It is a crisis that threatens to cripple the NHS. Around 8,000 patients are stuck in hospital beds in England every day because of discharging delays, costing the NHS up to £900m a year. The figures, revealed early this year in an independent inquiry commissioned by the government, show one in 10 beds is taken by someone medically fit to be released.
But OTs may offer a solution. Growing numbers are assessing patients needing urgent care and supporting them to remain in their own homes in a quiet revolution that is seeing them move to the forefront of healthcare.
Evidence of the impact of this changing role is highlighted in a report published last year by the College of Occupational Therapists. It reveals how OTs in frontline services, from working with paramedics to A&E departments, are preventing the need for hospital admissions and supporting patients to live safely in their own homes.
The results are impressive. At Sheffield teaching hospitals NHS foundation trust, a new discharge-to-assess model has led to a reduction in hospital stays on an elderly ward from nine days to one. Laura Evans, integrated pathway manager and head of OT at Sheffield, says concerns about delays in the discharge of older people in the hospital prompted the setting up of the new service.
“Often people were ready to go but were waiting around for different services. Now, as soon as the doctor says they can leave, they can do so. We aim to get them home within six hours, and we work until 10pm.
“The OT does an initial triage-style assessment on the ward to see if they are ready to leave,” she says. “When they get home, they are met by OTs in an active recovery team who carry out a more detailed assessment and get any extra equipment fitted the same day.”
The scheme currently applies to patients on the respiratory and care of the elderly wards, but it is hoped to be rolled out to orthopaedics.
Another new way of working has proved successful at Ipswich hospital NHS trust, where OTs partnering with physiotherapists have piloted weekend working in the emergency and frailty assessment units and in A&E. Between October 2015 and January 2016, therapists assessed 2,448 patients across the units – with 875 patients being sent home with support, avoiding hospital admission.
Anna Robinson, senior OT emergency therapy team lead, says: “Our aim is to avoid admission to the hospital by supporting patients to return to the community safely. We have come a long way since we first trialled this. The results are fantastic.”
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