Occupational therapy assessment clinic in Fife
Development of the occupational therapy clinic
Increasing rates of referrals, people waiting for treatment, travel time, staff vacancies were just a few of the triggers to lead staff in the older adult mental health occupational therapy service in Fife to say:
“We are not having people waiting 4-5 months for an occupational therapy assessment”
We were also acutely aware that waiting months for an assessment was resulting in people with a cognitive impairment/dementia having deteriorated over this time, increase in stress and anxiety on carers and families as well as not having accessed other services and supports that they could have been receiving. This was not a positive outcome for people living with dementia, their families or the occupational therapy staff.
We considered a number of solutions to this issue, but all of them had an adverse effect on other parts of the service. So in a room covered in “post it’s” with various ideas and suggestions plastered across the walls – the Cognitive and Functional assessment clinic was born.
The solution, simple really, we invited people to the occupational therapy service to undertake functional occupation focussed assessments which were:
Claudia Allen Screening tool: This cognitive assessment tool measures global cognitive processing capacities, learning potential, and performance abilities.
Occupational Self-Assessment (OSA): The OSA is a tool that facilitates client-centred therapy and reflects the uniqueness of each person’s values and needs. The OSA self-report and planning forms assist the client in establishing priorities for change and identifying goals for occupational therapy.
We had 3 members of staff for each clinic, 2 occupational therapists and 1 member of clinical support staff. The occupational therapists carried out the standardised assessments and the clinical support member of staff carried out the OSA.
We carried out a pilot of the clinic with the grateful assistance of some volunteer service users and identified that each assessment took 30 minutes to complete. Therefore, the full assessment process took 1.5 hours. We received positive feedback from the people who we worked with during the pilot stage who were comfortable attending an occupational therapy clinic within the hospital or seeing more than one therapist which had been an initial concern for us.
“An Occupational Therapy Clinic” 7 things you need to know
- We treated more people in a day, offering 3 appointments at one time over 4 sessions from 9:30am-11am, 11:30am-1pm, 1:30pm-3:00pm and 3:30pm-5:00pm.
- We reduced the length of time people were waiting to be seen by an occupational therapist to a month.
- We utilised the skills of our occupational therapy staff more effectively.
- We had the opportunity to assess people quicker allowing us the chance to signpost to services that people thought would be helpful, make referrals to other agencies more timely or engage the person in occupational therapy sooner if required.
- We linked people to the post diagnostic support service in Fife if they were not already receiving support from them.
- We worked with carers. We invited carers to attend the occupational therapy clinic if they wished and a member of staff was available to speak with them, to offer support, advice or information which all carers who attended found very useful.
- It is an award winning service which we highlight in the section on “what’s next”
This service was a “win win” for all concerned. The Occupational Therapy assessment clinics are now running across Fife in the Mental Health Occupational Therapy service as standard clinical practice.
We are currently planning to pilot an extended AHP assessment clinic that will include physiotherapy, mobility and falls assessments, with the hope that this prevents unnecessary falls and identifies people who will benefit from targeted intervention earlier.
NHS Fife Occupational Therapy Cognitive and Functional Assessment clinic was recognised at the Advancing Healthcare Awards in London in 2015. Winning the category for maximising resources for success, sponsored by the Department of Health, Social Services and Public Safety, Northern Ireland Award and we are going to be sharing the experience of developing the clinic at the AHP national conference in November this year as we have been invited to do a presentation and workshop session for delegates.
“There was excellent evidence of service user involvement and leadership skills were very evident in bringing the team along the change process.”
As a service, we feel very strongly that it is important that as AHP’s we constantly challenge how we work and strive to make our services more efficient, relevant and accessible to the benefit of carers and service users: the challenge for us all continues and we are always developing the occupational therapy services in Fife to be innovative, more patient centred, effective and delivered to a high quality. The assessment clinic is just one example of innovation and creative thinking which has been successful for all.
Thank you for reading my blog post and I would welcome any comments
- I would also invite to share, if you are an allied health professional, what have you done do enable people living with dementia to directly access your service.
- If you are living with dementia or a family member, what service from an allied health professional would you like access to?
You can read more about this work on pages 27-28 in the Alzheimer Scotland publication http://www.knowledge.scot.nhs.uk/media/CLT/ResourceUploads/4052050/02295%20AHP%20report%20on%20post-diagnostic%20support.pdf
For more information on the Chamberlain Dunn awards 2015, follow this link http://www.chamberlaindunn.com/AHA/documents/AHAAwards2015Compendium.pdf
I am proud to also share a picture of my family supporting everyone ‘Talking About Dementia’ – Lynn
Occupational Therapy Professional Manager
I work in NHS Fife Mental Health Occupational Therapy Service where I manage the adult and older adult service across 3 clinical hubs. I have been an Occupational Therapist for 20 years and spent most of that time working older adult mental health services so am passionate about improving services for people with dementia and their families, hence the development of the assessment clinic.
Dr Norma Clark
AHP Clinical Services Manager and Lead OT
I work in NHS Fife Mental Health Occupational Therapy service as the Lead OT. I am also an AHP Clinical Services manager within Fife Mental Health Service. I am always thinking of creative an innovative ways to improve the quality and efficiency of services for people with mental health problems in Fife and together with Lynn, came up with the idea of the cognitive and functional assessment clinic.