Occupational Therapy Services: Assessments Adaptations, and Equipment
Our report aimed to assess the current status of access to OT services and adaptations and to identify any ongoing issues or examples of best practice.
What did we do?
We identified anecdotal evidence from both patients and health professionals that suggested there were ongoing problems and delays with accessing OT and adaptations during and post-pandemic. As a result, Healthwatch Trafford began investigating people’s experiences in Trafford between November 2021 and February 2022, and published a report on this in April 2022.
We also conducted research involving our student intern from 27th June to 19th August. We attended regular meetings with community groups and key organisations within Trafford, studied previous reports, and gathered feedback.
Key findings
- We heard anecdotal evidence that suggests many issues exist around accessing OT and adaptations services. However, we found that there is little readily available physical evidence to support this.
- We found there was not much published on the topic of OT and re-ablement services in the Healthwatch report library. While there may be currently unpublished projects in progress, there was a lack of easily available work from the network to draw on for this study.
- We were able to find some general sources on OT services and re-ablement to better understand the national situation, however even these acknowledged there is a need for more qualitative study. We also noted a lack of localised analysis, which presents a gap for future study.
- We heard from community groups that there may have been issues accessing OT related services over the pandemic. However, we were not able to gather more in-depth public comment or published evidence to support this.
- We were able to speak to local commissioners about OT services and found that these can be accessed at different levels. COVID has caused challenges for the planning and delivery of services, with a mixture of funding changes, staff sickness, difficulty recruiting, and necessary adaptation during the COVID pandemic playing a part.
- Following our conversations with service commissioners we were able to conduct survey work with local GPs. This revealed the importance of OT services, the knock-on effects for patients when they cannot be accessed, and some potential areas for better understanding.
Our recommendations
Community level
We recommend that there be a wider discussion between stakeholders on meaningful sets of data related to their activities. Improved and more available local data would allow community groups to better understand the local context and build on this understanding as well. Gathering and sharing regular case studies could provide evidence for commissioners and service planners on best practice and current issues experienced by patients. For those organisations that work under contract to the Local Authority, there is an opportunity to review how data related to public experience is reported, in order to improve the quality of data and available evidence.
Commissioner and service delivery level
We suggest that issues reported around the supply chain for adaptations such as wheelchairs or home modifications be looked at in conjunction with the One Stop Resource Centre to clarify whether or not these have been resolved.
We also suggest that work be undertaken to look at reducing the waiting times for an initial OT assessment. Available evidence shows that reductions in waiting times are likely to improve long term health outcomes and prevent re-admission to hospital (see 'benefits of occupational therapy’ in the Relevant national reports and publications section).
It would be useful for us to be updated as community OT services resume. Following this report, we would like to monitor the ongoing situation in order to better signpost potential enquiries and represent local people.
A review of the referral process would be beneficial; We heard some referrals from GPs had been rejected or delayed after being received by OT services.
Healthwatch England
This project has found few published reports by the wider Healthwatch network on this topic. Local Healthwatch are in a position to improve understanding of the local situation and identify whether the situation differs across the country. In its role as a lobbying group, Healthwatch England could collate the findings and could encourage further work on the topic such as lobbying for changes at parliamentary level and with wider system leaders.
Conclusion
We started this project with a limited understanding of the issues around occupational therapy and re-ablement services in the local area. While we had conducted some research in the form of a survey, the response was limited, and we felt more could be done. The findings of this initial research did not seem to fully illuminate the experiences that had been highlighted to us earlier this year.
Following the work done by our student intern we have been able to better understand the local situation regarding occupational therapy and re-ablement services. There is an identified gap in understanding nationally, due to a lack of evidence that fits stricter academic criteria for comparison and the complexities of individual needs. Alongside there is not much published at our locality level, which led us to rely on a mixture of national reports and ‘grey’ literature as summarised in the ‘relevant national reports’ section.
We are aware there is an ongoing improvement plan for Occupation Therapy services in Trafford, details of which can be found at the following links:
- https://democratic.trafford.gov.uk/ieListDocuments.aspx?CId=131&MId=3522&Ver=4
- https://democratic.trafford.gov.uk/documents/s44078/OSRC_OT%20Assessment%20Team_Adaptations%20Scrutiny%20November%202022%20Final.pdf
We have worked with the Managing Director of Trafford Local Care Organisation and will be remaining involved in this area.
Downloads
Download the full report including statistics below. If you require this in an alternative format, please get in touch.
