otnews march 2010

OTnewsOccupational Therapy News

published by the College of Occupational Therapists

ISSN

096

9-50

95

18(3) 2010March

The breakfast clubUsing cooking with adolescents with eating disorders

to improve social engagement

Vocation unwrappedHelping clients arrive

at a chosen vocation

Are you engaged in

commissioning?Come forward with

your ideas

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Cover: Özgür Donmaz© iStockphoto.comTracey Samuels, Editor

Last month, OTnews was joined by a new permanent

part-time journalist, Andrew Mickel, who kicks off this issue

by looking at Unison’s critical response to last month’s

Conservative Party health manifesto, which plans to put more

attention into prevention, and for all providers to operate on

a payment by results system through the whole of the NHS.

A letter by Karen Jennings, national secretary of the

union’s health group, claims that many policies on choice

and payment by results are already being pursued by the

current government, and that that rather than axing all

targets, the Conservatives still plan to measure outcomes.

Turn to page 6 to find out more.

Also in the news this month, the government has

announced its proposed changes to the Medical Statement,

to come into force from April this year. I talk to Anne Byrne,

chair of the COT Specialist Section – Work about the

College’s response to the original consultation.

Individual budgets are undoubtedly high on the

government’s agenda, with personalistion in health being

widely propelled forward. So a survey by disability charity

Livability that says nine out of 10 disabled young people have

never heard of individual budgets and, more worryingly, 54

per cent of those surveyed do not even know which local

authorities provide their services, will likely raise some

eyebrows (page 7).

In features this month, OT Nicola Carlyle, on the contract

monitoring team at Caerphilly County Borough Council,

makes a plea for all ‘OTs, budding entrepreneurs and kindred

spirits’, involved in the commissioning process, to come

forward and share ideas about innovative practice concerning

commissioning operations (page 24).

Then, on page 40, Marietta Birkholtz and Cara Lovell look

at the factors that influence people’s ability to get back to

work after accident or illness, focusing on specific return to

work models that can help OTs to help clients arrive at their

chosen vocation.

Still with vocational rehabilitation, on page 32, research

OT Joanna Sweetland says that there is growing concern that

vocational rehabilitation services are inaccessible for people

with long-term neurological conditions.

She is about to embark on a study, led by Dr Diane

Playford and Dr Kate Radford, and funded by the National

Institute for Health Research, to identify existing services and

consider how they fit published recommendations, and

would like to hear from members.

WELCOME

If you have any feedback about this issue of OTnews, or would like to contribute a short article or feature for a future publication, please email me at: editorial@ cot.co.uk

EDITORIALCONTACTS

www.cot.org.uk

Tracey Samuels

Contacting OTN

For all EDITORIAL enquiries tel: 020 7450 2339 or email: [email protected]

For all ADVERTISING enquiries tel: 020 7450 2341 or email: [email protected]

Contacting BAOT or COT

For all GENERAL enquires tel: 020 7357 6480

For all MEMBERSHIP or SUBSCRIPTION enquiriestel: 020 7450 2348 or email: [email protected]

For all Unison enquiriestel UNISONdirect: 0845 355 0845

OTN staff

Editor Tracey Samuels email: [email protected]/Assistant editor Andrew Mickel email: [email protected] and design officer Marianne Taylor email: [email protected] and design officer Suzanne Jefferson email: [email protected] manager Katy Eggleton email: [email protected]

British Journal of Occupational Therapy email: [email protected]

Occupational Therapy News is published on the 1st of each month by the College of Occupational Therapists Ltd, a registered charity in England and Wales (275119) and in Scotland (SCO39573), 106-114 Borough High Street, Southwark, London SE1 1LB.

Copyright:Copyright of the magazine is held by the College of Occupational Therapists. No part of Occupational Therapy News may be reproduced in any material form (including photocopying, storing in any medium by electronic means or transmitting) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 6-10 Kirby Street, London EC1N 8TS. Visit: www.cla.co.uk or email: [email protected]

Disclaimer:The views and opinions expressed in this publication do not necessarily reflect those of the British Association/College of Occupational Therapists. The publication of advertisements does not constitute endorsement of the advertised products, services or events by the British Association/College of Occupational Therapists.

