The challenge of discharging post COVID-19 patients  - an OT perspective

By Nikki Thompson | 19 May 2020

It is well recognised that adult and children’s social care was under significant pressure pre COVID-19. In the early days of the outbreak we saw a focus on non-COVID-19 patients who might otherwise remain in hospital for rehabilitation being discharged back into the community to clear beds at the same time as the NHS duty to complete continuing healthcare assessments also being suspended. These two categories of people with possible additional needs layer on top of an already over-burdened social care system is likely to pose unprecedented challenges to directors of social care and their teams.

Many COVID-19 patients are likely to require an extensive period of rehabilitation and additional support post discharge.  Some are unlikely to be able to transition from an acute bed immediately back to their own homes without rehabilitation, reablement and either short or longer-term additional support. Much of the responsibility for resourcing this will fall to the local authority. Now more than ever before directors need to focus their resources on ensuring their services are in as good a shape as possible for the incoming wave of need in their communities.

Occupational therapy can play a significant part in a council’s tool box of solutions. Many of the post COVID-19 clients will require an OT assessment and intervention. One of the outcomes of OT specialist input is that the long-term care costs to councils are reduced through:

  • The client being enabled to remain in their own home rather than requiring a residential or care placement
  • Ensuring domiciliary care provision is proportionate

An OT will assess a client and their environment to analyse their current and likely future levels of function. They will use clinical judgement to identify risks and challenges and implement solutions to reduce, mitigate and manage these.

Whatever solutions an OT provides, the benefit for both the client and the council are significant. For the client they can remain in their own home with maximum independence and dignity and for the council a managed short term spend to prevent a significant uncapped medium and longer term one.

In November 2019 it was reported that there were over 40,000 people on OT waiting lists across 152 local authorities in the UK. If councils are to cushion the impact of COVID-19 they must ensure that their OT waiting lists are cleared before the end of lockdown.

As an organisation that has strong partnerships with many councils nationally, we can testify to the fantastic innovation being adopted with the sole purpose of clearing waiting lists. Examples include: remote assessments and equipment trials and closer working with housing colleagues to fast-track disabled facilities grants. Throughout the sector there is a real drive and determination to build the additional robustness and capacity into services that will be needed in the coming months.

With many OT vacancies across social care in the UK and internal OT teams being redeployed to other roles or focused on their own busy caseloads, increasing the capacity of an existing OT team to clear a waiting list can be challenging. This is leading to more and more councils successfully partnering with private sector OT practices on a spot purchase arrangement to clear or triage waiting lists. There is the capacity, skills and experience within the private sector to supplement resources immediately and we would strongly urge Council leaders to explore this collaboration.

Nikki Thompson is director of The OT Practice

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