For an upcoming uni task, I have had to create a leaflet based on how, as an OT, I could market myself to GPs through assessing for return to work and "fit notes".
Having completed a module on Vocational Rehabilitation (VR) two years ago, and writing an Extended Research Proposal about cognitive VR Assessments I felt that I was pretty clued up about OT and VR. I had never had to research the specifics of the assessments though and was very shocked with what I found. Between 2008 and 2011 Incapacity Benefit was replaced by Employment and Support Allowance (ESA) and the process of claiming ESA involves completing a questionnaire and then possibly being called for a medical assessment. For my assignment I chose to focus on the role of the OT completing this Work Capability Assessment (WCA).
There is a copy of the questionnaire on the DirectGov website and the general aim is to discover how the claimant's illness/disability affects their abilities. It is broken down into several sections, including mobility, manual dexterity, concentration, communication and anxiety. The inclusion of both physical and mental capabilities suggests that the person who wrote this questionnaire has experience in both areas, like an OT. The questions are all graded, for example "Can you move around and use steps without difficulty? / Can you walk 50 metres without needing to stop? / Can you walk 200 metres without needing to stop?", I'd say that they look like they have been written by an OT.
The information provided on the medical assessments states that an interview will be carried out to discuss any previous employment, brief medical history, domestic situation, how the illness/disability affects performance in everyday tasks and an outline of a typical daily routine. This sounds like a good basis for an OT Initial Interview to me. The medical assessment may also contain a physical assessment which looks at ability to perform certain physical movements, functional anatomy anyone?
So imagine my surprise when I see on the Atos Healthcare website (who conduct the WCA assessments) that they employ Doctors, Nurses and Physiotherapists. But NO Occupational Therapists.
The College of Occupational Therapists have published information about how OTs can help GPs meet their NHS Priorities, one of which is to support patients back into work through WCA and Fit Notes, but it does not seem like this information has got through to the wider world of health and social care.
I actually found the leaflet a struggle to produce, as it appeared to me that it was just common sense to have an OT complete the WCA. OTs are trained to analyse activity breaking it down into both physical and cognitive demands and adapt the environment or occupation to allow for independence.
I really hope that this is going to change soon, because it just doesn't make sense to me!
Useful links:
DirectGov website : http://www.direct.gov.uk/en/MoneyTaxAndBenefits/BenefitsTaxCreditsAndOtherSupport/Illorinjured/DG_171894
Atos Healthcare website : http://www.atoshealthcare.com/index.php?option=com_content&task=view&id=126&Itemid=425
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