A guide for contributors is available on request or on the website.

Deadlines:(Editorial): 10th month prior (Advertising):14th month prior

Pre-press and printed in England by:The Lavenham Press LtdTel: 01787 247436

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HIV/AIDS, Oncology,Palliative Care

Older People

BrightonBrighton2010

ContinuingProfessionalDevelopment












Specialist Sections

• Learn about the opportunities for OTs as a result of the national dementia strategy from Prof. Jane Gilliard from the DH.

• Find out from Dr Dawn Skelton, a leading light on falls prevention, how OTs can contribute to healthy ageing and falls prevention

• Prof. Sheila Payne, Vice President, European Association of Palliative Care will reveal how OTs can support families and carers in providing palliative care

• Discover the implications concerning assessment and treatment for HIV-related neuro-cognitive impairment from Camilla Hawkins, OT from Mildmay UK

22–25 June 2010, Brighton Centre, Brighton, Sussex

College of Occupational Therapists34th Annual Conference and Exhibition

PLUS TWOSpecialist Sections’ Annual Conferences:

HIV/AIDS, Oncology, Palliative Care and Older People

Provisional Programme available NOW – www.cot.org.uk/threeannualconferences

HIV/AIDS, Oncology, Palliative Care

• Hear how to develop care for older peopleas life expectancy increases from Heléna Herklots, Service Director, Age Concern and Help the Aged

• Find out how personal health budgets will affect you and how it can enhance your role

College highlights

Older People

Enjoy huge savings – book the early bird rate by 16th April 2010 and receive TWO FREE publications

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NEWS06 News

ABOUT COT13 Policy Mental capital and wellbeing

14 Council Future proofing headquarters

16 Guidance Online assistive technology tool

18 Awards COT award reports

MEMBERS19 BAOT/Unison Personal care issues and pay freeze concerns

20 Member activities Launch of a dementia cafe

22 Member activities Campaign for greener healthcare

23 Member achievements Raising money for spinal injury

PROFESSIONAL NETWORKING44 Networking Professional networking opportunities

FEATURES24 Those all important performance indicators Nicola Carlyle calls on OTs in commissioning to come forward

25 The twists and turns of road safety assessments Paula O’Neill and Colette Hughes look at road safety assessments

26 Development of a breakfast group A breakfast group for young adolescents with eating disorders

28 The role of art in recovery Barbara Philipsz shares service user feedback from an arts group

30 Motivating clients to return to work Helping OTs to help clients arrive at their chosen vocation

32 Vocational rehabilitation survey Helping people with long-term neurological conditions into work

34 Developing a new model of practice Andy Smith’s model of integrated vocational rehabilitation

36 Walking on the road to mental health recovery Helping patients in a low secure mental health setting to recover

PROFILES46 Back in my day Jill Wilson reflects on her personal journey since qualifying in 1959

REPORTS38 Striding into the next decade – clowns and all Are we fit for purpose, fit for practice? Peggy Frost reports

40 COT study days Facilitating group work and cycling for health

41 Promoting the profession throughout Europe Kate Sheehan reports from the autumn COTEC meeting in Malta

42 Clinical academic training pathway Elizabeth White reports from the NIHR workshop

43 Promoting social inclusion Jane Melton reports on a royal event

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HIV/AIDS, Oncology,Palliative Care

Older People

BrightonBrighton2010













Specialist Sections

• Learn about the opportunities for OTs as a result of the national dementia strategy from Prof. Jane Gilliard from the DH.

