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Occupational therapy can help support independent living

A multidisciplinary approach to healthcare is key to reducing pressure on hospitals and occupational therapists have a vital role to play.


When the NHS was founded in 1948, 48% of people in the UK died before the age of 65. In 2016, that figure was just 12%. By 2020, seven million of England's over-60s are likely to be living with two or more long-term conditions.

This represents a massive challenge for health and social care, which is why there has been so much discussion in recent years about developing new models of care to reduce pressure on frontline services. At the heart of the strategy is an age-old, but nonetheless relevant, catchphrase: prevention is better than cure.

In 2016, a report by the independent Commission on Improving Urgent Care for Older People highlighted the importance of preventative practice in a more integrated health and social care system: "A focus on wellbeing and, often, community support can help avoid an older person being admitted to hospital and preserve their independence in day-to-day living".

There's one group of allied health professionals whose contribution is going to be hugely valuable in helping reduce the burden of an ageing population on health and social care services: occupational therapists. Working alongside doctors, nurses and physiotherapists, OTs can provide essential advice and support to help older people live independently, reducing admissions to hospitals and care homes.

The Royal College of Occupational Therapists (RCOT) has published its own report on the value of occupational therapy in reducing pressure on hospitals. "Shifting towards integrated care pathway delivery models that focus on maintaining or regaining an individual’s independence is not a new concept for occupational therapists," says the report. "Occupational therapists work across, and within, health and social care and understand the importance of this interplay in preventing readmission or repeat crises – as such, occupational therapists must be considered as an integral part of the solution."

In September, the National Institute for Health and Care Excellence (NICE) issued a new guideline for health and social care staff, advising them on how to support people to be independent following a hospital stay or when daily life at home becomes a challenge.

"Providing high-quality intermediate care has the potential to ease the pressures facing the NHS and social care sector," commented Dee Christie, an occupational therapist who chaired the guideline committee. "Better support for people and their families to recover fully and regain independence will mean they can quickly return home and stay out of hospital or avoid hospital admission altogether."

The figures speak for themselves. For example, the average cost of a fall leading to a hip fracture can be more than 100 times the cost of installing a simple home adaptation such as hand and grab rails. Falls are the single biggest reason for emergency hospital admissions for older people, accounting for 40% of ambulance call-outs. They're also a key factor in older people moving into long-term care because they no longer feel they can cope at home.

"Occupational therapists are unique in that they are trained to work within both health and social care settings, and across mental and physical health," wrote RCOT CEO Julia Scott in her foreword to the Reducing Pressure on Hospitals report. "This knowledge enables them to navigate care and support systems efficiently, liaise appropriately, and work effectively in multidisciplinary settings; they are the key workforce when it comes to reducing hospital-related pressures."

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