Occupational Therapy in primary care: a lot to offer

Pressures on primary care are well documented and change is required to meet the growing need for healthcare services. The unique contribution of Occupational Therapy within primary care is that, as part of the multidisciplinary team, they can offer to help GPs streamline their workload, whilst meeting patient need.

 A qualitative evaluation shows that the impact of this leads to a reduction in:

• Secondary service referrals
• Home care need
• Medication reliance
• Falls risk
• Sickness absences/reliance on sickness benefits
• Intervention times

And an increase in:

• Equality of access to health
• Earlier intervention and prevention
• Patient engagement and compliance with treatment

A GP commented “the more we’ve seen, the broader the range of people we feel OT can benefit”.

What difference do Occupational Therapists make in Primary Care?

People who experience barriers to functioning due to mental and physical health conditions have access to streamlined support. Improved access to early intervention results in better compliance and shorter interventions. Comprehensive assessment and a focus on ‘what matters to you’ improves identification and resolution of a wide range of unmet needs. Improved access to preventative interventions and community assets facilitates self-management, builds resilience and keeps people safe.

Occupational therapists are dual trained in mental and physical health, so are well suited to deal with complex case management. Occupational formulation is key to our role in setting individualised goal which build up relationships, take on a positive approach to measurable outcomes so the person can self-manage.

One example of a patient goal is “learning better ways to express my emotions”. Other goals areas may focus on gradually working to enhance/ practise/ improve/ and/or sustain:

• Activities of daily living (ADLs)
• Health and wellbeing
• Social inclusion and community participation
• Social interaction and communication
• Job finding / retention and return, or into Education / Voluntary activity
• Work-life balance
• Personal, social and working relationships
• Healthy and enabling roles /routines
• Carer’s to maintain their own health in their caring role.

Evidence has shown the impact of occupational therapy leads to:

• Reductions in GP appointments
• Patients supported to return to work within a six-week window
• Patient reported outcomes - improvement in confidence and ability to cope

An increase in the numbers of:

• People engaging with social prescribing.
• Services and activities delivered through partnerships, with charitable and voluntary sector organisations

Improvements in:

• Response times - people supported to return to work within a 6 week window.
• Referral pathways/agreements onto other services to provide integrated, wrap around support to individuals.
• Patients reported outcomes - confidence and ability to cope.
• People with long-term conditions reviewed and support plans in place
• People offered groups sessions to manage their ongoing health needs
• People engaging with social prescribing
• Services and activities delivered through partnerships with charitable and voluntary sector organisations.

55% of patients had fewer GP appointments after Occupational Therapy intervention than before.

Cost effective:

GP time & involvement = £38 per consultation (9.22 minutes)

£150 per hour of GMS activity

£242 per hour of patient contact

Practice administration time & involvement

Occupational therapist time & involvement = £43 per working hour

Data source: 3 Sinclair A (2019) Evaluating the Occupational Therapy in Primary Care Service. NHS Lanarkshire report