A new report from the Royal College of Occupational Therapists, (RCOT), has identified three key factors to enable personalised care:
- Focusing on a person’s strengths and balancing choice and risk
- Enabling people to take part in daily activities that are important to them
- Ensuring people stay connected to family, friends and communities
1 – The current approach to health and social care focuses on what people can’t or shouldn’t do – often for fear of aggravating or exacerbating existing conditions and placing further burden on services for treatment. Effective personalised care embraces risk taking so people focus on what they need and would like to be doing.
2 – A ‘can do’ culture enables people with health conditions to feel productive and valuable both to themselves and the community.
3 – When people can’t or shouldn’t do things, they end up isolated, lonely and disconnected from family, friends and the community. Social connections are vital for a person’s wellbeing and enabling participation in the daily activities that are important to them often facilitates social connections. With around 50% of disabled people and 1.2 million people reporting being ‘chronically lonely’, there is a vast need to support wellbeing through social connections.
Julia Scott, Chief Executive of RCOT, says: “Personalised care is about placing what matters to the individual at the heart of their health and social care. For occupational therapists, personalised care is about focusing on people’s strengths and enabling individuals to carry out the activities they need and want to do in their lives. It is intrinsic to our profession and always has been. We would urge health and social care leaders, commissioners and managers to look to their occupational therapy workforce to enable personalised care across their services.”
Alan, a service user from the Gateshead Foundation Trust who had respiratory problems and received occupational therapy intervention through the Respiratory Service to enable him to manage his condition, says: “What they (the service) have achieved, I think is absolutely fantastic. It is a help to the community, especially with people in our situation with COPD. I think it’s fantastic. Now I am controlling the situation, I’ve got a better way of managing what this situation is, I am taking control now.”
Caroline Speirs, head of the organisation Think Local Act Personal (TLAP) says: “TLAP welcomes this timely report from the Royal College of Occupational Therapists. Using occupational therapists wisely as a key component in the workforce to deliver personalised care will make a real difference. The breadth of their impact can be considerable from leading the training of other health and care staff, to advising on guidance and support services as well as working one to one with people with complex conditions. The Royal College has clearly stated how to make personalisation a reality and the focus on people’s strengths, balancing choice and risk is a keystone to personalised care to enable people to do what they need and want to do.”
Anna Severwright and Nigel Mathers, co-chairs of C4CC, said:
“The Coalition for Collaborative Care warmly welcomes this timely guide to the role of Occupational Therapy in the delivery of personalised care and support. The guide is full of practical examples and people's stories from both lived experience and clinicians perspectives, and we look forward to it being shared widely.”
Further information
In compiling the report, RCOT called for service example evidence from its 33,000 members – here are two of the examples from the report.
Example A – Respiratory Service, Gateshead NHS Foundation Trust
In 2016, the Pulmonary Rehabilitation Team at Gateshead won the AbbVie’s inaugural Sustainable Healthcare ‘Patients as Partners’ award for supporting individuals to take control of their care. The six-week programme, run by an occupational therapist, provides tools and strategies to support people to maintain the activities which are meaningful to them. This team has given people across Gateshead with respiratory conditions (such as chronic obstructive pulmonary disease and asthma) the confidence to lead their own recovery. In a review of the service following a year from discharge, 75% of people have been able to maintain their exercise levels and control their breathlessness. This has resulted in fewer GP appointments andhospital admissions and a reduction in medication.
Example B – Thom’s story
Thom has autism and finds language and comprehension difficult. He is an avid runner, and following contact his parents made with his local running club, they were signposted to an occupational therapist involved in Parkrun. Parkrun offered a perfect opportunity to work on Thom’s social skills, as well as being part of a community activity that had meaning for him. Through one-to-one coaching sessions with the occupational therapist, Thom became familiar with the environment, learnt skills for personal interactions to build relationships, as well as how to manage personal care and transport.
As a result of Thom’s increased confidence and new skills, he is now a member of a gym. Thom also won the junior trophy at the Wedding Day Race in Bushy Park in August 2017.
Thom’s occupational therapist said: “The therapeutic process of Parkrun has meant that Thom has no choice but to communicate and interact all the time, which has built up his independence and confidence.”
Thom has missed only a handful of Parkruns over the past couple of years, and he ran his 100th Parkrun on Christmas morning 2017.