1. Cost Improvements: What goes? What stays? Strengthening the OT Role in the Current Climate Background In the current health care climate driven by key performance indicators, cost improvements and competitive commissioning of services, OTs are being challenged to do more with less. Clinical experience suggests focus on ‘throughput’ combined with resource cuts challenges our holistic, person-centred, occupational focus. Methods A literature review of the OT role and specialist skills informed a survey of qualified stroke care pathway OTs. Common themes were identified from survey results and literature. Solutions were found in the literature. Common themes The OT Role within stroke:  Complex and diverse in nature  Can be ill-defined  Differences between OT’s as to their unique contribution  Can be confused and misunderstood by others  OT’s lack of perceived status in relation to other professions in MDT  Generic working reduces time available for OT to be OT’s  Positive engagement in 'multi-skilling' while preserving the uniqueness of OT can be beneficial for the service, patient and clinicians  Joint sessions with other Therapies promote clinical effectiveness What does your day look like? Additional themes from survey  Current political climate poses significant challenges to OT role  Pathway discrepancies regarding perceived amount of time spent on OT specific tasks (10-90% of day) Purpose An exploration of OT roles and uniqueness in the current climate, identifying key issues, challenges and solutions using the stroke care pathway as an example. References:  BOOTH, J., HEWISTON, H., (2002). Role Overlap between Occupational Therapy and Physiotherapy during in-patient Stroke Rehabilitation: an Exploratory Study Journal of Interprofessional Care 16(1), 31-40  CLARK, F., (2010). Power and Confidence in Professions: Lessons for Occupational Therapy Canadian Journal of Occupational Therapy 77(5), 265-269  NANCARROW, S., (2004). Dynamic Role Boundaries in Intermediate Care Services. Journal of Interprofessional care 18, 141-151  MURRAY, C., LAWRY, J., (2011). Maintenance of Professional Currency: Perceptions of occupational Therapist. Australian Occupational Therapy Journal 58, 261-269  PARKINSON,, S., (2009)..The Balance of Occupation-focused and Generic tasks within mental Health and Learning Disability Occupational therapy Service. British Journal of Occupational Therapy 72(8), 366-370  WIT, L., (2006). Stroke Rehabilitation in Europe. What Do Physiotherapists and Occupational Therapists Actually Do? Journal of the American Heart Foundation 36 1483-1489 Solutions 1. Cultivate an internal and external confidence in the OT role as essential for patients 2. Pro-active promotion of the OT role at every level 3. Sustained focus on Occupation and patient focused interventions 4. 'Keep current' in a complex, changing health care environment 5. Develop clear definitions of OT role 6. Continuous, active engagement in research and evidence base with clear links to practice 7. Robust evaluation of interventions, however complex, capturing quality E.g.  Supervision  DADL and PADL Ax and Rx  Home assessments  Cognitive Ax and Rx  Perception Ax and Rx  Driving Ax/information E.g.  Admin tasks e.g. faxing referrals, filing, completion of home care documentation  Stair assessments  Medication management assessment  Generic assessments Julia Clifford 1 Jennifer Read 2 1 Sheffield Health and Social Care NHS Foundation Trust, 2 Sheffield Teaching Hospitals NHS Foundation Trust and The University of Sheffield Impact of unclear role:  Underutilization of OT’s skills as misunderstood  Reduced morale Sheffield Health and Social Care NHS Foundation Trust Contact details: Julia Clifford 0114 2261766 Juliaclifford@nhs.net How do you strengthen your OT Role?