Updated: Jul 14
Here at THC Primary Care, we provide a range of resources for Primary Care Network leaders, which includes guiding you through the roles which are funded via the additional roles reimbursement scheme.
In one of our recent webinars, I was delighted to meet Melissa Chieza, a qualified Occupational Therapist who is currently working as a Primary Care Mental Health Liaison Practitioner.
Within the webinar and this blog, we cover:
1️⃣ The role of the Primary Care Network Occupational Therapist
2️⃣ How Occupational Therapists add value in Primary Care
3️⃣ What to consider when recruiting and embedding an OT into the PCN team
4️⃣ Six top tips for OTs who are new to Primary Care
And if you’re already working as a PCN OT and would like access to some helpful and supportive OT networks (and top tips for making sure you can fully exploit your role in Primary Care), there’s something for you here too...
Let’s jump in!
1. What’s an Occupational Therapist (OT)?
Primary Care OTs are Health and Care Professions Council (HCPC) registered and educated to a university diploma standard (having graduated from a training programme which is approved by the Royal College of OTs and the HCPC).
The main objective of their role in Primary Care is to support patients to optimise the quality of their everyday lives and / or assist in effecting necessary changes to a patient’s environment to enable them to live independently, more easily, and to achieve their individual lifestyle goals.
OTs provide holistic care and can support patients with all aspects of their lifestyle; from eating and sleep hygiene, to managing issues at work, housing, personal finances, and more. They will then signpost and assist with any required onward referrals which can be anything from an appointment with a GP or nurse, to liaison with social care and wider community support services.
2. Occupational Therapists in Primary Care
OTs are commonly based within a multidisciplinary Primary Care team who are collectively focused on boosting patient wellbeing either in isolation, or in complementing any care or treatment related to any health conditions.
Within Melissa’s team, she currently works alongside the following roles:
➡️ A Specialist Nurse (who is primarily responsible for medication and prescribing-related requirements).
➡️ Outreach / support workers (who usually provide follow-up and potentially more domiciliary-based care when a patient has already been seen by the nurse or OT).
➡️ A Recovery Practitioner (who is concerned with management of mental health and anxiety-related issues).
➡️ Health Coaches / Care Coordinators.
3. How do referrals work?
A patient may be signposted directly to the OT or at the suggestion of a clinician or GP. Within Melissa’s practice, she offers a maximum of six, 30-minute consultations and clinics are booked four weeks in advance. OTs will typically see patients with physical needs (such as frailty) and those requiring support with managing mental health and wellbeing and / or practical support with their everyday lives.
4. Clinical supervision and support
OTs should have access to monthly supervision from a GP, consultant practitioner, or advanced practitioner. They should also, ideally, have support from an appropriate individual within the PCN to whom they can refer to for more general advice on a day-to-day basis. There is also a range of online support networks and resources available for OTs to access themselves, which we have also outlined below.
5. How OTs add value
The Royal College of Occupational Therapists (RCOT) say that Occupational therapists possess three main superpowers when it comes to supporting Primary Care:
1. Management of frail older adults
Use of frailty indexes to identify people needing a proactive approach
Rapid crisis response to prevent hospital admission or to speed discharge
Assessment and interventions to ensure people can cope at home, including support for carers
Short-term rehabilitation interventions and referral to specialist services, if indicated
Use of digital and assistive technology to ensure safety at home
2. Management of people with mental health problems
Risk assessment for acute distress
Personalised care plans for self-management
Patient activation to achieve personal goals
Social prescribing, and signposting or referral onto recovery support and services
3. Management of working age adults with employment difficulties
Use of AHP Health and Work report in place of GP fit note for sick pay
Tailored, specific advice about workplace modifications
6. What does the caseload look like?
Melissa is currently averaging 32 patient contacts per week and, in her role as a Mental Health Liaison Practitioner, these are some real-life examples of what she is covering right now:
🎯 Managing those struggling with the post-Covid impact on their mental health.
🎯 Supporting recovery and re-introduction into society following a change in circumstances and / or a deterioration in wellbeing.
🎯 Working with a cohort of university students who may be struggling with anxiety or poor mental health whilst on campus.
Alongside her colleagues in their multidisciplinary team and working to the recommendations within the Royal College of Occupational Therapists’ (RCOT) Improving Lives mandate, they employ a range of creative and cost effective approaches to care and have established a wealth of local contacts in order to quickly and effectively triage and manage the needs of their patients, whilst reducing health inequalities.
As a team, they are equipped to support the Enhanced Access agenda by potentially diverting patients with mental health-related needs away from the GP and freeing up appointments. They are also appropriately skilled to adapt to seasonal pressures and are flexible in having the ability to manage their caseloads both in-practice and remotely.
7. Recruitment (and retention) of your Occupational Therapist
As with the other additional roles, there is often a lack of awareness about what an OT can manage and where they can be best deployed within the developing Primary Care workforce and vice-versa; when an OT is new to Primary Care and unclear about expectations and the environment.
There is also a need to be mindful that OTs are a long-term investment, and both patience, and planning, are key. Before you advertise for your OT, make sure you are clear on the following:
✅ The role, remit and responsibilities of the position. (To support you with this, check out NHS Jobs and the Royal College of Occupational Therapists website for outline job descriptions and information on core knowledge and skills).
✅ What you’re hoping to achieve in terms of outcomes / measures of success and how they can demonstrate their value.
✅ Who will be responsible for supervising and supporting the OT?
✅ What meetings and forums they should be involved in, and how you can best promote the service and their skills?
✅ What space is available for them to practice and be involved with the wider team, within the current estates’ setup?
Above all, Melissa advises PCNs to be bold, to be brave, and to be curious when it comes to their mindset around deployment of an OT. In her words, “it might not work out, but when it does – great!”
8. Six top tips for OTs who are new to Primary Care
Lastly, here are a few tips for OTs who are starting out in Primary Care:
1️⃣ Be visible; let people know who you are and what you can do.
2️⃣ Be resilient; you may be the first OT in the network, and there may be no day-to-day point of reference.
3️⃣ In line with above, always proactively seek out formal (and informal) support:
- Use Twitter
- Check out the wealth of resources available on the RCOT website
- Attend the RCOT monthly meetings for OTs working in Primary Care
4️⃣ Make time for reflection; consider what you want to achieve within your role and how it fits within your long-term career plan.
5️⃣ Utilise the skills you have learnt in previous roles.
Most importantly, have fun! Primary Care OT roles are varied and there is always room to be creative.🌻
Before you leave, please check out our Comprehensive Guide to the Primary Care Network Additional Roles Reimbursement Scheme (ARRS) 23/24
If you would prefer to listen to this topic in the form of a podcast, please check out episode 254 of our Business of Healthcare podcast. Or if you would prefer it in video form, we also have this covered.
We hope this is helpful.
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About the Author
Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation, and interim network programmes, we have now supported over 120 PCNs!
Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs and also hosts The Business of Healthcare Podcast.
Find out more about THC Primary Care at www.thcprimarycare.co.uk