• Find out from Dr Dawn Skelton, a leading light on falls prevention, how OTs can contribute to healthy ageing and falls prevention

• Prof. Sheila Payne, Vice President, European Association of Palliative Care will reveal how OTs can support families and carers in providing palliative care

• Discover the implications concerning assessment and treatment for HIV-related neuro-cognitive impairment from Camilla Hawkins, OT from Mildmay UK

22–25 June 2010, Brighton Centre, Brighton, Sussex

College of Occupational Therapists34th Annual Conference and Exhibition

PLUS TWOSpecialist Sections’ Annual Conferences:

HIV/AIDS, Oncology, Palliative Care and Older People

Provisional Programme available NOW – www.cot.org.uk/threeannualconferences

HIV/AIDS, Oncology, Palliative Care

• Hear how to develop care for older peopleas life expectancy increases from Heléna Herklots, Service Director, Age Concern and Help the Aged

• Find out how personal health budgets will affect you and how it can enhance your role

College highlights

Older People

Enjoy huge savings – book the early bird rate by 16th April 2010 and receive TWO FREE publications

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Following last year’s consultation on replacing ‘sick notes’ with ‘fit notes’, the government has announced that, subject to Parliamentary approval, it will be implementing a number of changes to the Medical Statement from April this year.

In its formal response to the consultation, published on 29 February, the Department for Work and Pensions (DWP) says it will remove the option for a doctor to state that their patient is ‘fit for work’; instead the new format notes will have two options, ‘unfit for work’ or ‘may be fit for some work taking account of the following advice’.

In the case of the latter, the form allows doctors to suggest various adaptations such as a phased return to work, altered hours, amended duties and workplace adaptations. Where a doctor considers another option is more appropriate, they will

be able to state this in the comments box.

It seems that the onus will be on the employer to make a decision as to whether they can accommodate any changes to facilitate a return to work.

Anne Byrne, chair of the COT Specialist Section – Work, helped COT to inform its response to the consultation. She told OTnews: ‘The main points of my submission were directed at the vagueness of the statement “maybe fit for work”, as I felt that [this] would only be an effective addition to the existing “unfit/fit” statements if it was qualified with additional advice, or led to a further appropriate assessment of the individual that would facilitate a safe, suitable and sustained return to work.’

Anne said she also indicated that ‘occupational health, or better still, occupational therapy, had to be added to the

list of “common types of work/job changes” that may facilitate return to work, with the more specific recommendation for an assessment of the patient’s functional abilities and the job demands’.

‘Occupational therapy should have a leading role in the assessment, rehabilitation and the provision of advice to both employers and those workers who are off work and are returning to work following injury, illness or disability,’ she stressed.

‘In order to be seen as a leader we need to take opportunities such as this consultation to indicate what we have to offer in this area of practice, and also to give an informed opinion on changes that may affect our practice. The fact that some of the changes to the proposed new statement reflect our comments highlights the importance of participating in such consultations.’

●● Tracey Samuels, editor,

OTnews

People aged over 65 will be given up to six weeks’ support in their own homes after being discharged from hospital or residential care, under plans unveiled by Labour for if they win a fourth term.

The policy would form part of a national care service, which would also fund home care for the most vulnerable people.

However, over half of the councillors in England who lead on adult social care co-wrote a letter to the Times claiming the plans were ‘unclear, unfunded and are likely to have a significant impact on existing local services’.

The details of a potential national care service will be included in the green paper on adult social care, which is due

to be released before the election.

The national care service would form part of a plan to shift more NHS treatment to being delivered in people’s homes, alongside a pledge to provide one-to-one nursing care for the estimated 1.6 million who have, or have had, cancer in the next five years.

The Conservatives claimed that more details were needed on how it would be funded.

The launch is just part of a flurry of activity about the shape of health and social care services after the election, expected in May.

The COT’s own manifesto is in the draft stage and will be released by the next issue of OTnews.

Elsewhere, Unison responded critically to last month’s Conservative health

manifesto, which planned to put more attention into prevention, and for all providers to operate on a payment by results system through the whole of the NHS.

A letter by Karen Jennings, national secretary of the union’s health group, claimed that many policies on choice, payment by results, and focusing on cancer, stroke and infection were already being pursued by the government. Ms Jennings added that rather than axing all targets, as had previously been claimed, ‘the Tories still plan to measure outcomes and now only speak of scrapping “politically motivated process targets”.’

