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You can find the current article at its original source at https://www.theguardian.com/social-care-network/2016/jun/29/occupational-therapists-urgent-care-hospital-admissions-beds
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| Quiet revolution puts occupational therapists at the forefront of healthcare | Quiet revolution puts occupational therapists at the forefront of healthcare |
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| It is a crisis that threatens to cripple the NHS. Around 8,000 patients are stuck in hospital beds in England every day because of discharging delays, costing the NHS up to £900m a year. The figures, revealed early this year in an independent inquiry commissioned by the government, show one in 10 beds is taken by someone medically fit to be released. | It is a crisis that threatens to cripple the NHS. Around 8,000 patients are stuck in hospital beds in England every day because of discharging delays, costing the NHS up to £900m a year. The figures, revealed early this year in an independent inquiry commissioned by the government, show one in 10 beds is taken by someone medically fit to be released. |
| But OTs may offer a solution. Growing numbers are assessing patients needing urgent care and supporting them to remain in their own homes in a quiet revolution that is seeing them move to the forefront of healthcare. | But OTs may offer a solution. Growing numbers are assessing patients needing urgent care and supporting them to remain in their own homes in a quiet revolution that is seeing them move to the forefront of healthcare. |
| Evidence of the impact of this changing role is highlighted in a report published last year by the College of Occupational Therapists. It reveals how OTs in frontline services, from working with paramedics to A&E departments, are preventing the need for hospital admissions and supporting patients to live safely in their own homes. | Evidence of the impact of this changing role is highlighted in a report published last year by the College of Occupational Therapists. It reveals how OTs in frontline services, from working with paramedics to A&E departments, are preventing the need for hospital admissions and supporting patients to live safely in their own homes. |
| The results are impressive. At Sheffield teaching hospitals NHS foundation trust, a new discharge-to-assess model has led to a reduction in hospital stays on an elderly ward from nine days to one. Laura Evans, integrated pathway manager and head of OT at Sheffield, says concerns about delays in the discharge of older people in the hospital prompted the setting up of the new service. | The results are impressive. At Sheffield teaching hospitals NHS foundation trust, a new discharge-to-assess model has led to a reduction in hospital stays on an elderly ward from nine days to one. Laura Evans, integrated pathway manager and head of OT at Sheffield, says concerns about delays in the discharge of older people in the hospital prompted the setting up of the new service. |
| “Often people were ready to go but were waiting around for different services. Now, as soon as the doctor says they can leave, they can do so. We aim to get them home within six hours, and we work until 10pm. | “Often people were ready to go but were waiting around for different services. Now, as soon as the doctor says they can leave, they can do so. We aim to get them home within six hours, and we work until 10pm. |
| “The OT does an initial triage-style assessment on the ward to see if they are ready to leave,” she says. “When they get home, they are met by OTs in an active recovery team who carry out a more detailed assessment and get any extra equipment fitted the same day.” | “The OT does an initial triage-style assessment on the ward to see if they are ready to leave,” she says. “When they get home, they are met by OTs in an active recovery team who carry out a more detailed assessment and get any extra equipment fitted the same day.” |
| The scheme currently applies to patients on the respiratory and care of the elderly wards, but it is hoped to be rolled out to orthopaedics. | The scheme currently applies to patients on the respiratory and care of the elderly wards, but it is hoped to be rolled out to orthopaedics. |
| Another new way of working has proved successful at Ipswich hospital NHS trust, where OTs partnering with physiotherapists have piloted weekend working in the emergency and frailty assessment units and in A&E. Between October 2015 and January 2016, therapists assessed 2,448 patients across the units – with 875 patients being sent home with support, avoiding hospital admission. | Another new way of working has proved successful at Ipswich hospital NHS trust, where OTs partnering with physiotherapists have piloted weekend working in the emergency and frailty assessment units and in A&E. Between October 2015 and January 2016, therapists assessed 2,448 patients across the units – with 875 patients being sent home with support, avoiding hospital admission. |
