Occupational Therapy in Self-management Making the case for Occupational Therapy in Self-management Royal College of Occupational Therapists Occupational Therapy: Improving Lives: Saving Money Demonstrating the Impact of Occupational Therapy

DeMand Demographics of the population is changing – Increasing complexity from co-morbidities Health and Social Care System is straining to meet demand Financial pressures – Government needs to spend the public’s money wisely – on what has proven to have impact

Challenges or Opportunities….. £1.1bn Funding gap between demand for care and monies available Bed days lost for the NHS as a result of delayed discharges 1.5m Annual cost of in-patient care for those who have no medical need to be there Of all ambulance call outs are due to falls. The single biggest cause of death from injury in the over 65s £760m 40% Are these risks….. Shortage of money, hospital closures, or are they opportunities Opportunities for a profession that perhaps has unrealised potential? RCOT saw an opportunity Is there a place for Occupational therapists to have a bigger impact? But first a question… why weren’t occupational therapists being seen as the answer to this dilemma? Why weren’t we at the forefront of everyone’s minds….of commissioners minds…. We needed to know how occupational therapists were viewed by stakeholders – those with the money and power to commission servcies

Policy Drivers Next Steps on the NHS five year forward view and personalisation. Sustainability and Transformation Plans (STPs) Care Act (2014) Social Services and well-being Act (2014) Gaun Yersel Making Life Better Not going to talk in depth about facts and figures; benefits to person – lack of dependence on system Hopefully this is clear to us Rising capacity for Health and social care vs. Falling capacity to provide. Could talk about austerity and how this agenda is being talked about. But hopefully with ageing population we could be talking about this anyway. People expecting more from service struggling to cope. Technology advancing and people taking part in this. Better information about there about what is needed to live a healthy life. What has emerged is that with increasing talk in legislation / policy about self management, self care, prevention. Better engaged with people in formulation of services. Support to carers Policy and key terms overview to provide context. THIS IS NOT AN EXHAUSTIVE LIST. NEXT STEPS ON 5 YEAR FORWARD Prevention - helping frail and older people stay healthy and independent “harnessing people power, the NHS also needs to leverage the potential of technology and innovation, enabling patients to take a more active role in their own health and care while also enabling NHS staff and their care colleagues to do their jobs - whether that is giving them instant access to patient records from wherever they are, or to remote advice from specialists. (Chapter Ten) - Make it easier for patients to access urgent care on line. - Enable 111 to resolve more problems for patients without telling them to go to A&E or their GP. - Simplify and improve the online appointment booking process for hospitals. - Make patients’ medical information available to the right clinicians wherever they are. - Increase the use of apps to help people manage their own health. That collaborates to ensure that services are designed around patients. STPs – pull together resources in local areas. Strength partnerships for person centred care ACO Talks about strengthen role of prevention and early intervention. In my local STP plan -  self care talked about  - prevention  - citizen led approach - communication and engagement. Care Act and welsh SS and wellbeing act themes Prevention Sign posting Wellbeing Gaun Yersel: Scotland Sets out what it is, key messages, why its important, examples. Set out policies Making life better: NI A Whole System Framework for Public Health 2013-2023. seeks to create the conditions for individuals and communities to take control of their own lives and move towards a vision of Northern Ireland where all people are enabled and supported in achieving their full health and wellbeing potential and to reduce inequalities in health. ALSO… A strategy to develop the capacity, impact and profile of allied health professionals in public health 2015-2018 AHP contribution across 4 domains of public health. Pick out two on bottom two Left – Health and care and public health – supported self-managament, rehab and enablement Right – health improvement – falls prevention, community development AHP into action .Talks about indviduals and populations taking control or health an wellbeing. Prevention, self-managememt approaches. Greater choice and contorl for people AHP plan scotland .Simular themes in supported self management, prevention co-production Everyday interactions New report, public health england aims to help help care pros in everyday care. NEXT A FEW KEY APPROACHES / TERMINLOGY

Key Messages: Occupational therapists support self-management by:   1. Giving advice and guidance that supports people in adopting healthy behaviours and adaptive strategies that enable participation in occupations. 2. A co-production approach that moves people from being passive recipients of health and social care services, to collaborative partners to achieve outcomes that have meaning for them. 3. Supporting people with complex needs to overcome barriers to accessing existing opportunities such as social prescribing. The Royal College of Occupational Therapists encourages members to show leadership, to ensure the profession demonstrates its value in this area and is seen as a key partner in local health and social care delivery.

