Client Centred Working

This afternoon I went to visit a local brain injury service that I would have been going to on placement if it were not for some circumstances.

I found it very interesting, and not only because I'm a bit of a Neuro Geek, the service seemed to represent everything that we are taught about in uni. One of the biggest things we are taught from day one is that OT is client centred and I'm not saying that it is anyone's fault but unfortunately some services are not always as client centred as they could be. In a busy hospital setting the need for client centred-ness is often overlooked by the medical model and the need to clear beds. Of OT's that I know working in this setting, they really do try their best to make their practice as good as it can be for the clients but it just isn't always practical.

I don't want to sound pessimistic but I'd like to think I'm being realistic in my opinion of the differences between theoretical OT and practical OT. There are so many examples of fantastic individuals who really champion the cause of OT and the need to be client centred, and I am very grateful to be able to engage with some of these people through social media, such as twitter. However there is still a lot that needs to be done to ensure that in bigger agencies, the disability model is just as recognised as the medical model.

Whilst we as OTs are a small(ish) minority of health and social care, we have loud and passionate voices and we need to ensure that they are heard, especially with the changes to the NHS happening quickly around us!

:)

The Role of an OT as a Benefit Claims Assessor

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



Visit from COT Student Officer

At my university we have a student-led regional BAOT group that organises monthly events and talks. Although I am not part of the committee for this, I am a regular attendee and many of my friends are involved in the committee.

Several months ago I noticed via twitter that Fiona Fraser (COT Student Officer) was beginning a tour of universities and so I invited her to present as part of our student group. This very event happened during the week and it gave me lots to think about.

Firstly I learnt that this event was a bit of a first. It was the first presentation that Fiona had been a part of that had been organised through twitter. This lead onto a pre-event discussion about how personally and professionally we are moving into a technological age where more and more networking is done on line. I can (and have) go on for hours about the benefits of social media for our profession as a whole, and for an individuals' continuing professional development, so I'll save that for another time ... if you're really interested there is an older post that touches on the subject.

Fiona's presentation was entitled "Developing your toolkit:  Constructing a career that enhances the profession and helps you fulfil your potential" she included a brief overview of several topics including BAOT/COT; Specialist Sections; CPD; Job prospects and Personal Development. Fiona provided many tips for students in all years, and the few practitioners that were in attendance.

The biggest thing that I will take away from this event is that CPD can be fun! In university, CPD has always appeared as a heavy chain that hangs around your neck from the moment you qualify. It is something that requires extensive time to attend conferences and write up reflections. There is a cost to attending these conferences which often appears completely impossible on a student loan budget (!)

However, Fiona presented a different side. A picture of CPD being about what you come across on a daily basis that makes you think, even just for a second, about being an OT.

• That news article where no-body reported that the individual had seen an OT, even though you know they must have ...
• That film that dealt with a mental health issue, or included a character with a physical disability ...
• The person you spoke to on the bus this morning who had never heard of OT ...

I know that each persons' CPD is theirs to make their own and that is why mine contains a lot about my contribution to social media, and a lot of my CPD can be found online, through this blog and my twitter account, but it was refreshing to hear these being encouraged. 

The final message that I will take with me from the event was nicely summed up in the badges we received as we left and a quote from the presentation "there is no such thing as an overly enthusiastic or too geeky OT"

Such a busy few weeks ...

Hi Everyone :)

I'm sorry for neglecting this blog recently but I've had a very busy few weeks!

The dissertation was (finally) handed in on Thursday, and we went straight to the pub to celebrate! I am proud of the work I've done, and would like to think at at some point in the future I'll actually get the opportunity to discover just how "Occuaptional Therapists assess the return to work potential of individuals following traumatic brain injury"!

Plans have also been made for my next module at uni, using activity analysis techniques to evaluate the use of live interactive music concerts for those with dementia in care homes. I'll keep you all up to date with the progress after Christmas!

Whilst most of the busy-ness in my life has come from uni work, unfortunately my Nanna also passed away a couple of weeks ago, which gave me the opportunity to make the motorway my new best friend travelling between home and uni. As sad as this was, I would really like to take this opportunity to publically thank the healthcare staff involved; the commnity COPD nurses, the staff in A&E, and finally the ward staff who were so fantastic for those few days. My family flocked from around the country, and we are not a small family, but the staff on the ward were welcoming and never made us feel like we were intruding or in the way. The medical staff were so willing to talk to us, explaining procedures and the nursing staff included us in all situations. It was also touching to see how many of the staff were visibly upset when we left the hospital for the final time. I have taken these experiences as a personal best practice situation that I will always remember when I am qualified.

So, despite the sad circumstances, I have so many thank you's for the staff on Ward 2C of Whiston Hospital that I know are shared by all my family and our friends.

x

OTs in non-OT Jobs

Sparked from a twitter discussion last night ...