The letter also said: ‘The document confirms that the big dividing line between Labour and the Conservatives on the NHS is that the Tories would

scrap [health secretary] Andy Burnham’s recent “preferred provider” pledge, moving instead to an “any willing provider” model of provision, which would inevitably create many more opportunities for private sector incursion into the NHS.’

Anna Dixon, the acting chief executive of health think tank the King’s Fund, welcomed the party’s manifesto more warmly. She said: ‘An independent board, changes to the way that drugs are approved and paid for, and real budgets in the hands of GPs could significantly change the way in which the NHS operates. But more detail is needed before the impact of such policies can be properly understood.’

●● Andrew Mickel, journalist,

OTnews

Fit notes to replace sick notes from April 2010

Parties put out their election stalls on health and social care

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A third of parents with disabled children do not get the support they want for their children’s emotional and mental problems, a new survey has shown.

The survey of over 100 parents, conducted by children’s mental health charity YoungMinds, found that 87 per cent of parents felt there were barriers to accessing help for them, while only 68 per cent received any help. Less than two thirds of those who did receive help found it useful, while one parent claimed that CAMHS (child and adolescent mental health services) told her to ignore her son’s self-harming and depression until his behaviour reached crisis point.

Genevieve Smyth, professional affairs officer, said:

‘COT is pleased to welcome the release of this report that clearly shows that disabled children frequently experience additional emotional and mental health problems. It is saddening to hear that parents either do not receive help or feel this help is lacking. We would hope that the recently-released government response to the

independent review of CAMHS (Keeping children and young people in mind 2010), which describes how professionals can work together to improve responses, will rectify this situation.’

Barriers to accessing services mentioned by respondents included a lack of available services, uncaring attitudes of

staff, long waiting lists, and children not fitting into any criteria of support.

Parents felt that there was little professional help available to create strategies to deal with their children’s problems. Strategies used included reward charts and visual cues, identifying calming activities for their child, and using distraction, relaxation and exercise techniques.

One respondent said: ‘Social services need to be able to react when problems are still small, not to wait until it has been worked up into a major issue. I don’t know if it really is due to a lack of resources or the mindset of wait and see, but it’s wrong and people suffer.’

Nine out of 10 disabled young adults have never heard of individual budgets, according to a survey commissioned by disability charity Livability.

This was despite 46 per cent of respondents claiming they would be interested in having an individual budget if offered it. The survey of 500 disabled adults aged 16 to 24, conducted by nfpSynergy in September 2009, also showed that 54 per cent of the people surveyed did not even know which local authority provided their services.

The findings are a knock to local government’s ambitions to provide individual budgets, as younger disabled adults have been considered a forerunner group in their uptake. As part of the Putting People First agenda, 30 per cent of those who are eligible for social care support should have an individual budget by 2011.

Fifty three per cent of respondents said they would

use an individual budget to access services they currently cannot access, while only 24 per cent said they would not want a personal assistant.

Julia Skelton, head of professional practice at COT, said: ‘I’m disappointed that people have not heard of individual budgets, but on the other hand there’s a lot of different terminology used that’s confusing, such as direct payments, personal budgets, and self-directed support.’

However, she added that the differences between social care and health mean that the results do not necessarily bode badly for personalisation in health care: ‘People are more aware where their hospital is than where their local authority is so I don’t think it’s the same.’

In a separate systematic review by Livability, a mystery shopper rated the information available about individual budgets on the internet and by

telephone in 103 local authorities. Forty five per cent of local authority websites had no information at all, while half of telephone enquiries were misdirected.

The City of London and Portsmouth City Council were the only two authorities to get perfect tens in each score, while 14 local authorities failed to provide any information by either medium.

The results also showed that the individual budget pilot sites, which have offered the budgets the longest, did not necessarily have higher levels of awareness. Original pilot site East Sussex County Council came 77th out of the 103 local authorities.

Mark Harper, shadow minister for disabled people, said: ‘There is a clear role here for central government to show more leadership and to impress upon local authorities the importance of making these opportunities available for disabled people.’

