Demonstrating the Value of Occupational Therapy

1. This presentation aims to help you inform colleagues about the RCOT Improving Lives, Saving Money campaign and can be used as a CPD session. • Please do adapt the presentation to suit your service. For example by including local examples. If you need further resources from RCOT e.g. if you have running a training event, please email clare.leggett@rcot.co.uk with details. • All suggestions / instructions are shown in RED

2. Demonstrating the Value of Occupational Therapy

3. The RCOT campaign Occupational Therapy – Improving Lives Saving Money is making the case for occupational therapists in key pressure points in NHS and care services: • It has four strands: • Urgent Care –the value of occupational therapy (released Nov 2015) • Reducing the pressure on hospitals (released Nov 2016) • Living not existing, putting prevention and the heart of care for older people (released July2017) • Mental Health – the value of occupational therapy (likely release May 2018)

4. Why now? • NHS and care services reaching a tipping point across the UK • People with commissioning powers under extreme pressure • Critical in this climate that occupational therapy states how it is • Improving lives and • 2. Saving money for public purse

5. Policy Drivers in England Sustainability and Transformation Plans (STPs) • Submitted in June to be actioned in the autumn • 44 STP footprints • Combined health and social care approach to meet local population needs. • Shift to place based systems approach. • Combine resources, create alliances and partnerships - relationship centred delivery of care. • Move away from competition as driver for care.

6. Policy Drivers in Wales The Social Services and Well-being (Wales) Act • Duty to promote wellbeing and take a preventative approach • People have control over what support they need, making decisions about their care and support • Carers have an equal right to assessment for support. • Easy access to information and advice • Stronger powers to safeguard people • Local authorities and health boards work together in new statutory partnerships to drive integration, innovation and service change

7. Policy Drivers in Scotland Public Bodies (Joint Working) (Scotland) Act 2014 • Live from 1st April 2016 • Are integrated from the point of view of service-users • Take account of the particular needs of different service-users within the local population and their participation in the community. • Respects the rights and dignity of service-users • Protects and improves the safety of service-users • Are planned and led locally in a way which is engaged with the community and makes the best use of the available facilities, people and other resources • Best anticipates needs and prevents them arising • 9 National Health and Wellbeing Outcomes to drive quality improvement across health and social care.

8. Policy Drivers in Northern Ireland • Quality 2020(Nov 2011) A 10 year strategy to protect and improve quality in health and social care Northern Ireland Safe and Effective • Transforming Your Care (Dec 2011) A Review of H&SC in Northern Ireland • Personalisation, independence and integration • Making Life Better – A Whole System Framework for Public Health 2013-2023 Prevention and tackling inequalities • Systems, Not Structures, (2016) Changing Health & Social Care Expert Panel Report ‘Accountable Care Systems’ to integrate, Triple Aim Objective (population health, experience of care and per capita cost) • Health & Wellbeing 2026 (2016) Delivering Together

9. Northern Ireland (continued)12 key principles of Transforming Your Care • Individual at centre • Evidenced based services • Right care right place right time • Population- based planning of services • Prevention focus and tackling inequalitites • Integrated care • Promoting independence and personalisation of care • Safeguarding most vulnerable • Ensuring sustainability of service provision • Realising value for money • Maximising use of technology • Incentivising innovation at a local level

10. 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.

11. Reducing the pressure on hospitals: A report on the value of occupational therapy (Nov 16) Living not existing: putting prevention at the heart of care for older people (July 17) Versions published for each of the four nations and available at: http://cotimprovinglives.com/value-of-occupational-therapy/

12. Reducing the pressure on hospitals: A report on the value of occupational therapy - November 2016 launch events in all four country parliaments

13. Reducing the pressure on hospitals: A report on the value of occupational therapy • Great media coverage • Positively received from RCOT members • Extensive distribution of the report • Follow up work with stakeholders – meetings with NHS England, speaking opportunities at the Kings Fund and the Public Policy Exchange

14. Significant outcomes Sevennew services working with Ambulance Trusts since publication. Lancashire Care Trust featured in the report and was shown on BBC Breakfast – this raised the profile of the service and showed the impact occupational therapy has made 78% of people who received an innovative joint assessment between a paramedic and an occupational therapist were able to remain at home

15. Significant outcomes Chris Moulton, Vice President, Royal College of Emergency Medicine, and Consultant in Emergency Medicine at Royal Bolton Hospital stated at an event at the Public Policy Exchange that he supported the deployment of occupational therapists in every Accident and Emergency department.

16. What the report says: key recommendations The reports call for six key recommendations to put occupational therapy on the frontline in hospitals and emergency services:

17. England

18. Northern Ireland

19. Scotland

20. Wales KEY RECOMMENDATIONS

21. 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

22. 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

23. 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.