As a soon-to-be-qualified OT, I've recently started taking more of an interest in the jobs on offer. More and more Band 5 OT jobs are now asking for post-graduate experience in certain areas. Given that this post-graduate experience is difficult to find when no-one will offer you a job in the first place it is not surprising to see an increasing amount of qualified OTs in non-OT roles. Last night I learnt that this is also affecting other professions, such as social work. This issue was reflected in a recent uni task, where we had to find a job not advertised as an OT, but one where we felt we could use our OT skills. Whilst there were many jobs put there, such as "rehabilitation officers" and "vocational advisors" that specified a desirable degree in OT, there is a lot of opinion surrounding this topic and it lead to a bit of a discussion.

The main themes that came out of a quick chat on twitter last night were:

It distracts from our unique skills base. We (and I'm speaking from experience) put a hell of a lot of effort into getting a degree in OT and this should be recognised with a protected title.

In a way it is good, as it allows OT skills to be spread to more people in need of our services, and we will be educating more people about OT who may have previously not heard of us.

However, OTs often struggle to identify a professional identity and definition as it is, and by moving away from the title of Occupational Therapist this may confuse us, and our service users, even more!

Ultimately though, it is becoming a necessity. If I want a job when I graduate where I can use my knowledge and skill base that I have built up over the last three years, then I am going to have to look further than the traditional roles and protected titles.


This topic is in line to be discussed further in a future #OTalk, so I may be able to update you with more experiences and opinions then.

Many thanks to @Clissa89 , @OT_Expert and @Ermintrude2 for the original twitter discussion :)

OT Week Celebrations

Happy OT Week everyone :)

Hope you've had a great week sharing the vision of OT and generally spreading the word of such a fantastic professional (yeah ... so I might be a little biased).

Unfortunately, I have to say that my OT Week has not been spectacularly different. I had great plans, some were lived out, others weren't, but I've really enjoyed hearing what others have been up too.

One of my main plans was to increase OT awareness in the setting where I work as a support worker. I had plans with the OT there to create a noticeboard promoting the profession and to hold some sessions to further explain the role of OT in the particular setting. As with all good intentions, things didn't quite go to plan though. Workmen never installed the noticeboard we were planning to use, and a sickness bug knocked down staff and clients alike to leave us too short staffed to run sessions :( but the plans and resources are still there to be completed another time on another day, and hopefully it will only be the dates on the OT Week pens that don't match up!

However, Tuesday came around and presented us (on twitter) with #OTuesday in #OTweek featuring #OTalk, which was guaranteed to cheer me up! This weeks topic was how to use SM for CPD and provoked some interesting discussions. So here is my experience and opinion ...

I first began using social media (SM) professionally after rediscovering my twitter account, and a slow Saturday afternoon searching by interest. I began tweeting about my experiences as an OT student; lectures I'd just been too, articles I had just read, and calls for help with assignments! I then started my blog when I struggled to fit everything I had to say into 140 characters! My main outputs of SM are on twitter, participating formally in OTuesday, NHSSM and more recently, OTalk and OChat. I also use twitter for informal discussions with OT students from other universities, practicing OTs and academics (a personal highlight was a tweet from E Duncan!).

I get a lot of benefits from my use of SM, the main one being the opportunity to communicate with so many other people, each with their own interesting stories and viewpoints on current issues. It allows exposure to a wider range of opinions - and with NHSSM, not just from OT perspectives - which breeds constructive debates. Another benefit of using SM is the speed at which information in shared. Previously we talked of how journals bypassed text books in getting information out there, now with SM your news, findings, thoughts and experiences are spread to a waiting audience instantly! I also find SM is a nice fall back for those days when the work can get too much, as a gentle reminder of why OT is so fantastic, why we do it, and mostly importantly why we love it!

The role of OT with people with Eating Disorders

Hey :)

It's been a while since I updated this, I've been mad busy over the last few weeks. It's my own fault, I need to learn to say no to opportunties (!).

Anyway, since it's been a while I thought I'd start with a (relatively) easy post. A few weeks ago I went to a SHOUT event. SHOUT is a student led regional BAOT group and I would highly recommend checking them out on twitter and facebook! This month's event was entitled "The role of Occupational Therapy with People with Eating Disorders". I will confess that I had never shown any particular interest in ED before, but I was pleasantly surprised at how engaged I got in discussions.

One thing that I never knew before the event was that ED are classed as a Mental Health Condition. I knew about the background of mental health disorders to ED, resulting in the need for control, but had not thought about how they were classified. This put ED in a very different light for me. I have always maintained that I am more of a mental health OT, and suddenly ED was on my radar.

Whilst my local area has very good service provisions for those suffering from ED, there is still a lack of OT input into their therapeutic programmes and deliveries. One of the speakers had spent a role emerging placement with the ED team and she presented her experience. Many of the situations she came across and the methods used to deal with these were "bread and butter OT". There was nothing spectacularly different about helping people with ED. The emphasis was simply put on being there for them, listening to them and supporting them to change their life. Surely this sums up all OT interventions?

The talk certainly challenged many of my ideas and preconceptions about ED, both from a personal and professional level. It made me realise that our inherent OT skills ARE transferable and they should be used in so many more situations. It does not take a team of researchers to realise there is a role for OT, nor does it take an academic to implement changes. These are grass roots plans that can be put into action by any qualified or student OT.