Livability is calling on the government to launch a national campaign to raise awareness, and for local authorities and PCTs to consult and engage with disabled people about what they want.


OTnews

Parents of disabled children not getting support for children’s emotional and mental problems

Nine out of 10 disabled young adults have ‘never heard of individual budgets’

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Health and social care systems need to focus on supporting people’s independence to cope with pressures on their budgets, two separate major reviews have warned.

The first annual review of health and social care in England by the Care Quality Commission (CQC) said that 1.7 million more adults will need care and support by 2030. Dame Jo Williams, interim chair of CQC, said that delivering changes to support those people would require ‘helping people maintain their independence and health’.

While the report said there have been improvements in the last year, it claimed that future pressures on finances will require reforms to be sped up.

It cited the rapid expansion of services to prevent unnecessary emergency admissions as a positive area, with the number of people accessing such services up from 80,000 in 2004 to 148,000 in 2009.

However, there is a wide variation in how well services are applied – the review estimates that £2 billion a year could be saved if all the country was as good as the best areas at

preventing repeated admissions of older people and reducing their length of stay in hospitals.

The report also said that more work was needed on safeguarding and training, noting that providing mandatory training had the lowest compliance of all NHS standards.

Julia Skelton, COT head of professional practice, welcomed the report and said: ‘The College has long advocated more integration of services, following Interface to integration [the College’s strategy to integrate health and social care in 2002]. We would support it where it is appropriate along the lines of increased productivity and better services for users.’

The CQC report also urged the acceleration of person-centred care, stating that billions could be saved by enabling people to manage long-term conditions at home, which Julia said OTs were ‘well-placed to deliver’.

A separate report, sponsored by the Department of Health and written by Professor Jon Glasby at Birmingham University, warned that failure to reform adult social care could

lead to costs doubling in the next decade.

The case for social care reform – the wider economic and social benefits said a more preventative service was needed, and attributed the failure to create one so far to many factors including the long-term outcomes of prevention not matching shorter term political timescales, and the difficulties of proving the efficacy of prevention.

The study suggested that strategic commissioning, collaboration between health and social care, more personalisation, better use of IT and assistive technology and workforce reform could allow spending to stay near current levels, even with an ageing population.

In addition to saved social care costs, the report said that billions would be saved in knock-on effects to other services, such as reduced emergency admissions, and reduced benefits to both service users and carers if they were supported in employment.


OTnews

Invest in people’s independence to save future costs, warn two major studies

Julia Scott, chief executive of COT, has been advising the Social Care Institute for

Excellence on the setting up of a national college of social work (OTnews October 2009, page 14).

The college of social work is being developed from a recommendation by the Social Work Task Force, which was set up in the aftermath of the Baby Peter case to examine the work of the profession.

To support the developments of a new structure, Scott has held ongoing meetings to advise about governance. She said: ‘In the spirit of partnership working the College [of Occupational Therapists] is pleased to support the development of the college of social work, which will support a group of professionals who work closely with OTs in the field.’

COT boss advises on formation of new national college of social work

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©CareFlex Ltd 2010

We will be exhibiting our new huggle range at the Kidz in the Middle exhibition at the Ricoh Arena in Coventry on the 11th March.

Please come and visit us on stand E0

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©CareFlex Ltd 2010

We will be exhibiting our new huggle range at the Kidz in the Middle exhibition at the Ricoh Arena in Coventry on the 11th March.

Please come and visit us on stand E0

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A new method of providing community equipment has begun in the London Boroughs of Barking and Dagenham and Havering.

Previously, an OT would assess a user’s needs, and then arrange for equipment to be supplied by council-run services.

Users will continue to have an OT visit, but they will now get a prescription that they can use to get equipment free of charge from retailers. The plan is intended to provide users with greater choice from the 34 trained and accredited retailers across both boroughs, which includes two mobile shops.

Users will get demonstrations of the equipment in store. A follow-up phone call after they have used the items will replace the previous system of having a second visit by an occupational therapist.

