Occupational therapists call to cut hospital admissions

Discharge notes box at Cardiff's University Hospital of Wales

Thousands of hospital bed days could be saved if occupational therapists were used more to help patients, a report has said.

The College of Occupational Therapists said such action could cut avoidable admissions and delayed discharge.

A pilot service in a Cardiff hospital saved more than 15,000 bed days in a year, saving almost £1m in cash terms.

Health Secretary Vaughan Gething said occupational therapists could help with the changes needed in healthcare.

They offer advice and provide people with help to maintain their independence.

The report said research has found by using occupational therapists more, patients could be discharged on the same day as an assessment or within three days.

Freeing up resources

Ruth Crowder, Wales policy officer for the College of Occupational Therapists (COT), said health and care services were under "considerable financial pressure".

She added: "We don't want people to be in hospital if they don't need to be there.

"Ideally, we would have occupational therapists in with A&E and out with paramedics and stop them [patients] going into hospital if they don't need to medically so they are able to be independent.

"If we don't get them at the right time, they are more ill and less able to do things.

"The added bonus is it's saving significant amounts of money and bed days and freeing up resources to deal with other people."

Impact of occupational therapists

BBC Wales' Sarah Moore reports on the year-long study by the College of Occupational Therapists, focusing on a pilot project in Pembroke Dock

A frail older persons' assessment and liaison (Fopal) team at Cardiff's University Hospital of Wales emergency department assessment unit was launched in 2012.

It is the only one of its kind in Wales and it prioritises those who could be discharged the same day as an assessment.

  • Before the launch, the length of stay was in excess of 21 days

  • Over a 12 month period, 854 patients were seen by the team

  • 33% were discharged the same day, saving 5,501 bed days

  • 66% were discharged within three days, saving 10,134 bed days

  • Based on the average cost of non-elective hospital stays, it equates to a £961,552 saving

Source: Reducing Pressure on Hospitals report

The year-long Reducing Pressure on Hospitals study by the college has highlighted key points it believes health boards and local authorities should adopt regarding occupational therapists (OTs).

  • Emergency care services should have OTs "embedded within the multi-disciplinary teams"

  • Health boards should include occupational therapy in funding for out-of-hours services to achieve "optimum patient flow and fast-paced assessments"

  • Admission and discharge teams should include OTs

  • OTs should be put at the front of reablement and community support programmes

Dr Alan Rees, vice president of the Royal College of Physicians Wales, welcomed the report saying the Welsh NHS needed to "break down barriers and invest in more integration of health and social care".

Older People's Commissioner Sarah Rochira added: "At a time where resources across our health and social care services continue to be limited, occupational therapists have a vital role to play in supporting older people to maintain and regain their independence."

Mr Gething, who will deliver a speech at the launch of the report on Wednesday, said: "Occupational therapists are one of the key health and social care professionals across health, social care and housing that can help achieve the changes that are needed.

"This report clearly shows the innovative ways they are delivering services which help people avoid unnecessary admission to hospital, reduce the time they stay in hospital and ensure they have a successful and safe discharge back home."

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