Occupational therapy proves crucial for reducing hospital admission in Wales

In News and Updates by COT Editor

The College of Occupational Therapists has called for urgent action to reduce avoidable hospital admissions and delayed discharge in Wales.

A year-long study by the College, launched today (8th November 2016), found one service saving 15,000 bed days in a year if a patient is discharged on the same day as assessment or within three days, through extending the use of occupational therapists.

Vaughan Gething AM, Cabinet Secretary for Health, Wellbeing and Sport has written the foreword to the report and is due to make the key note speech at the launch of the report at an event at the National Assembly for Wales on 9th November. Gething commented saying:

“Occupational therapists are one of the key health and social care professionals across health, social care and housing that can help achieve the changes that are needed. This report clearly shows the innovative ways they are delivering services which help people avoid unnecessary admission to hospital, reduce the time they stay in hospital and ensure they have a successful and safe discharge back home.”

The College is urging Health Boards to increase investment in the use of occupational therapists now to support the implementation of the Integrated Medium Term Plans (IMTPs).

Ruth Crowder, Policy Officer, Wales, College of Occupational Therapists said:

“Welsh health and care services are under considerable financial pressure. To make services sustainable in the long term it is vital Health Boards and Local Authorities look at valuable examples from across the system that show how early intervention by occupational therapists can make a real difference to people’s lives whilst saving the NHS money.

“Shifting occupational therapy resource to the front line of care, in everything from A&E Departments to primary care and in the community, can play a vital role in reducing hospital admissions in Wales.”

The College’s Improving Lives Saving Money report calls on Health Boards and Local Authorities to adopt the following recommendations:

  • To prevent inappropriate admissions for frail older people, there should be access to occupational therapists as part of the wider primary care workforce.
  • All rapid response and acute and emergency care services should have occupational therapists embedded within the multidisciplinary teams.
  • Health Boards should include occupational therapy in funding for extended or out-of-hours services to achieve optimum patient flow and fast-paced assessments.
  • All multidisciplinary admission and discharge teams should include occupational therapists, with therapy-led discharge planning for people with complex health care needs
  • Health Boards should support the development of therapy led services to ensure timely and successful discharge.
  • Planners, managers and leaders, in both health and social care services, should put occupational therapists at the forefront of reablement and community support programmes.

Service example 1: The Frail Older Persons Assessment and Liaison Team at University Hospital of Wales Emergency Department Assessment Unit

The service began in March 2012 and is the first and only one of its kind in Wales. In the FOPAL team, the occupational therapist screens and prioritises those who could be discharged home the same day. All interventions seek to return the person home wherever possible and maximise their level of independence and maintain established community services to prevent the breakdown of a person’s care package or the collapse of informal care networks.

  • Prior to the FOPAL team the length of stay for a ‘well frail’ cohort was in excess of 21 days.
  • Over a 12 month period, 854 patients were seen by the FOPAL team.
  • 33% were discharged on the same day as assessment – a saving of 5,501 bed days
  • 66% were discharged within 3 days – a saving of 10,134 bed days
  • Based on the average cost of a non- elective hospital stay this equates to a saving of £961,552

Service example 2: Occupational therapy in a general practice pilot project November 2015 – June 2016

The introduction of the occupational therapist in the Argyle Street Primary Care Practice in Pembroke Dock delivered an alternative, proactive model of care for identified frail, older patients and made a significant difference in several ways. 104 patients were seen within an average of 2 days. A wide range of occupational therapy interventions were required including rehabilitation programmes; assistive aids and home adaptations; advice; enabling techniques; supporting self-management of conditions; working with patients to facilitate change; and engagement with other services.

  • There was a significant reduction in repeat visits to the surgery
  • 14 patients avoided an acute hospital admission following assessment by the occupational therapist, based on a GP’s professional opinion
  • Six patients saw the occupational therapist following a hospital admission. Four weeks post discharge none had been re-admitted and there had been only two contacts with a GP
  • 81% of patients who had fallen reported increased safety and confidence in their ability to undertake everyday activities
  • 12/13 patients reported no falls in the four weeks following occupational therapy intervention

Download the reports

Reducing the pressure on hospitals a report on the value of occupational therapy in Wales – Welsh language version

Reducing the pressure on hospitals a report on the value of occupational therapy in Wales – English language version

Notes to Editors

  • For more information please contact Ned Lamb on 02073401153, 07508743737 or ned@gkstrategy.com
  • The College is the professional body and Trade Union for occupational therapy and represents over 1600 members in Wales and 31,000 occupational therapists across the UK.
  • Occupational therapy improves health and wellbeing through participation in occupation. Drwy gymryd rhan mewn galwedigaeth, mae therapi galwedigaethol yn gwella iechyd a lles