The third element of the triumvirate which makes up the collective experience of OT Services is specialist suppliers who provide the equipment necessary to support independent living. These are some of their observations on working with Occupational Therapists.
Here are links to the companion articles:
The Arcane Workings of the Occupational Therapy Service a user’s experience
Integration of Occupational Therapy Services the professional body’s response
Relationships are definitely key, though I’m a true believer in ‘horses for courses’ and what might influence or works for one person, will not necessarily influence the next. From our perspective, we focus on providing OTs with clear and relevant product information in order to facilitate a more informed decision. Backed up by our sales team, we provide product demonstrations and assist the OT with patient evaluations in order to help prescribe the best solution possible for the client. We understand and appreciate that OTs have increasingly busy workloads which is why we try to work in partnership with them. After all, we share the collective goal of making everyday life easier for the client.
The problem is the same for us as for users, when we speak to the OTs themselves. Different areas of the country work totally differently. Some Social Services OTs will assess for and deal with beds for example, whereas some areas don’t, and always refer to Health for funding etc. Also some equipment comes from health or social services budgets and some comes from the Continuing Care budget. There doesn’t seem to be a uniform way of purchasing equipment.
We have good communications with Occupational Therapists. Overwhelmingly, they contact us because of technical queries about our products, and we find them to be very helpful. Often, OTs are not familiar with our products, so we refer them to the website and product demo movie, where they can find all the specifications, and see what kind of problems our bidet toilet seat can help with. We have a good response from OTs, and work with over 80 local authorities around the country. We sometimes do joint visits to a client with the OT, but don’t have the resources to do this all the time, so we are trying to get the product set up in Disabled Living Centres, where OTs can take their clients to try it out for themselves.
A Question and Answer session with Nigel Reaney
IL. What would you say is the worst aspect of your dealings with OT services?
NR. Services can be very patchy. I deal mostly with equipment for children and adults with learning disabilities, and occupational therapists are not always well-informed about what is available. I’m not sure whether this is due to a lack of systems in place to disseminate information, or whether they are expected to manage such large caseloads, that there isn’t time to keep themselves properly up-to-date.
IL. How about funding for equipment?
NR. Well, I’m not sure that OTs always join up the dots in the right way here – it is, after all, just as important to get the funding sorted out, as identifying the right equipment. So understanding and knowing how to access the possible options for funding is another part of the expertise they need. Sometimes, an OT will produce a comprehensive list of all the equipment a family could do with – but there is no possibility at all of getting it funded. This means delays and disappointment for the service user, whereas, if they had focused on one or two essential items instead – perhaps, an extra strong bed for a child who regularly breaks their “normal” bed – that would be achievable, and rather more quickly. The parents are happy, because a serious problem has been sorted out, and they then feel more able to manage other areas of their lives.
IL. Is there a problem for you, over working with either social care or health care occupational therapists?
NR. Interestingly, we are seeing more joint projects, which is a very good sign. You need to have a mechanism for ensuring that information about people flows smoothly from the NHS to social services, and in the reverse direction as well, because it would be naive to assume that once a client leaves a hospital, for example, they will not have contact with NHS services again in the future.
IL. One issue that keeps coming up amongst our site visitors, is a loss of specialisation – perhaps there are too many generalists, and not enough practitioners with in-depth expertise in a particular area?
NR. Yes, I think that is an increasing problem. There are certain issues – for example, postural problems – that require specialist intervention. Unless they are directed to an OT with a good understanding of their needs, their situation may be made worse. There are certain broadbrush decisions that can be taken at the point where someone first contacts OT services, but then they should be pretty quickly referred on to a specialist in their area. And it would, of course, save money if people get seen early in the process by someone with appropriate skills. Equally, human nature being what it is, if you know that you are being advised by someone who is not a specialist, and you aren’t happy with their advice, you are much more likely to carry on seeking other opinions. Hearing from an expert, you are far more likely to accept what they tell you, even if it is not what you hoped to hear.
IL. What about specifying very high value items of equipment? Do you think budgetary constraints are having an effect here?
NR. I’m not sure. I suspect that if an OT finds that they specify a highly specialised wheelchair for a client that costs, say, £10,000, and that assessment goes into the system and gets stuck there for many months, also holding up everything else behind it, while on another occasion they specify a chair at £5000, and that intervention gets processed much more quickly, the experience is bound to have an effect on how they shape their recommendations in the future.
IL. Are the changes that are currently going on, in the way that the NHS and social services are organised, having an effect on people accessing OT services?
NR. Yes, I think it can be quite hard for people to find their way. In fact, I am amazed at how many come to us who have no OT support at all. Others, of course, are really very well supported. Often, people aren’t aware of the services that can help them, and I think we need better signposting from people like GPs, to help them access what they need.