An opportunity arose to develop a service looking at the role that Occupational Therapist in keeping the Frail Elderly well.
Utilising the evidence and good practice developments from a number of sources – I developed the OTs in primary care service specification and a business case to get this service piloted.
I believe good practice should be shared and the evidence that I used for the business case are highlighted below.
The RCOT recommendations that their needs to be input of OTs in primary care. ” Living Not Existing: Putting prevention at the heart of care for older people in England.A case study highlighting a pilot where they are using an OT in a GP Practice and a press release
Research from abroad on the benefits of OTs in primary care - The integration of occupational therapy into primary care: a multiple case study design
The pilot is intending to build on the learning of existing prevention / proactive care service being provided by the Frailty Clinics in PCH 1 in Wolverhampton.
It will test the use of an OT to lead this type of proactive care.
This will be an upstream intervention which is lacking at the moment as all the services being commissioned are focusing on the 2-5% patient cohort that could be admitted to Hospital (Admission Avoidance services) or are frequent attendees of hospital based services.
The OT will identify fall risks and do general assessment of health / Social Care / Housing / Adaptation needs / Mental Health issues.
The OT will review the holistic needs of the patient include goals in being more mobile and regain confidence to engage in community activities / hobbies. This will help to reduce isolation of the Frail Elderly population within primary care which is known to have multiple health and social care benefits.
The main focus of the service will be proactive care and the referrals could come from any of the following neighbourhood team’s services in the selected area for the pilot.
• Patients identified as risk of falls by the falls service
• West Midlands fire service.
• GPs within the identified locality.
• Referrals from the monthly health and social care MDT.,
• Housing services.
• Mental Health services.
• Care Navigators
• Social Prescribers.