Gillian Perkins, team manager for the community disability service in Barking and

Dagenham, told OTnews that the new system will allow them to focus on more complex cases. She said: ‘It’s still early days. We’ve done in the region of 40 to 50 prescriptions so far, but we’ve got positive feedback from the service users who have it in their homes.’

Barking and Dagenham and Havering are two of the leading sites in the Department of Health’s work on Transforming Community Equipment Services, which will move much

of the delivery of items to a retail model in England. The project started in September, with the first new prescriptions written in January.

People not eligible for council help can also use shops, while users who do get council assistance can ‘top up’ their own allocation to get better equipment.

It is estimated that around 80 per cent of equipment will be issued under the new scheme.

First of community equipment scheme sites starts work

An amnesty of equipment has been launched by Norfolk County Council adult social

services to try and recoup the value of items that have been

provided and not returned.

The first two of five amnesty sessions have so far yielded 25 items.

In 2009, the Community Equipment Service delivered 66,000 items of equipment and collected

33,000 items, from which £3.2 million worth was reused.

Sarah Ellis, head of occupational therapy for Norfolk County Council, said: ‘Many people might think that it isn’t important to return equipment or might not know how to. Sometimes people hang on to items after they have recovered from an illness or operation ‘just in case’ they might need them again.’

Equipment amnesty launched in Norfolk to save cash

Self-employed and private occupational therapists may be required to register with the Vetting and Barring Scheme.

The scheme requires people who regularly work with children or vulnerable adults in England, Wales and Northern Ireland to register with the Independent Safeguarding Authority. However, a review of the new scheme before Christmas by Sir Roger Singleton concluded that the scheme was too extensive, echoing sweeping public criticism of the new required checks.

All recommendations made by Sir Roger Singleton were accepted by government, including a review of whether

self-employed and private practitioners would need to register with the scheme. The Department of Health has confirmed that review will include OTs, although there is no timetable for when the review will be concluded.

Sharmin Campbell, chair of the COT Specialist Section – Independent Practice, says that she does not believe independent OTs should need to register: ‘Most self-employed occupational therapists working with children and vulnerable adults will offer a service in the home and through private arrangement, and therefore as the law currently stands, there is no requirement for them to be

registered. I believe that this is the correct approach given the nature of the intervention that we offer.

The original plan would have required an estimated 11 million people to register, while the revised plans will require around nine million people to do so.

OTs who are employed by local authorities or the NHS will also be required to register with the scheme.

Independent OTs may need to register with Vetting and Barring scheme

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A member’s bill has been proposed in Scotland to create an autism strategy for the nation. A consultation around the proposed bill is being held to establish if there is a need for a strategy, which is

intended to ensure national standards of service.

Liberal Democrat MSP Hugh O’Donnell, who proposed the bill, told OTnews that it has so far been well-received, and that responses are coming in ‘fast and furious’ ahead of the 30 March deadline.

Scotland is the only UK nation with no autism plan, but O’Donnell says that while other nations’ experience can be helpful, ‘just because something may have worked elsewhere doesn’t mean that it is necessarily right for the Scottish system.’

Submissions can be made at: bit.ly/61tcbc.

The Welsh Assembly Government will invest £1.7 million in adult autism services over the next three years.

The plans will introduce a diagnostic framework for autism in the next two years; extend awareness campaigns at employers and in JobCentre Pluses; and fund building design research for housing.

Ruth Crowder, COT policy officer for Wales, said: ‘What is new and really excellent from an occupational therapy perspective is the focus on employment, so occupational therapists attempting to get people into work should find this support invaluable and the

focus on designing appropriate housing will be key in enabling independence and workable environments for people.’

Gwenda Thomas, deputy minister for social services in Wales, said: ‘This money will make a real difference to the lives of all those affected by [Autistic Spectrum Disorder] by improving diagnosis provision and employment opportunities, as well as widening the range of services available consistently across Wales.’

New care pathways for cancer rehabilitation were launched in January this year, and represent the culmination of a great deal of hard work to improve services for people with cancer.

The incidence of cancer is rising, partly due to an ageing population and partly due to the good news that many more people are surviving with a diagnosis of cancer. This means that rehabilitation is playing an increasingly important role.