How do we… influence, market and promote occupational therapy to people who are not occupational therapists? So the question…. How do we… influence, market and promote occupational therapy to people who are not occupational therapists?

Demonstrate cost effectiveness Impact for the organisation e.g. Number of bed days saved, reduction to single handed care, delay/avoidance of admissions- hospital, residential care. Impact for society e.g. Remaining or returning to work, reduction of reliance on benefits, not re-offending Impact on the individual - improving lives. The patient’s story e.g. impact on prevention and wellbeing   Impact for the organisation e.g. Number of bed days saved. Discharge from hospital or services. Delay/avoidance of admissions- hospital, residential care Reduction in number of other agencies involved Reduction in the number of care visits or numbers of staff involved in delivering care e.g. reduction in the need for double handling. Reduction in use of emergency and crisis response services e.g. Calls to 999 Impact for society Some savings may not be specifically quantifiable but still have a positive financial impact for the person or society. For example: Remaining or returning to work Reduction of reliance on benefits Not re-offending Impact on the individual - improving lives. The patient’s story e.g. impact on prevention and wellbeing Certain services are expensive but their positive impact justifies the investment e.g. services for children with complex needs. If this is the case for your service, make sure you have included evidence of the impact on prevention and wellbeing.

Overarching campaign 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 training and supervising others to be competent to deliver on aspects of traditional practice. 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 education and employment rates.

HYWEL DDA UNIVERSITY HEALTH BOARD (HDUHB), GENERAL PRACTICE Primary Care HYWEL DDA UNIVERSITY HEALTH BOARD (HDUHB), GENERAL PRACTICE Occupational therapy has reduced demand on GPs. Following occupational therapy, patients’ average number of visits in a month to see their GP have either halved or been reduced by up to 72%. “A fabulous service that I am thrilled to see has expanded, it has provided improved quality of care for patients and saves GP time” GP

2 occupational therapists supporting 9 teams across the county Limited resource- using our expertise Kent Reablement at Home Teams 2 occupational therapists supporting 9 teams across the county 83% of people seen are able to live independently at home SAVING: £3.2 million

Partnership working Fire and rescue services Overall services have Established Safe and Well Checks including: dementia, falls prevention, social isolation, home, security, housing and warmth. Overall services have Developed a referral system for occupational therapy assessment.   Integrated evaluation of fire risk into the occupational therapy assessment. Developed new roles e.g. Secondment for a Band 6 occupational therapist to NFRS Health and Social Care Services Coordinator, GMFRS Fire Safe & Well Regional Manager, London. Worked on joint delivery of fire risk and public health campaigns. Carried out joint working on complex cases including joint visits Provided role emerging placements for students.

Tools for reporting impact

= £198 = £404 £403 - £198 = £205 Demonstrating potential cost savings Estimate cost of the occupational therapist e.g. 6 hours of Band 5 occupational therapy is £33 x 6 hours = £198 2. Estimate potential alternative journey if person had not had occupational therapy e.g. not using mental health bed per day = £404 £403 - £198 = £205 Saving per person 3. Subtract cost of occupational therapy from alternative journey e.g. Demonstrating potential cost savings

Demonstrating potential cost savings Next scale this up to increase the impact. Remember the saving is £205 per person. If I do this for ten people cost savings could be: £205 x 10 = £2050 If I have 10 occupational therapists doing this, savings could be: £2050 x 10 = £20,500

What would be your service’s infographic? What data do you need to evidence this? Impact is important Tasks in the workshops

What we are asking members to do…… Share the reports with your managers, head of therapy services and senior leaders across your organisation There is a presentation in the toolkit use 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.

Start your data impact form.

Send in service examples to find out how http://cotimprovinglives.com/send-us-your-service-examples/

Key to influencing Frame your points as solutions to the challenges! Prepare your headline message Take stats and figures Be prepared to follow each point with a real life example

Occupational therapists talking about occupation-centred practice Impact of the Campaign Greater visibility of occupational therapy with politicians ,key senior health officials and public Raised RCOT profile: e.g. Increased number of speaker invites, high level strategy group invitations, media Members are engaged and want to be a part of the campaign What’s Next? 12 months on… Reducing the Pressure Mental Health Children and Young People Fire and Rescue Services Prisons And many more… Use the microsite www.rcotimprovinglives.com

Questions

Thank You paul.cooper@rcot.co.uk @RCOT_Paul