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Reablement. Is it under-valued?

Occupational therapists and physiotherapists both play key roles in reablement services, which can not only relieve pressure on hospitals and GPs, but also deliver huge savings in social care costs.

"Occupational therapists are central to reablement services." It's obvious when you think about it. However, the key role that reablement plays in healthcare, and the important contribution of OTs, is often overlooked, as was highlighted in a recent Guardian article by Julia Skelton, Director of Professional Operations at the College of Occupational Therapists.

It's not just the important rehabilitation therapy that OTs provide directly to patients. It's also the unique skills and knowledge they can draw on to train support workers and carers. In turn they can help patients learn or relearn the skills necessary for daily living, so that they hopefully become more independent quicker and need less ongoing care. A 2011 report by the Social Care Institute for Excellence (reviewed in 2014) said, "Among reablement users, 60% savings have been demonstrated in the cost of subsequent social care provision."

Physiotherapists are also unsung heroes of reablement teams. What's more, according to Paul Burstow, Chair of the Liberal Democrat health backbench committee, their vital skills, as well as those of OTs, are underused by the NHS. "We have workforce pressures on GPs and on other parts of the system," he said at the Westminster Health Forum conference held last month. "The areas where we don't have workforce pressures, or nowhere near as much, are in terms of physios, occupational therapists and pharmacists. All three of those have a contribution to make which is under-recognised in primary care."

The College of Occupational Therapists believes that OTs are an essential part of the skill mix required to make reablement services successful. As evidence, they quote a survey by the National Institute for Health Research School for Social Care Research, which says that, once discharged from reablement services, "50–90% of older people (depending on the LA concerned) needed less or no support than when they initially contacted the service".

Wales seems to be leading the way in making the case for more reablement services. The Welsh Reablement Alliance is an umbrella organisation whose members include the College of Occupational Therapists and the Chartered Institute of Physiotherapy. They've called for a stronger framework for the delivery of reablement services, providing 'coherent and equitable access across Wales'.

Despite its relatively low profile, there seems to be little doubt that reablement improves outcomes for patients and cuts costs. So it's hard to see why it wouldn't get the attention, and funding, it deserves from government and Clinical Commissioning Groups. As Julia Skelton puts it, "It is time to critically evaluate what reablement currently achieves and unlock the untapped potential to achieve more."

Are you an occupational therapist or physiotherapist who works on a reablement team? Share your thoughts in the comment box below.

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