The College of Occupational Therapists (COT) has called for an urgent increase in the use of occupational therapists to reduce pressure on hospitals.
A year-long study by the College of Occupational Therapists demonstrates how occupational therapists can not only reduce hospital admissions but also improve patient flow and earlier discharge once people do find themselves in hospital. The ‘Reducing Pressure on Hospitals’ report which is being launched today identifies six recommendations to ensure occupational therapy services are supported to help more people avoid admission to hospital or return swiftly home once admitted.
The Health and Social Care (HSC) system in Northern Ireland is facing unprecedented demand and financial constraints. With 612,996 patients attending the 10 major accident and emergency (A&E/EM) departments in Northern Ireland in 2015, the system is under continual and increasing pressure. In 2015 just 77.5% of patients were treated within four hours – the worst performing of all the UK nations*.
Access to occupational therapy at the hospital front door cuts admissions and discharge delays, reducing the time medically fit patients spend in hospital. Dr Patricia McClure, Chair of Council at the College of Occupational Therapists highlights this role:
“There’s a growing crisis in our hospitals and occupational therapists are proving they can deliver a solution. Occupational therapists are one of the key health and social care professionals who work across health, social care and housing and can help achieve the changes that the Health Minister wants to see in the next 10 years for health and well-being in Northern Ireland.
To make services sustainable in the long term it is vital Trusts look at valuable examples from across the system. This report clearly shows the innovative ways occupational therapists are delivering services. Occupational therapists at the front line of care, from A&E Departments to primary care and in the community, can play a vital role in reducing hospital admissions”
With ever constrained resources the correct infrastructure, services and workforce model must be put in place on a sustainable basis to turn the tide on the ever increasing strain on emergency care. There are growing opportunities to develop an integrated approach right through from prevention and early intervention to urgent and emergency care, involving hospitals, community, primary care and ambulance services through joint service planning across different agencies.
Occupational therapists across these services support patients to return or remain at home and continue to take part in daily occupations and activities.
The College argues that a medical ‘fix’ is not enough for frail older people and that hospital should equally focus on patients’ needs for recovery and long term independence. The Reducing the Pressure on Hospitals report from COT provides six key recommendations to help deliver the change required across our health service.
Service example 1 – Acute Care at Home Team
The ‘Acute Care at Home’ team in the Southern Trust area, in which occupational therapists are part of the multidisciplinary team, ensures that patients are receiving appropriate care and support at home rather than being admitted unnecessarily to hospital. As a result of this programme 770 older people with complex healthcare needs have been managed, assessed and treated in their own home over the past two years.
Service example 2 – Reablement Programme
There has been a significant increase in the number of people needing rehabilitation, community occupational therapy and reablement at primary care level. Occupational therapists working in intermediate care and reablement teams can help ensure smooth transition into the community. This can minimise bed days lost to patients who are medically fit and reduce the chance of readmission by maximising a person’s independence. A Retrospective Longitudinal Audit in 2014 found that reablement services across Northern Ireland had led to net domiciliary care costs avoided of £1.2m.
Notes to Editors
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The College’s Reducing Pressure on Hospitals Report (Northern Ireland) will be published on 11 November 2016 at www.cotimprovinglives.com as part of its Improving Lives, Saving Money Campaign.
The report makes six key recommendations:
- To prevent falls-related admissions, there must be increased partnership working between occupational therapy services and ambulance services when responding to falls.
- All hospital at home schemes, rapid response and acute and emergency care services must have occupational therapists embedded within the multidisciplinary teams, and this includes ‘Home Treatment’ teams for mental health.
- To achieve optimum patient flow and fast-paced assessments, commissioners must include occupational therapy in funding for out of hours services.
- All multidisciplinary admission and discharge teams across the hospital environment must include occupational therapists, with therapy-led discharge planning for people with complex health care needs.
- To ensure timely and successful discharge, commissioners and providers must support the development of therapy-led services.
- Occupational therapy-led reablement services should expand to include all adults and provide a seven-day programme of care.
The College is the professional body for occupational therapy represents 31,000 occupational therapists across the UK, with around 1,000 members in Northern Ireland.
Occupational therapists provide life changing support to people managing illness, injuries and a wide range of physical and mental health conditions. Uniquely, they enable people to carry out daily activities (‘occupations’) which are essential for health and happiness. This vital care helps people recover and build new skills to enjoy a full and independent life.