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Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
Overcoming Difficulties with Waiting List Targets
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Overcoming Difficulties with Waiting List Targets

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Presentation from the COT Specialist Section - Learning Disabilities conference 2010

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  • 1. College of Occupational Therapists Overcoming Difficulties with Waiting List Targets 23rd September 2010 Genevieve Smyth
  • 2. Introduction <ul><li>Policy background </li></ul><ul><li>Feedback from occupational therapists </li></ul><ul><li>How to influence </li></ul><ul><li>Collecting the evidence </li></ul>
  • 3. Policy Background <ul><li>Tony Blair- central part of 1997 campaign to cut waiting lists that public disliked </li></ul><ul><li>England “ The NHS Plan ” (2000) set targets </li></ul><ul><li>Wales “ Improving Health in Wales –a plan for the NHS and its partners ” (2001) set targets </li></ul><ul><li>Scotland “ Better Health, Better Care ” introduced HEAT targets (2007) </li></ul><ul><li>Northern Ireland “ Priorities for Action ” (2004) </li></ul><ul><li>Public monitoring and evaluation against targets </li></ul>
  • 4. Has it worked? <ul><li>Health Service Journal 1 st July 2010 p12-13: </li></ul><ul><li>A dramatic fall in average waiting times that benefits service users </li></ul><ul><li>Unintended perversities where clinical priorities are distorted </li></ul><ul><li>Micro management, performance management, departure of Chief Executives </li></ul><ul><li>Fragile situations that are unsustainable </li></ul><ul><li>   </li></ul>
  • 5. Views of Occupational Therapists <ul><li>OT and People with Learning Disabilities 2010 p41-42: </li></ul><ul><li>Limitations on work undertaken and role </li></ul><ul><li>Focus on quantity of referrals rather than quality </li></ul><ul><li>Long term work more difficult </li></ul><ul><li>Does not emphasise quality of life or holism </li></ul><ul><li>Derives from medical model </li></ul><ul><li>OTs do not enjoy working in this way “ people shout at you to see the next case” </li></ul>
  • 6. Where are we now? <ul><li>The right to Referral to Treatment in 18 weeks is in the NHS Constitution in England </li></ul><ul><li>Coalition Government wants to remove process driven targets </li></ul><ul><li>Still current policy in Scotland, Northern Ireland and Wales but elections next year </li></ul><ul><li>Will regulators still use targets to measure performance? </li></ul><ul><li>Financial pressures raise questions about sustainability </li></ul>
  • 7. Collecting the Evidence <ul><li>Aim – to construct a template to disseminate to members to enable collection of evidence about impact of waiting list targets on OT service provision </li></ul><ul><li>Jo Griffin, Jill Blount, Moira Scanlon, Sue Young and Ruth Jeffrey </li></ul><ul><li>Need for quantitative data </li></ul><ul><li>Analysis of current templates and audit tools –not the right data </li></ul>
  • 8. Collecting the Evidence <ul><li>Increasing numbers on caseloads </li></ul><ul><li>Only being able to deal with the referral reason </li></ul><ul><li>Type of work requested is changing </li></ul><ul><li>Increasing pressure to accept referrals </li></ul><ul><li>Decreased scope of who gets seen </li></ul><ul><li>Carrying out tasks other people could do </li></ul>
  • 9. Collecting the Evidence <ul><li>Size of caseload </li></ul><ul><li>Number of referrals received and number of discharges in set period </li></ul><ul><li>Type of referrals accepted and type not accepted </li></ul><ul><li>Who decides whether referrals accepted or not </li></ul><ul><li>What tasks are carried out that are not part of specialist OT role </li></ul><ul><li>Number and type of needs from assessment </li></ul><ul><li>Number of unmet needs at discharge </li></ul><ul><li>Reason for unmet needs </li></ul>
  • 10. Collecting the Evidence <ul><li>Pilot of data collection tool </li></ul><ul><li>Discussion time about the tool </li></ul><ul><li>Feedback about the tool </li></ul>
  • 11. Questions about the tool <ul><li>Could you complete the tool? </li></ul><ul><li>Will members be able to complete this tool? </li></ul><ul><li>Additions for question 7 “referral type”? </li></ul><ul><li>What type of tasks are not part of the OT role? </li></ul><ul><li>Any other comments about the tool? </li></ul>
  • 12. Summary <ul><li>Why waiting list targets have evolved </li></ul><ul><li>Impact of waiting list targets </li></ul><ul><li>What can we do about this </li></ul><ul><li>[email_address] </li></ul>

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