How Can Occupational Therapy Help Reduce the NHS’s Bed Capacity Problem?
“Occupational therapy services are part of the immediate solution to help facilitate patients through their care pathways and reduce the growing pressure on the NHS. We can make an immediate, critical impact as long as our services are integrated into the admissions avoidance and discharge process as early as possible.”
Nikki Thompson, Founder at The OT Practice
With the NHS still feeling the legacy effects of the pandemic, now exacerbated by the effects of winter pressures, a challenging workforce landscape, and an unprecedented backlog in hospital bed occupancy, utilising private sector providers is imperative.
Collaboration between the private sector and the NHS is a well-trodden path, and Covid-19 demonstrated how successful this relationship can be to deliver efficient, cost effective, timely and positive service and patient outcomes. Further development and utilisation of these successful partnerships can now be applied to reduce the burden on NHS resources, delivering flexible support through the patient journey, from admission through to discharge.
The key challenges the NHS faces have been well documented in the press and can begin at the critical stage an ambulance is needed. The latest mean average response time for an ambulance for category 1 cases (time critical/life threatening) is 15 mins vs the NHS target of 7 minutes. Then, there are issues once the ambulance reaches A&E. In December, a quarter of patients had to wait more than 60 minutes to be admitted to A&E, with just 68.9 per cent of people being seen within four hours - the target is 95 per cent.*
Once within the NHS system, if hospital admittance is needed the next challenge occurs due to limited bed capacity:
a) There are too few NHS hospital beds. The UK has below the average number of hospital beds relative to its population, compared to OECD EU Nations.**
b) This limited suite of beds has a high bed occupancy rate. Since 2010, average bed occupancy has consistently surpassed 85%, the level generally considered to be the point beyond which patient safety and efficiency are at risk***
One of the reasons bed capacity is so high is because of delays in discharging patients who are medically stable and no longer require a hospital bed, however, do still require a level of social care intervention or just more time to recover before being discharged home. This has caused a bed backlog of 13,000 (out of the 100,000 potential NHS beds available) where patients are remaining in hospital either until the required social input is available, or they have recuperated and /or rehabilitated enough to allow them to return home independently.
The Health Secretary, Steve Barclay, has this week announced that the government is making £250m of additional funding available to purchase additional beds in community care settings such as care hotels and care homes. An excellent step in reducing the mounting pressure although important that occupational therapy is fully integrated into the community bed pathways to prevent these becoming blocked also.
Combined with the above there are also more immediate and effective, solutions available through the effective utilisation of the skills of occupational therapists.
Occupational therapy services can:
• Provide early assessments and interventions by working with frontline and A&E services to reduce unnecessary hospital admissions.
• Ensuring OT is involved as early as possible following hospital admission to plan for discharge so that once a patient is medically optimised the scaffolding around their discharge is already in place and there are no avoidable delays in acute beds being vacated.
• Rehabilitation or maintenance programmes within step down/reablement beds or home first/reablement community teams to support patients reaching their optimal level of functional independence with the view to the care package needed being as low as possible or resolving the requirement for one all together.
• Home adaptations and equipment provision to maximise peoples independence and safety in their homes to avoid the risk of falls and inevitable chain of events that follow that require ambulance and NHS/social care resource.
• Adopting preventative measures such as ensuring homes are adequately prepared with minor aids and equipment post-discharge to prevent the likelihood of readmission.
• The utilisation of single-handed care packages to ensure spare domiciliary care capacity is appropriately used where most needed.
• Work as part of a community-based and virtual multi-disciplinary care team so patients can receive the care they need at home.
With the number of hospital admissions rising a major challenge for healthcare providers and local authorities is finding and managing resources to accommodate patients who could be managed outside of a hospital setting; and at a time where there is a shortage of NHS occupational therapists, private occupational therapy services are a critical, immediately available resource.
Accelerating the use of private OT services will help reduce long term dependency on the health and social care system, and by working to maximising a patients’ independence and their ability to conduct daily activities, freeing up valuable beds.
Nikki Thompson, founder of The OT Practice said:
“As occupational therapists, we are passionately committed to providing effective interventions that help patients regain their functional ability and a standard of independent daily living, enabling them to transition back into their communities as quickly as possible.
But occupational therapists can also play a much more integrated role in providing support to the NHS, Local Authorities, and care hotels in helping to tackle the current health and social care crisis.
Through early assessment of a patient’s domestic needs and providing access to necessary equipment we can help with patients being able to leave hospitals as soon as safely possible, with access to the care and equipment they need to return home safely. Unlocking the potential of our professional occupational therapy services early in the process is one of the ways we can help reduce the pressure on NHS beds.
Occupational therapist and the utilisation of the capacity within the independent OT community will play a vital part in the multi faced initiatives needed to improve the current patient outcomes. A widespread alliance between the public and private sectors has never been more essential. Together, we can keep up with the escalating challenges our trusted and much respected NHS is facing."
For more information on out how integrating The OT Practice's services to support your organisations immediate OT capacity needs please contact Laura Tilling, Client Relationship Manager at enquiries@theotpractice.com or 0330 024 9910.
*source: https://inews.co.uk/opinion/rishi-sunak-nhs-recovery-plan-work-compromises-strikes-2017818
**source: https://www.oecd-ilibrary.org/sites/518727bb-en/index.html?itemId=/content/component/518727bb-en
*** source: https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis
