Integrated Occupational Therapy

1. Understanding Integrated
Occupational Therapy
My role as Occupational Therapist within the Promoting
Independent Living Service (Worcestershire, England)
Shelley Faulkner
Webinar

2. This presentation will….
 Describe my clinical background and current role
 Provide clarity of difference between OT & TA adaptations
 Discuss our team & wider MDT
 Give opportunity for questions relating to integrated OT
 Provide you with resources to broaden your understanding
 Summarise key learning & lead on to next presentation

3. Firstly, definitions & acronyms
Acronyms used in this presentation:
 ADLs – Activities of daily living
 Ax – Assessment
 COT – Community Occupational
Therapy/Therapist
 CRW – Care and Repair,
Worcestershire
 HIA – Home Improvement Agency
 MDT – Multi-disciplinary team
 OT – Occupational Therapist /
Therapy
information
of
Every
piece
helps.
What does integrated mean?
• Combining or coordinating separate elements so as to
provide a harmonious, interrelated, integral,
coordinated whole.
• Organised or structured so that constituent units
function cooperatively.
• With two or more things combined in order to become
more effective
Please use the
‘comments’ box for any
queries.
 PILS – Promoting Independent
Living Service
 QEHKL – Queen Elizabeth Hospital,
King’s Lynn
 SCI – Spinal Cord Injury
 SMART goals – Specific,
Measurable, Achievable, Realistic
& Timely
 TA – Trusted Assessor
 WHaC – Worcestershire Health and
Care NHS Trust

4. A bit about me….
How I got here
 SCI 2013
 Patient to Practitioner
 UWE BSc OT 2014-17
 QEHKL rotations 2017-18
 WHaC 2018-20
 PILS – Ongoing
 The OT Hub
 Back Up Trust
and where I am
 The PILS was previously CRW
 COT ‘Housing OT’, was not an
integrated role
 This way of working & caseload
 Impact of COVID-19
 Evolution of the role

5. How my role integrates within Worcestershire PILS
 Commissioned service provision
 Being a spokesperson
 Supervising trusted assessor work
 Providing guidance for team
 Liaison with community teams
 Minor & major adaptations
 Hospital discharge assistance
 Triaging direct referrals
 Updating public information
 ‘Translating’ for the team
 Signposting
Occupational
Therapist
Trusted/Focussed
Assessor
Assessment of
need
Assessment of
need
Understanding of
complex issues
Limitation to
‘routine’
adaptations
Knowledge &
clinical reasoning
into practice
Refers more
complex to HIA OT
or COT
Able to support TA Able to complete
Casework
Liaison with
Caseworker
Liaison with OT
Clarity of OT & TA remit ….

6. What interventions are
integral to my role?
In a nutshell
 “interventions aimed at removing
environmental barriers and accessibility
problems” (Chiatti and Iwarsson, 2014)
 Major adaptations, including private works
 Housing options & re-housing
 Minor adaptations
 Provision of equipment
 Signposting & referring to external agencies
_________________________________
Prioritisation of need, inc.
 Hospital discharge
 Admission avoidance
 Falls prevention
 Homelessness
 Self-neglect
Major adaptations
Minor adaptations
Equipment provision
Referring/Signposting
Housing options
A rough idea
of time spent
on
interventions
big
other
small

7. Team working & system navigation
 Casemanager – major adaptations and case documents
 Millflow – minor adaptations and supporting documents
 Carenotes – the local NHS system
 Elms – ICES equipment ordering
_____________________________________________________________________
 Being a lone clinician
 Addressing “the need for an integrated inter-agency approach to meeting disabled
people's housing needs.” (Nocon and Pleace, 1997)
 “Shared language” among OTs
 Multi-professional team working
 Time management
 Circle of control & remit of role

8. Resources & Signposting
 Client centred care
 Enabling and empowering
 Sharing relevant information
 Identifying a need and addressing it
 Working within a community
 SMART goals being met

9. To summarise….
 My integrated role engages communication to provide
suitable interventions in a timely manner
 The benefits of integrated working have shown in 6
months, in spite of COVID-19
 There has been “better coordination of the delivery
of adaptations and improvement of working practice
between the disparate professionals involved.”
(Grisbrooke and Scott, 2009)
 Shared knowledge of colleagues from different
professions and fields of work
 Clearer communication, better understanding and
more effective outcomes for clients
 OTs have an understanding of:
ADLs, occupational performance and deprivation,
meaningfulness, the social and medical models of
disability, health and social care systems and the
ability to assess holistically
Client centred
care, health &
social care
liaison
Time saving,
efficient, cost
effective
Knowledge,
value &
holistic case
handling
added
Shared
systems, data
awareness &
protection
For a client, this means that holistic
needs are being met, when they have
previously been missed.

10. Thank-you for your time today, enjoy the
following presentations
Any comments or questions?
Shelley Faulkner
Occupational Therapist, Millbrook Healthcare
Worcestershire Promoting Independent Living Service
Email: shelley.faulkner@millbrookhealthcare.co.uk
Tel: 07788 496730

11. Referencing & further reading
 Chiatti, C. and Iwarsson, S., 2014. Evaluation of housing adaptation
interventions: integrating the economic perspective into occupational therapy
practice. Scandinavian Journal of Occupational Therapy, 21(5), pp.323-333.
 Grisbrooke, J. and Scott, S., 2009. Moving into Housing: Experiences of
Developing Specialist Occupational Therapy Posts in Local Authority Housing
Departments. British Journal of Occupational Therapy, 72(1), pp.29-36.
 Nocon, A. and Pleace, N., 1997. ‘Until Disabled People Get Consulted …’: The
Role of Occupational Therapy in Meeting Housing Needs. British Journal of
Occupational Therapy, 60(3), pp.115-122.
 The Occupational Therapy Hub: https://www.theothub.com/
 Shelley’s story: Becoming an occupational therapist | Back Up, 2017.
https://www.backuptrust.org.uk/blog/new-beginnings/shelleys-story-
becoming-occupational-therapist
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