Rehabilitation care pathways have been developed for both specific cancers and for symptoms, and provide a useful demonstration of how various professionals, including occupational therapists, work together to provide high quality care.

The pathways were welcomed by participants at the event, since they make the roles of different allied health professionals clear, but also reflect a certain amount of flexibility within those roles. The pathways have been put

together in a ‘user friendly’ way and will be a useful resource for occupational therapists..

The overall aims of the National Cancer Action Programme are to prevent cancer, to maximise the quality of life for those with a diagnosis of cancer and to manage the long-term consequences of cancer. The launch event therefore included presentations on other aspects of this work.

An update was provided on the evidence base for rehabilitation, which is currently being developed. This

will help to improve commissioning of cancer rehabilitation services. Information was also given on the development of a workforce model, which should help to identify the additional workforce, which will be needed to deliver the rehabilitation pathways.

The draft pathways are available at: www.cancer.nhs.uk/rehabilitation/rehab_pathways.html. If you would like further information on these subjects, please contact: [email protected].

…while Scotland considers getting an autism strategy

Autism services in Wales gets £1.7 million…

National Cancer Action Team launches cancer rehabilitation pathways

The number of people in the UK with dementia has been estimated up to 820,000. The figures, compiled by the Alzheimer’s Research Trust, had previously stood at 700,000. The number of people with a cognitive impairment, which is typically caused by dementia, is expected to reach 765,000 by 2031.

The statistics were released shortly after the government’s public spending watchdog, the National Audit Office, released a critical review of the first year of England’s dementia strategy. Audits of how well the money allocated by central government to implement the strategy has been spent will be released this month. There will be a full update of progress on the dementia strategy in the next edition of OTnews.

The Scottish Government is also due to reveal its dementia strategy next month.

Number of people with dementia estimated up to 820,000

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The Allied Health Professions Federation (AHPF) represents the 12 professional bodies for AHPs, including COT, and director Paul Hitchcock talks to OTnews about the federation’s recent activity and future challenges, focusing on England.

‘Looking back over the last six months, the AHPF has been involved in a number of initiatives to ensure that AHPs have a voice and are being heard,’ he says. ‘There has been an emphasis on engaging with the health care agenda, [as] we have had to prioritise where we can have maximum impact.’

The Transforming Community Services (TCS) initiative will continue to have the potential for major impact upon the way that services are delivered, following the publication of the NHS Operating Framework for the coming year, he says. ‘The AHPF meets regularly with members of the TCS team and is part of the TCS expert advisory group.’

The federation has been part of the stakeholder panel for reform of the care and support system and, led by Julia Scott, has produced a detailed response to Shaping the future of care together, the green paper on care and support.

‘We have been working with the expert reference group on data collection for referral to treatment times for AHPs. It

had been expected that this project would have been sufficiently far advanced to enable data collection to become mandatory in April 2010, but this will now be on a voluntary basis until next year,’ he says.

‘This data is important for AHPs as it enables effective influencing of commissioners and hence the commissioning of appropriate services. While the AHPF continues to influence nationally on this agenda, your local influence to ensure the voluntary collection of this data will be key to ensuring the future development of this work.’

Through the professional bodies, the AHPF has contributed examples of good practice to inform the QIPP1 agenda and is involved in an ongoing dialogue with Jim Easton and his team. ‘We will be producing a “manifesto” to ensure that the importance of AHPs and what they can add to the productivity agenda is highlighted,’ he points out.

Looking forward, there are likely to be some significant challenges to everyone involved

with delivering services for patients, clients, users and their carers, he believes.

‘In the immediate short term, improving quality has to be the watchword,’ he says, ‘while at the same time ensuring it is delivered at a price that ensures the service is sustainable in the overall context of care… integration and working across boundaries are part of the expertise and experience of many AHPs and the AHPF will push to ensure that these strengths are recognised as employer organisations look to enhance their service delivery.’

In the longer term, as part of a three-year plan, the AHPF will be highlighting the role of AHPs in improving health and prevention services. ‘Throughout 2010 and onwards the AHPF will continue to develop its role and profile as a federation working alongside your professional body,’ he ends.

