Occupational therapy in acute and emergency care
18 March, 2025
The role of an acute occupational therapist at Warwick Hospital has evolved to enhance the assessment and discharge processes for patients.
Traditionally, foundational assessments focused on discharge planning and identifying specific patient needs. However, with the increase in patient referrals and complexity, these assessments have been streamlined to prevent delays and support efficient patient care.
The occupational therapy team, comprising 13 qualified staff, two assistants, and one apprentice, operates across 15 wards and units, addressing various specialties such as A&E, frailty, and respiratory care. Working seven days a week, they collaborate closely with physiotherapists and the multidisciplinary team to provide timely assessments for equipment and care needs.
Challenges arise from staffing gaps, national shortages, and the demand for a seven-day service. To address these, the team has adopted flexible working patterns and encouraged voluntary bank shifts, though this may lead to staff burnout and affect work-life balance.
During the COVID-19 pandemic, NHS policies shifted towards a 'Home First' approach for discharges, removing the need for extensive functional assessments in acute settings. While this posed challenges and blurred professional boundaries, it highlighted the essential role of occupational therapy in the discharge process.
Challenges
Acute occupational therapists face difficulties in meeting high public expectations amidst an ageing population and complex social circumstances. The reduction of functional assessments has impacted morale, as therapists felt they weren’t using their core skills.
National bed pressures and increased patient flow across wards have also disrupted continuity of care, making communication vital for effective discharge planning.
Onward and upward
To provide optimal occupational therapy services, the team has streamlined functional assessments and site visits, focusing on efficient discharges aligned with NHS England's 'Why not home? Why not today?' Campaign.
Occupational therapists now play a leading role in discharging patients to appropriate pathways, such as the Community Response Team and Reablement services.
With improved communication tools and daily patient flow meetings, the team facilitates timely discharges and utilises the trust’s volunteer service for essential equipment delivery. Emphasising the importance of home-based assessments, the team has adapted to challenges and showcased a patient-focused approach.
Regular wellbeing initiatives and newsletters help staff manage work-related pressures. Despite the challenges, working in an acute setting offers rewarding experiences and opportunities for continuous learning. The team encourages occupational therapists to consider careers in acute care, highlighting the diverse skills developed through this dynamic environment.
Key takeaways
- Acute occupational therapy roles are evolving – streamlined assessments enhance discharge processes and patient care.
- Collaboration is crucial – working closely with multidisciplinary teams improves service delivery and patient outcomes.
- Flexibility in staffing is necessary – adapting working patterns helps manage challenges but can impact staff wellbeing.
- Home First approach shapes practice – policies promote timely discharges and reduce the need for extensive functional assessments.
- Continuous learning is key – the acute care setting offers valuable opportunities for professional growth and skill development.
This is a summary of an article first published in OTnews, in September 2023. Read it in full on our OTnews page
Reference: Lediard C and Ansell J (2023) Right here, right now..., OTnews, 31(9): 32-35.
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