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College of OT presentation for OTs by Genevieve Smyth. Conference in Feb. 2014
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Making your voice heard
Road Show Programme
• Economic and demographic challenges• Proposed Government solutions • Promoting and marketing OT• Group exercise - what’s in your control?
- how to influence/promote/market• Getting your voice heard – how COT influences
decisions and supports you
Economic and demographic challenges
• Global recession• NHS release of £20 billion efficiency savings by 2015 – a
fifth of the NHS budget
• Local authority reduced funding up to 30%• Increased tension and scrutiny in funding decisions• Impact of demographics –aging
population (over 65s will increase by
50% in next 20 years), 2nd highest
obesity rates in the world• How do we ensure health and social
care are sustainable in the future?
Government solutions
• Health promotion including tackling social determinants of health and addressing health inequalities
• Increase productivity (QIPP) and professionalism
• Giving power to the clinicians to decide in commissioning
• Increased role of competition and markets
• Encourage innovation
• Increased role of technology
• Focus on outcomes rather than process
• Social care reform and reablement
Health promotion and public health
• Improving people’s ability to take care of their own health –encouraging healthy lifestyles and behaviours in particular diet, exercise, alcohol intake, smoking.
• OT role in targeted interventions for those who are currently well (e.g. NICE PH 16 OT for well elderly), those at risk of developing health problems and those with advanced health problems.
• Tacking the social determinants of health and health inequalities – despite access to health and social care life expectancy between communities in the UK is different. The challenge is to make our services more accessible for groups with poor health outcomes.
Productivity and professionalism
• QIPP – Quality, improvement, productivity and prevention. Good examples –the AHP Service Improvement Programme –common features of service redesign, AHP QIPP toolkits www.improvement.nhs.uk
...but not at any cost!
• Falling standards of care at Mid Staffordshire NHS Foundation Trust (also Winterbourne View) –blame placed on Trust Board and professionally regulated staff – a need to return to our HCPC and BAOT standards and ethics. QCQ will develop fundamental standards of care, new Chief Inspector s of hospital and social care
Giving power to the clinicians to decide
• Clinical Commissioning Groups will commission the
majority of secondary healthcare -mainly consist of GPs, nurse, hospital doctor and mandate to consult with AHPs
• Great freedom about how and what they commission• Currently 212 CCGs with 80% of NHS money• Health and Well Being Boards in Local Authority bring
health and social care together, drive for
integration, Joint Strategic Needs
Assessment
Increased role of competition and markets
Commissioners are expected to break monopoly provision of health and social care unless there is a special reason to retain it. Markets are more responsive and will Increase choice and personalisation .
• “Competition for the market” –competitive tendering for services where episodes of care are not well defined and outcomes difficult to measure e.g neuro rehab
• “Competition in the market” – using Any Qualified Provider where episodes of care are well defined and outcomes easily monitored. Quality based competition with fixed price e.g. wheelchairs www.supply2health.nhs.uk/AQPResourceCentre
Innovation
“Simply doing more of what we have always done is no longer an option. We need to do things differently. We need to radically transform the way we deliver services. Innovation is the way –the only way- we can meet these challenges. Innovation must become core business for the NHS” Sir David Nicholson 2011
Example – AHP Advisory Fitness for Work Report
launched this year, AHPs can reduce
sickness absence –we need to trial this!
Available on COT website.
Technology
Increased role of technology to improve productivity and bridge the gap between resources and demand:
• Telecare, telehealth, telerehabilitation• New devices, sensors, screens• Social media and internet sites which rate care• In April 2012, there were 13 600 health related
apps available• Health care delivery transcending local and
national boundaries
Focus on outcomes
Three national outcomes frameworks - NHS Outcomes Framework, Public Health Outcomes Framework,
Adult Social Care Outcomes Framework. •Examples – health related QoL for people with long term conditions (EQ-5D), admissions to residential and nursing homes, falls in over 65s.•How do we evidence the intended and unintended outcomes of our interventions? Standardised OMs, generic tools –need for more quantitative data especially about cost effectiveness
Social care reformCare Bill 2013
• Reform of care and support which focuses on the need to prevent and reduce care needs
• Introduces a national eligibility threshold for care and support.
• A cap on the costs that people will have to pay for care (Cap at £72,000 from 2016)
• Universal deferred payment scheme (people will not have to sell their home in their lifetime to pay
for residential care. )
• Impact on OT equipment and adaptation• Focus on reablement
How are we going to influence, promote and market occupational therapy?
Influencing/promoting/marketing
• Building knowledge, awareness and understanding. Be ahead of the game.
• Develop networks. Find useful allies in order to collaborate, engage, share best practice. Create opportunities, get involved.
• Know your outcomes so you can demonstrate quality, value, cost effectiveness. Use standardised outcome measures to collate larger data sets.
• Provide information which is accurate and timely for commissioners, GPs and service users. Use service user outcomes, results of audits, what people say about your service.
Group Exercise
• Write within the circle the aspects of your role that you feel are within your control.
• Record outside of the circle the aspects of your role that are outside of your control.
Outside of my
control
Within my control
Within my control
What are you currently doing to influence and
promote your service?
One action you can take forward / the next
step?
What can you do?
COT- influencing decisions
• Representation and networking• Political influencing, consultation responses• Media influencing • Promotion and marketing- 10 High Impacts of
Occupational Therapy• Films for commissioners, leaflets• NICE involvement- e.g. NICE Public health Guidance 16• Position Statements• Best Practice Guidelines
How COT is supporting you
• Unison membership• BJOT, OTN, website, social media • Conferences and study events• Library and research services• Enquiry service 0207 450 2330 [email protected]• Briefings, Hot Topics, SPEaR• UK OT Research Foundation• Support for CPD and HCPC audit• Supporting OTs in the economic down turn – resource pack To join: www.cot.co.uk/join-baot/join-baot £22.32 a month -25% reduction in first year
Specialist Sections are groups of Occupational Therapists and support staff with a common
practice interest. They are known as a Specialist Section, a Branch of the College
of Occupational Therapists.
4 countries12 BAOT regions100 BAOT local
groups
Scottish Northern and Eastern
Scottish Western
Northern Ireland
Northern and Yorkshire
Wales
South West
South East
London
Eastern
TrentNorth West
West Midlands
UK BAOT Regional Groups [email protected]
What can you do?
• Improving quality and efficiency with an OT focus– Responsive, accessible, flexible services based on the person’s needs
– ‘Joined up’ care pathways
– Self management Information
– Care closer to home, admission avoidance Provision
– Equipment and assistive technology
– Personal budgets
– Support for Carers
• Focus on outcomes- Outcomes Frameworks, competency driven
• Understand basis for commissioning decisions• Look at the ‘bigger picture’ e.g. prevention & health promotion
• Be aware of your skills and how to communicate them to others...
The Professional Affairs Officers:
• Genevieve Smyth- Mental Health and People with Learning Disabilities.
• Amy Edwards- Long Term Conditions
• Karin Tancock – Older People
