1. Occupational Therapy in General Practice
Value & Impact
November July 2017
389 new patients were seen by 2 Occupational Therapists average wait to be contacted/seen is 2 days. All patients were provided with individual assessment and advice with a strong emphasis on self-management.
Introduction
Initially a project was conducted between November 2015 and June 2016 and saw 1 Occupational Therapist (OT) working in a large General Practice. Aspects of the Anticipatory Care Plans (ACP) approach was utilized with referrals triaged by the Occupational Therapist and General Practitioners (GPs) to identify patients who were regular users of the practice and were increasingly frail and isolated. Due to the recognized success of the project in November 2016 funding was provided by the General Practice cluster for 2 band 7 Occupational Therapists to cover 5 surgeries over the whole of South Pembrokeshire.
Quotes from GPs on the
Occupational Therapy service
“A fabulous service that I am thrilled to see has expanded, it has provided improved quality of care for patients and saves GP time”
“As a service it has been more beneficial than I could have ever imagined”
“Benefits both patients and GPs, for patients who are repeat users of our surgery it has opened other avenues or support networks. Patients feel more confident/informed in managing their conditions and therefore as a result have attended the surgery less”
Examples of reduction
in GP visits
Age of patient 52 91 81 87 50 93
GP/surgery contact 1 month prior to OT intervention 4 6 5 9 14
GP/surgery contact 1 month post OT intervention 1 7
Saving of £45
per visit
£135
£225
£360
£315
£255
Aims
Enabling people to maximise their own potential, promoting self management, preventing ill health and dependency, thus releasing professional capacity.
Reduce demand on GPs by addressing and resolving underlying functional issues that are the root cause of multiple and regular contacts with the practices.
Proactively resolve health and social issues at an early stage, minimizing crisis situations that result in inappropriate presentation/admission to residential or hospital care.
Increasing awareness amongst the practice teams of the added value of Occupational Therapy, resulting in people receiving the right service, at the right time, closer to home to achieve improved health and well-being outcomes.
Feedback from patients
100% asked strongly agreed that the service response was timely and addressed their individual needs. All reported the service should
continue and would recommend the Occupational Therapy service to another patients.
“my fear of falling has gone, and even if I fell I know what to do”
“I felt listened to, it made a real difference”
“I plan and pace my day better which means I achieve something every day”
“I now feel I can stay in my own home, I did not believe it would
be possible”
Prevention of hospital admissions
13 patients = Improved Quality Care
+ Cost savings of £12’000
How it works
Patients are referred via the GP electronic system
Referrals are triaged by the Occupational Therapist, either signposted to the appropriate service or a full Occupational Therapy assessment is completed based on the individual needs.
Whenever possible assessments are completed within the patients home.
Conclusion
The benefits seen with initial pilot project have continued with the introduction of practice based Occupational Therapy across the South Pembrokeshire cluster. It shows improved multidisciplinary working, improved patient care, reduced patient admissions, reduction in GP visits and reduction in crisis management. It is well received by patients, GPs and the Occupational Therapists report job satisfaction.
References: College of Occupational Therapists (2017) – Reducing the pressure on hospitals: a report on the value of occupational therapy in Wales page 8
GPs highlighted the benefits as
Increased ability to holistically address patient’s
needs & prevented repeat GP visits
Improved communications and feedback
Ability to provide timescale for Occupational Therapy assessment
Prevented crisis and avoided admissions
Reasons for referrals
Declining function and mobility
Recent or frequent falls
Patient or carer unable to cope
Socially isolated
Cognitive impairment .