Eileen Dickinson, Deputy Director for Social Inclusion/Head of Occupational Therapy. Subject: Occupational Therapy Workforce Strategy 2009/2014

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1 From: To: Eileen Dickinson, Deputy Director for Social Inclusion/Head of Occupational Therapy Trust Board Date: 22 nd October 2009 Subject: Occupational Therapy Workforce Strategy 2009/ Purpose of the Report 1.1 The purpose of this report is to present the five year Occupational Therapy Strategy to the Board which is in keeping with the Trust's Workforce Strategy and its business objectives. 1.2 A paper on the review of Occupational Therapy was discussed and approved at the May Trust Board. 2.0 Executive Summary 2.1 The Occupational Therapy Strategy has been informed by the College of Occupational Therapists' document "Recovering Ordinary Lives: The Strategy for Occupational Therapy in mental health services " (COT 2006) and the Trust's 5-Year business plan. 2.2 The national strategy calls upon Occupational Therapists to assert the value of occupation as a means to improve mental health and well being and as a bridge to social inclusion. 2.3 The strategy focuses on workforce development, promotion of social inclusion including employment, clinical effectiveness, partnership working and involvement of users and carers. 3.0 The Occupational Therapy Strategic Context 3.1 Occupational Therapists use their specialist knowledge of occupation to assess clients' readiness for, and to facilitate participation in, work, leisure and self care activities. 3.2 Occupational Therapists have a key role to play in raising awareness of the importance of everyday occupations which have value and meaning for service users and enable them to lead lives of their own choosing. 1

2 4.0 Occupational Therapy Workforce Development 4.1 Staffing levels throughout the Trust are adequate with the exception of Specialist Services. Discussions are being held with the Service Director regarding expansion into the areas of community Child and Adolescent Mental Health and Addictions Services. 4.2 Vacancies rates are low. Recruitment into posts is done in a timely and imaginative fashion. The service aims to improve on this further by a more co-ordinated approach to recruitment across the boroughs. We aim to ensure a vacancy rate of less than 5% in keeping with other clinical vacancy objectives. 4.3 The development of staff at all bands is an ongoing priority and is done through supervision and a variety of continuous professional development activities. Currently six support staff are being supported to attend Occupational Therapy training on a part time basis. Development will be further enhanced through the introduction of the Model of Human Occupation from Autumn The model is based on the premise that occupational participation in the areas of work, recreation and daily living tasks is a central force in creating and maintaining health and well being. Important concepts contained within the model are those of values, interests, habits and routines which determine a person s motivation to engage in occupations. 4.4 Involvement of service users in recruitment, training and appraisal of staff is weak and needs to be strengthened using a systematic approach. This is a priority for the next twelve months. 4.5 Job planning for all bands has begun based on a two week data collection period. Further work will be undertaken by the Head of Occupational Therapy and Occupational Therapy leads over the coming months to agree realistic job plans in line with other professions. 4.6 Some Occupational Therapy staff are working outside of the traditional hours and roles. This needs to be further built upon to provide a more client centred approach to therapy. 4.7 The service is committed to the education of Occupational Therapy trainees and has a good track record in the provision of student placements. The service needs to introduce a consistent approach to the induction, training and evaluation of students as well as providing placements in non-traditional settings. This will be achieved through the establishment of a fieldwork educators group. 5.0 Promotion of Social Inclusion and Employment 5.1 Evidence of some socially inclusive practice exists but the service needs to critically examine the full range of interventions that are offered, paying particular attention to ensure that the timing, location and type of activities available facilitates social inclusion and recovery, from in-patients through to community based service users. 5.2 Evening and weekend social and recreational activities need to be provided on in-patient 2

3 wards and a plan for increasing the involvement of community groups and volunteers was approved at the August Service Delivery Board. Occupational Therapists will contribute to the implementation of this plan. 5.3 All community services offered need to be outwardly focused and inclusive, with strong links with mainstream providers in education, leisure and community participation. The aim should be for service users to have the same opportunities to participate in their communities as any other citizen. 5.4 The Trust has made significant investment in service user employment through the funding of employment specialists. Occupational Therapists need to work in close partnership with employment specialists to ensure that they prepare service users for employment through a programme of capacity building and that employment specialists focus on job brokerage and employer engagement. 6.0 Clinical Effectiveness 6.1 Clinical effectiveness forms an important part of the work and is implemented in a variety of ways such as through clinical improvement groups. The terms of reference for these groups needs to be revised and updated. 6.2 Evaluation of the effectiveness of interventions will be supported through the Model of Human Occupation and the introduction of Occupational Therapy care pathways. This will take place over the next 1-2 years. 6.3 Audit activity is poorly developed and will be a key part of Band 7s work in the future, along with dissemination of relevant research findings. 6.4 There is a lack of confidence among staff in promoting and publishing their work. This needs to be urgently addressed so that the reputation of Occupational Therapy within East London NHS Foundation Trust is recognised externally. 7.0 Partnership Working 7.1 As Occupational Therapists are frequently the interface between health services and the community they need to develop close working partnerships with a range of external agencies in a number of different sectors (e.g. employment, education, leisure) as well as partnership working within the Trust. Occupational Therapists will explore joint working wherever possible and seek to work across boundaries. 8.0 Action Plan 8.1 The action plan sets down how the Occupational Therapy Strategy will be achieved. 3

4 Topic Action Lead Timeframe 1. Workforce development Provide Occupational Therapy to Specialist Services Service Director/ Promote social inclusion and employment 3. Clinical effectiveness 4.Partnership working Co-ordinate recruitment across the Trust Introduce the model of Human occupation Job plans agreed with all bands Extend out of hours working Modernise student placements Increase community engagement for both in-patients and community patients Implement out of hours initiative Complement the work of employment specialists Review clinical effectiveness groups Increase audit and research activity Promote and publish work Develop internal and external partnerships Fieldwork coordinators Senior employment leads/employment leads Chairs of groups/head of OT March July 2009 August 2010 December 2011 March 2010 August 2009 December Equalities 9.1 The work of Occupational Therapists impacts directly on social inclusion and the consequent areas of diversity and equality. This continues to be addressed by the service. 4

5 10.0 Financial Implications 10.1 Funding for the recommendations contained within this report can be contained within existing resources Risk 11.1 No risks associated with this report have been identified Conclusions 12.1 This paper outlines the five year Strategy for Occupational Therapy staff which focuses on promoting social inclusion and recovery through a skilled and motivated workforce Action being requested 13.1 The Board is asked to RECEIVE and APPROVE the strategy. 5

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