1. Occupational Therapy in Work
Making the case for
Occupational Therapy in Work
Royal College of Occupational Therapists
Occupational Therapy: Improving Lives: Saving Money Demonstrating the Impact of Occupational Therapy

2. 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

3. 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

4. Policy Drivers
Policy across the different countries focuses on good quality employment as a key determinant for good health.
Despite approx 75% employment rates this figures drops for people with disabilities (32% for mental health, 46% MSK)

5. Key Messages:
Supporting people to remain in, return to or obtain work is a key focus of occupational therapy.
All occupational therapists addressing employment needs can use the Allied Health Professions Advisory Fitness for Work Report.
Occupational therapists have specialist skills in vocational rehabilitation and can work in occupational health.

6. 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?

7. 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.

8. 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.

9. improved quality of care for patients and saves GP time” GP
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
GPs estimate that approximately a third of their consultations do not requiring medical interventions and they include in this the GP Fit note and return to work advice.
In England they signed 9-10 million a year in 2016/2017. That 9-10 million unnecessary contacts, which at £36 per consultation is £360 million!
Healthy Prestatyn, another Welsh service which features in the latest mental health campaign report is an occupational therapy services that offers employment satellite groups for speedy return to work, freeing up GP time that usually deals with this.

10. 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
Could we do something similar with work? Health and Work Champions model –they are training 500 healthcare professionals in one month –over 5000 in one year.

11. 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.
Hywel Dda University Health board, Lead OT has worked closely with Mind Aberystwyth to set up events for local employers such as TESCO about employing people with mental health problems, and developing an IPS type service where the OT is the Vocational Champion and takes a consultant role. Also in the mental health reports.

12. Tools for reporting impact

13. = £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
In work its about return to work.

14. 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

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

16. 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.

17. Start your data impact form.

18. Send in service examples
to find out how

19. 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

20. 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

21. Questions

22. Thank You
@rcot.co.uk
@RCOT_Gen