1. Occupational Therapy: Improving Lives Saving Money
Demonstrating the Value of Occupational Therapy
Julia Skelton
Director of Professional Operations
College of Occupational Therapists
FIRST SECTION HALF AN HOUR…..

2. The COT campaign Occupational Therapy –Improving Lives Saving Money has four strands :
Urgent Care –the value of occupational therapy (released Nov 2015)
Reducing the pressure on hospitals (released Nov 2016)
Primary care and communities (Various releases from April 2017)
Mental Health –the value of occupational therapy (for release Nov 2018)
   
Check people’s knowledge of campaign.
If no knowledge then some background.

3. Improving Lives, Saving Money
Launched in November 2016: Reducing the pressure on hospitals – the value of occupational therapy - in each nation of the UK. The reports marks the end of phase 1 of our Improving Lives, Saving Money Campaign. There are 4 reports for each country in the UK - England, Northern Ireland, Scotland and Wales - with an additional report available in the Welsh language. You can read the full reports and recommendations on our campaign microsite at
Activities that allow us to live independently and give us a sense of identity
This could be anything from essential day-to-day tasks, such as dressing or cooking, to the things that make us who we are—our interests, hobbies and relationships.
Look up definitions for activity and you will see it defined as something someone does. Being active simply means moving about or showing involvement.
With these definitions in mind we can expect everyone to be active – it is not just for the young and fit and everyone can and needs to engage in activities.

4. Why now?
NHS and social care services have reached a tipping point across the UK
People with commissioning powers are under extreme pressure
Critical in this climate that occupational therapy states how it is
Improving lives and
2. Saving money for public purse
   
*** people with commissioning powers will vary across the four nations

5. Where we are now:
During 2016 we collected data examples from members to demonstrate the value of their service. We ran numerous workshops and roadshows around the UK to explain the demonstrate template to members and this resulted in over 190 impact data examples.
In fact we received so many we decided the divide the campaign messages up and produce two sets of reports and additional topic focussed resources to demonstrate the Value of Occupational Therapy to stakeholders.

6. How we collect the service examples?
We collected occupational therapy data in a drive to promote the value of the profession.
We asked for impact data from occupational therapists around the UK.
We used a DEMO template to DEMOnstrate impact: Describe the services; Explain all interventions; Measure change to capture outcomes and state Overall return on investment.
This will showcase our skills and services to the top decision makers across England, Northern Ireland, Scotland and Wales.
   
DEMO is the acronym used to help members send in the information we are looking for. Full guidance is on our website.

7. How did members do this?
Visited our website to download the impact data form
Used the example template and guidance notes provided
COT ran Roadshows across the UK to assist members in calculating cost savings
Asked members to speak to their manager about getting involved in the campaign
Please continue to use forms to send in service examples
   

8. Examples in England included in the Report
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. An assessment is carried out and an intervention plan is put in place within two hours - providing advice, information and support, a care package and/or equipment.
The team measures effectiveness by looking at quality of care outcomes, assessing a person’s ability to return to their normal routines with the usual levels of dependency and confidence previously shown, as well as the timeliness of the team’s response and any resulting reductions in hospital admissions. 
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. 

9. Occupational therapists in the Rapid Response Service at the Royal Free Barnet Hospital have prevented more than 83% of admissions across 7 services. By working in the A&E and adult assessment unit they can ensure more than 96% of people return to their own home.
An A&E occupational therapy team at St Richard’s Hospital in Chichester has achieved significant financial savings. Its occupational therapy focused assessments across the emergency department have prevented 70% of admissions, with 58% of patients returning to their own home. Estimated savings a month are £169,304
England

10. What does the report say?
The report calls for six recommendations to put occupational therapy on the frontline in hospitals and emergency services:
Occupational therapy & paramedic partnerships to prevent hospital admissions
Occupational therapists in all rapid response & emergency care services
Extended occupational therapy services to improve 7 day hospital discharge
Occupational therapists in all hospital admission & discharge teams
Therapy led services across hospitals, in parallel with medical care
Occupational therapists to lead reablement & community support programmes

11. November 2016 launch events in all four country parliaments

12. Great media coverage
Positively received from COT members

13. Falls Response Service- occupational therapist and paramedic
Request for service data Urgent Care report Invitations to speak at Kings Fund and other events Recognition through awards Inclusion with further data in Reducing Pressure in Hospital report Filming for BBC Breakfast Parliament – attending launch of COT report Interest from other clinical commissioners on setting up the service model Two new services: St Helens Norfolk (seen on BBC Look East )

14. England

15. 78% Demonstrating the value of occupational therapy
The reports showed the following…
78%
of people who received an innovative joint assessment between a paramedic and an occupational therapist were able to remain at home

16. 70% Demonstrating the value of occupational therapy
The reports showed the following…
70%
Discharged home avoiding hospital admission
It has been demonstrated that occupational therapy is most effective within acute and emergency care when the therapists are an integral part of the team. On average the services see 100 people a month, with 70% discharged without needing hospital admission

17. Demonstrating the value of occupational therapy
The reports showed the following…
Where occupational therapy services were provided via a both a clinical decision unit and medical assessment unit
67% of patients were discharged rather than requiring ongoing admission.
Based on an average inpatient stay of £270 a night, a saving of £542,619 was made.

