 hour support.