College of Occupational Therapists 2006 NIMHE National Workforce Programme NEW WAYS OF WORKING FOR OCCUPATIONAL THERAPISTS IN MENTAL HEALTH

College of Occupational Therapists 2006 NIMHE National Workforce Programme Introduction Background to New Ways of Working (NWW) Trilogy of documents Three main Implications of NWW for OT staff in mental health Examples of NWW What will your service look like in the future? Summary

College of Occupational Therapists 2006 NIMHE National Workforce Programme Background Needing to address staff dissatisfaction and burn-out Needing to address staff shortages – part of the global picture of demand exceeding supply Needing to improve the overall capacity of the mental health workforce to manage demand Changing services using a whole team approach – if one person in the team changes, this has a knock on effect

College of Occupational Therapists 2006 NIMHE National Workforce Programme Background COT involvement with all other professional groups, service users and carers through out the project which started in OTs have been represented in the AHP grouping and in their own right OTs are part of the key clinical groups in mental health along with psychiatrists, nurses, psychologists and social workers (Boardman and Parsonage 2007) Developing the COT mental health strategy “Recovering Ordinary Lives” has been part of NWW

College of Occupational Therapists 2006 NIMHE National Workforce Programme What does NWW mean for OTs? Working across boundaries whilst ensuring occupational needs are addressed (DOH 2005)

College of Occupational Therapists 2006 NIMHE National Workforce Programme Trilogy of documents all available at Interim report (August 2004) Guidance on new ways of working for psychiatrists in a multi-disciplinary and multi-agency context: National Steering Group interim report Final Report (October 2005) New ways of working for psychiatrists: Enhancing effective, person-centred services through new ways of working in multidisciplinary and multiagency contexts.Final report 'but not the end of the story‘ contains plan for OT mental health strategy Progress Report (April 2007) Mental health: New ways of working for everyone.Developing and sustaining a capable and flexible workforce contains chapter about OT

College of Occupational Therapists 2006 NIMHE National Workforce Programme First Implication of NWW for OT staff in mental health Redistribution of Responsibility New roles of Approved Mental Health Practitionner and Responsible Clinician (MHA 2007) Patient group directives for medication (COT 2005, 2006) New roles, job descriptions, training, supervision, insurance (COT 2006)

College of Occupational Therapists 2006 NIMHE National Workforce Programme Changes to Team work Changes to traditional roles New team members – pharmacists, mental health graduate, black and minority community development workers, support time recovery workers (DOH 2005) Value based practice – The Ten Essential Shared Capabilities (DOH 2005), Capabilities for Inclusive Practice (DOH 2007) Creating Capable Teams Approach (DOH 2007) Second Implication of NWW for OT staff in Mental Health

College of Occupational Therapists 2006 The Ten Essential Shared Capabilities -A Framework for the Whole of the Mental Health Workforce NIMHE National Workforce Programme Working in partnership Respecting diversity Practising ethically Challenging inequality Promoting recovery Identifying people’s need and strengths Providing service-user centred care Making a difference Promoting safety and positive risk taking Personal development and learning

College of Occupational Therapists 2006 NIMHE National Workforce Programme Addresses each of the ten capabilities (DOH 2007a) Aimed at universities, professional bodies, commissioners, strategic leads, managers, supervisors, practitioners Gives examples of how each capability can be demonstrated and evidenced Capabilities for Inclusive Practice

College of Occupational Therapists 2006 NIMHE National Workforce Programme Creating Capable Teams Approach (CCTA) CCTA is an “off the shelf”, five step approach to support teams to implement NWW (DOH 2007b) It can be delivered by an experienced facilitator Steps 1 and 5 can be undertaken in normal team meetings. Steps 2, 3 and 4 are full day facilitated workshops for the whole team The five steps are Preparation and ownership, Team function, Service user and carer needs, Creating a needs led workforce, Implementation and review.

College of Occupational Therapists 2006 NIMHE National Workforce Programme Third implication of NWW for OT staff in mental health Leadership Who are the best people to lead in clinical, professional, managerial and political arenas? OTs need to develop leadership skills –how do we do this? Consultant OT posts in mental health – 13 OT consultants known of with 8 in mental health

College of Occupational Therapists 2006 NIMHE National Workforce Programme Examples of NWW Initial assessments for mental health services being carried out by any member of the team e.g.extended roles for OTs in memory clinics OTs in primary care offering CBT interventions Increasing times, venues and types of interventions offered OTs becoming Responsible Clinicians and Approved Mental Health Practitioners

College of Occupational Therapists 2006 NIMHE National Workforce Programme Current challenges for NWW Competing demands in mental health services e.g. foundation status, financial imbalance, private finance initiatives, proposals for “polyclinics” Lack of work force planning Professional defensiveness Short term solutions e.g. locum staff Anxiety caused by organisational change

College of Occupational Therapists 2006 NIMHE National Workforce Programme The future of NWW Implementation guide due Autumn 2007 Improving Access to Psychological therapies- ongoing projects Finding a shared vision of how mental health problems should be understood STR handbook due Autumn 2007

College of Occupational Therapists 2006 NIMHE National Workforce Programme Summary Background to the NWW documents Implications: responsibility, team work, leadership 10 shared capabilities Capabilities for inclusive practice Creating Capable Teams Approach Challenges Future of NWW

College of Occupational Therapists 2006 NIMHE National Workforce Programme References Boardman J, Parsonage M (2007) Delivering the government’s mental health policies. Services, staffing and costs. London, The Sainsbury Centre for Mental Health. COT (2005) Briefing 15: Prescribing, supply and administration of medicines and OTs. London, COT. COT (2006) Briefing 14: Extended scope practice. London, COT. DOH (2005) New ways of working for psychiatrists:Enhancing effective, person-centred services through new ways of working in MDTs. London, COT. DOH (2007a) Capabilities for inclusive practice. London, DOH. DOH (2007b) Mental health; New ways of working for everyone. London, DOH.

College of Occupational Therapists 2006 What will your OT Service look like in the future? NIMHE National Workforce Programme