18. 9.5 days to just1day Demonstrating the value of occupational therapy
The reports showed the following…
Occupational therapists on acute medical wards can cut stays from
9.5 days to just1day
Source: Urgent care report (COT 2015)
These are just some examples
go to for more

19. What health leaders are saying
‘Occupational therapists are usually very creative and driven to deliver, which means they often find themselves in role where they are leading on new ways of working and information organisational changes which are required to underpin our transformational work’
Joe Rafferty, Chief Executive of Mersey Care NHS Foundation Trust
A recent parliamentary report on the discharge of patients….identified us as having the lowest number of ‘delayed discharges’ in the UK. With doubt this is because our integrated service model which places occupational therapy teams as core members of our planning for home and facilitated discharge teams.
David Evans, Chief Executive Northumbria NHS Foundation Trust

20. What health leaders are saying
With A&E attendances increasing, the pressures on emergency departments are greater than ever before. Action must be taken to address demand and relieve pressure on A&Es. This report demonstrates the important part occupational therapists have to play in reducing pressures on primary care services alongside improving the overall quality of care that patients receive. I have been fortunate to work in a unit with front door occupational therapy seven days per week and so I am acutely aware of the benefits to the system that that brings.”
Dr. Sean McGovern, Vice President of the Royal College of Emergency Medicine Northern Ireland
‘A fantastic resource that has been underused in primary care…having an occupational therapist attached to the practice has many benefits….the occupational therapist is able to respond appropriately within 24 hours….to help people remain at home safely and comfortably. We are now recruiting two more occupational therapists.’
GPs from S Pembrokeshire cluster

21. How is the College using the report
Influencing activities
Key organisations / stakeholders have been sent report
Meetings with key stakeholders to promote the report
Communications strategy in place to optimise coverage of each report
Activities have been taking place in all four countries

22. What do we want members to do?
It is absolutely critical that members:
Share the reports with their managers, Head of therapy services and senior leaders across their Trust or Board.
Inform the communications team where they work so that they can include it on their website, newsletters and social media channels.
Get involved in the campaign by signing up to our microsite and using the hashtag #ValueofOT
Send in service examples

23. Further work with stakeholders
Influencing activities
Key organisations / stakeholders have been sent report and approached for meetings
England - Parliamentary questions to be tabled by Norman Lamb
Communications strategy in place to optimise coverage of each report
Toolkit for members
template letter for Communications teams for those in report
template letter for occupational therapists to send to their MP
template letter for all members to send to their CCG
network of people who have submitted examples to keep engaged

24. What’s next?
The College will be publishing another campaign report in Spring 2017 to show how occupational therapists are critical to older people in social care.
Reports/Press releases to follow on:
Work/Employment
Prisons
Schools
Mental Health
Group

25. What would your soundbite be?
  Phase 2 ILSM  
Focus on reducing reliance on primary and social care
Suggested soundbites:
Occupational therapists help people remain at home safely and assist in sustaining a  satisfying life at home.
Occupational therapists are the ‘all rounders’ in social care   as they undertake social care assessments and lead on prevention
Occupational therapists in care homes help to prevent falls  and  ensure mental and physical wellbeing for residents.
Occupational therapist span health, social care and housing  so are experts in integrated care and signposting.
What would your soundbite be?

26. What would be your service’s infographic?
What data do you need to evidence this?

27. Mental Health – the Value of Occupational Therapy
There is now a mental health DEMO template to use with real life mental health examples on the campaign website.
Please send mental health examples ASAP to
You can find the template here:
Any questions to
   

28. Remember every little helps – with a tweet you could get your message across widely and quickly…. people are busy – do what you can
Follow COT on twitter and retweet!
Tweet about your own service

29. Use the resources in the toolkit
Use the microsite
Request copies of the report to promote with your stakeholders.
Call our professional advisors for help and advice on producing impact data and influencing.

30. What can you do? Literature - Key health outcomes
You have concern but little influence
Gather information
Be selective in what you focus your energy on
You have some influence
Piloting work and demonstrating outcomes
Timely and focused suggestions
You have control of what happens
Your interactions with others
Your professional reasoning
What are your priorities for promoting the profession?
Now?
Next month?
Next year?
Link back to who it within people’s sphere of influence.
What is the evidence telling us?
Life span and disability
Interventions that result in outcomes
Implementation science
Sources of evidence:
Literature - Key health outcomes
Local findings (council, commissioners)
Service user involvement
Get involved when you are asked for your views
Propose ideas
Take responsibility for your own practice
Seek supervision and critical friend challenges
Be open to feedback
Consider those you aren’t seeing as well as those you are

31. Top Tips for promoting the profession…
What works?
What doesn’t work
E.g. Being open to change
Be proactive – invite self to meetings
Delegate meetings and tasks to all levels of practitioner
Manage expectation for self
Promoting what we do well – whatever size of change
Supporting students
Recognising compliments – write to MP
Networking - MDT
E.g. Seeking perfection in services
Not changing
Perceived as being too challenging
Overcomplicating things
Moving away from occupational therapy
Using promotional material inappropriately
Facilitate as a whole group. Ask regional members to facilitate.
Don’t be defensive – be proactive
What does work
Proactivity
Engagement
Collaboration
Openness
Options
Creativity
Awareness of context
“Good enough”
What doesn’t work
Doing what we’ve always done
Top down direction
Profession-centrism
Rigidity
Starting without stopping
Silo thinking
Hoping context doesn’t apply
Perfection

32. Resources from The College of Occupational Therapists
Occupation-centred practice position statement
c/Occupation-centred-practice-August2015.pdf
Occupation-centred practice briefing:
Outcomes and record keeping briefing and tools

33.
Media and human interest story.

34. “I am an Occupational Therapist”
What is the one most important thing we can all do to help raise our profile?
Introduce ourselves and say
“I am an Occupational Therapist”
Be Loud and Proud

35. Any Questions