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

25. 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 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 Action must be taken to address demand and relieve pressure on A&Es…… occupational therapists have ta key role to play in reducing pressures on primary care services alongside improving the overall quality of care that patients receive. I work in a unit with front door occupational therapy seven days per week and am acutely aware of the benefits to the system that it 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

26. Living not existing: putting prevention at the heart of care for older peoplePublication 13 July 2017 Briefing meeting at the Shard kicked off with a national debate how to deliver on prevention with key stakeholders Launch

27. Fred’s story • The report is supported by a film for the public and stakeholders and has been produced to show the difference occupational therapy can make.Available on You Tube https://youtu.be/8S7P0ON9w1A or downloaded from: http://mbf.me/Xp8e0M • The reports are being promoted to the media and to stakeholders. • There has been an extensive social media campaign

28. Fred’s story – rationale behind the film Its important that…. So the aim was….. The audience for the film is the GENERAL PUBLIC - our research shows that the understanding of what occupational therapy is and the value it adds to the health and care system is VERY LIMITED – so it’s a basic introduction. having watched the film people can understand how occupational therapy led services can help people to live life their way and not simply support them to exist we know FROM FEEDBACK THAT THE FILM SUCCEEDS IN DOING THIS. • to create a engaging film that left viewers with • a POSITIVE overall impression of occupational therapy, • our CAMPAIGN MESSAGES around living not existing • Anything more would be too much to achieve in a limited timeframe from a low level of knowledge The research shows that the most effective way to tell the profession’s story is to show the BENEFITS of intervention rather than the METHODS and PROCESSES used in practice - so that why it doesn’t show occupational therapy in action.

29. Fred’s story – rationale behind the film • Film considerations! • Walking frame too low so the actor fits in the frame! • Using a kettle tipper because its very visual • In summary • Its an introduction • Shows the difference between Living and not just Existing • There are clear links to further information including the causes of Fred’s difficulties and the outcomes following occupational therapy (these are shown on the next two slides) • No uniform • Because many occupational therapists don’t wear uniforms and they are different in different settings and countries. • The use of the College’s s branding, the voiceover and the context in which the film is set clearly suggests that the person depicted is an occupational therapist

32. Extensive media coverage • Television • Radio • Newspapers • All four countries

33. Living not Existing - Messages • Deploying more of the occupational therapy workforce in primary care to use our skills to intervene early • Occupational therapists are a limited resource. We can be more effective in addressing the needs of the local population by trainingandsupervisingothers to be competent to deliver on aspects of traditional practice – minor adaptations, practising skills in activities of daily living.  e.g. Trusted Assessors, Health & Work Champions • We need to support developing wider partnerships for further innovation. Occupational therapists can act as catalysts for addressing needs beyond traditional health and social care, such as poor housing and social isolation.

34. The next four slides are the specific recommendations please use the one for your country

35. Living not Existing: recommendations for England

36. Living not Existing: recommendations for Northern Ireland

37. Living not Existing: recommendations for Scotland

38. Living not Existing: recommendations for Wales Please choose the Welsh or English one and resize

39. We have chosen some data impact examples on the following slides. You can add local examples or other relevant report examples if this will be helpful. All the examples are in the reports if you need further detail

40. Demonstrating the value of occupational therapy The reports showed the following… Flint County Council Occupational therapists have enabled an average of three people a year to move from residential care to a suitable home. SAVING: £123,781.32

41. Demonstrating the value of occupational therapy Kent Reablement at Home Teams Nine teams across the country 83% of people seen are able to live independently at home SAVING: £3.2 million

42. Demonstrating the value of occupational therapy The Bridgeway Service: An occupational therapy and reablement programme enabled Mr Evans to stay at home and keep active in his community.. SAVING: £34,620 annually

46. What the College is doing • Sending reports to stakeholders • Meeting with stakeholders • Speaking at conferences and exhibitions • Promoting via social media and other avenues

47. Howcan you spread the word? • Share the reports with your managers, head of therapy services and senior leaders across your organisationThere is a presentation in the toolkit to help you do this. You can adapt it to your local service - for example by using a local example to demonstrate how occupational therapy improves lives and saves money. • Promote the report to your parliamentary representative There are template letters in the toolkit that you can use.

48. How can you spread the word? • Inform the communications team where you work so that they can include it on their website, email newsletters and social media channels • Get involved in the campaign by signing up to our microsite www.cotimprovinglives.com and using the hashtag #ValueofOT

49. How can you spread the word? • Send in service examplesto find out how http://cotimprovinglives.com/tell-your-story SUGGESTION – at this point have a discussion about a possible example you could develop and send

50. Group discussion • Who can I talk to? • Who is within my sphere of influence? SUGGESTION – at this point have a discussion about which service managers / commissioners might be helpful to approach, are there any new initiatives for services that have a place for occupational therapy, how can you get involved. Are there any regular meetings where you could present the ideas from the report - see the next few slides for some ideas