College of OT presentation for OTs by Genevieve Smyth. Conference in Feb. 2014

1. Making your voice heard

2. 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

3. 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?

4. 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

5. 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.

6. 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

7. 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

8. 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

9. 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.

10. 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

11. 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

12. Social care reform
Care 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

13. How are we going to influence, promote and
market occupational therapy?

14. 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.

15. 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

16. What are you currently doing to influence
and
promote your service?
One action you can take forward / the next
step?
What can you do?

17. 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

18. 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
professional.enquiries@cot.co.uk
• 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

19. 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.
Louise.Cusack@cot.co.uk

20. 4 countries
12 BAOT regions
100 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
Beriah.Nelson@cot.co.uk

22. 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...

23. The Professional Affairs Officers:
• Genevieve Smyth- Mental Health and People with
Learning Disabilities.
genevieve.smyth@cot.co.uk
• Amy Edwards- Long Term Conditions
amy.edwards@cot.co.uk
• Karin Tancock – Older People
karin.tancock@cot.co.uk