| Anna Robinson, senior OT emergency therapy team lead, says: “Our aim is to avoid admission to the hospital by supporting patients to return to the community safely. We have come a long way since we first trialled this. The results are fantastic.” | Anna Robinson, senior OT emergency therapy team lead, says: “Our aim is to avoid admission to the hospital by supporting patients to return to the community safely. We have come a long way since we first trialled this. The results are fantastic.” |
| Rachel Bedwell, North West ambulance service | Rachel Bedwell, North West ambulance service |
| Rachel Bedwell, 29, is employed by East Lancashire hospitals NHS trust but works for the North West ambulance service NHS trust’s Pennine Lancashire falls response service, helping older people to remain safely at home. | Rachel Bedwell, 29, is employed by East Lancashire hospitals NHS trust but works for the North West ambulance service NHS trust’s Pennine Lancashire falls response service, helping older people to remain safely at home. |
| We are keeping 78% of people home, which is much better for them | We are keeping 78% of people home, which is much better for them |
| “Yesterday was a typical day. Gail Smith, the paramedic I work with, signs me in and we are ready for jobs. | “Yesterday was a typical day. Gail Smith, the paramedic I work with, signs me in and we are ready for jobs. |
| “Our first call is to an 85-year-old lady found on her bedroom floor by her carer. Gail checks her for injuries. I assess her getting on and off the bed, the toilet and sitting up and down. I check her cognition. She is a bit confused as a result of a urinary tract Infection. We get her GP to prescribe antibiotics, and I look at getting a commode and some rails, which can be delivered the same day. I make referrals, arranging wraparound support, ring physiotherapy to make a further assessment, and social services to get her a crisis carer. | “Our first call is to an 85-year-old lady found on her bedroom floor by her carer. Gail checks her for injuries. I assess her getting on and off the bed, the toilet and sitting up and down. I check her cognition. She is a bit confused as a result of a urinary tract Infection. We get her GP to prescribe antibiotics, and I look at getting a commode and some rails, which can be delivered the same day. I make referrals, arranging wraparound support, ring physiotherapy to make a further assessment, and social services to get her a crisis carer. |
| “Our next job is an 89-year-old man with dementia who was found at the bottom of the stairs by the driver to his daycare centre. He has no physical injuries but I contact social services, to ask for a care review so he can get more support, and his GP, to exclude underlying infection. | “Our next job is an 89-year-old man with dementia who was found at the bottom of the stairs by the driver to his daycare centre. He has no physical injuries but I contact social services, to ask for a care review so he can get more support, and his GP, to exclude underlying infection. |
| “Then we go Burnley general hospital where I follow up on patients seen by other paramedics and make sure they get the occupational therapy assessments they need. We get a lot of referrals this way: we have had 1,400 since the pilot in January 2015. | “Then we go Burnley general hospital where I follow up on patients seen by other paramedics and make sure they get the occupational therapy assessments they need. We get a lot of referrals this way: we have had 1,400 since the pilot in January 2015. |
| “Our next call is to a lady found on the floor by her hairdresser. I discover she has an electric chair she doesn’t use because she doesn’t understand the remote controls. I put stickers over the bits she doesn’t need, leaving only up and down arrows. I leave a frame with her and notice she could benefit from a rail near her bed. | “Our next call is to a lady found on the floor by her hairdresser. I discover she has an electric chair she doesn’t use because she doesn’t understand the remote controls. I put stickers over the bits she doesn’t need, leaving only up and down arrows. I leave a frame with her and notice she could benefit from a rail near her bed. |
| “It’s been a long day, but rewarding. We are keeping 78% of people home, which is much better for them.” | “It’s been a long day, but rewarding. We are keeping 78% of people home, which is much better for them.” |
| Join the Social Care Network to read more pieces like this. Follow us on Twitter (@GdnSocialCare) and like us on Facebook to keep up with the latest social care news and views. | Join the Social Care Network to read more pieces like this. Follow us on Twitter (@GdnSocialCare) and like us on Facebook to keep up with the latest social care news and views. |
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