‘Its aim will continue to be to engage with those issues and opportunities that cross uni-professional boundaries and most impact upon you and your service.’

AHPF takes stock and outlines future plans

The final draft of the COT Informatics Reference Manual (COTIRM) was circulated ‘for comment’ as COTIM 100. COTIM is the regular COT newsletter covering all issues relevant to occupational therapy in the information age (eHealth, eCare, information

management etc), focusing on developments that will impact on occupational

therapy practice, management, education, and research.

Members can subscribe to receive COTIM by email by contacting: [email protected] Back issues are available on the COT website.

COTIRM will be updated at least quarterly, based on the content of COTIM, which provides more timely information. COTIRM is designed as an electronic resource and is not intended to be printed. Additional contributors would be very welcome; and draft content should be submitted to: [email protected].

There is some national interest in publishing an equivalent resource for the allied health professions, or perhaps even for all health care professions, so watch this space.

Informatics reference manual for OTs

Data collection on times from referral to treatment by AHPs has begun in 11 pilot sites in England.

All AHPs in England will need to collect the information from April 2011

as part of the AHP Referral to Treatment Data Collection

Project.Genevieve

Smyth, COT professional affairs officer, said: ‘People need to think now about

how they are going to be ready for this. Letters have been going to chief executives from [chief executive of the NHS in England] David Nicholson so OTs need to get in touch with them, push from the bottom up and ask: how are you going to work together to do this?’

She added that where IT systems may not be capable of generating the right data, paper collection may be necessary in some areas.

The initiative from the Department of Health was outlined in 2008’s Framing the contribution of allied health professionals.

Treatment time data collection under way in pilot areas

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COT recently attended an event run by the Inclusion Institute to discuss how to best use the results of the influential Foresight report to provide social inclusion and meaningful occupation for the UK population. The links between occupation and health are implicit within some of the report findings and articulated as the need to promote meaning and purpose for people through, for example, employment, social participation and networks.

The project defines mental capital as a person’s cognitive and emotional resources – almost a ‘bank account’ of the mind – while mental wellbeing is a dynamic state in which people can achieve their potential, fulfil their goals and have a sense of purpose.

Both concepts are interlinked and there is a need to nurture them both in the general population and in vulnerable groups. The report particularly concentrates on childhood adolescence, mental ill health, adult learning, adult working life and older adults and makes key recommendations about how to achieve our ‘five a day’ – most of which will be achieved by activity and occupational engagement.

The report sets out these five ways to mental wellbeing as:Connect: With family, friends, colleagues and neighbours, at home, work, and school or in your local community. Think of these as the cornerstones of your life and invest time in developing them. Building these connections will support and enrich you every day.

Be active: Go for a walk or run. Step outside. Cycle. Play a game. Garden. Dance. Exercising makes you feel good. Most importantly,

discover a physical activity you enjoy and that suits your level of mobility and fitness.

Take notice: Be curious. Catch sight of the beautiful. Remark on the unusual. Notice the changing seasons. Savour the moment, whether you are walking to work, eating lunch or talking to friends. Be aware of the world around you and what you are feeling. Reflecting on your experiences will help you appreciate what matters to you.

Keep learning: Try something new. Rediscover an old interest. Sign up for that course. Take on a different responsibility at work. Fix a bike. Learn to play an instrument or how to cook your favourite food. Set a challenge you enjoy achieving. Learning new things will make you more confident as well as being fun.

Give: Do something nice for a friend, or a stranger. Thank someone. Smile. Volunteer your time. Join a community group. Look out, as well as in. Seeing yourself, and your happiness as linked to the wider community can be incredibly rewarding and creates connections with the people around you.

The report also states that: 10 per cent (all figures are as per 100,000 of population) of children in the UK have dyslexia and/or dyscalculia; 10 per cent of children have a mental illness, and additional factors will contribute to a cycle of disadvantage, including living in a single parent family, low income, and maternal depression; 45 per cent of looked after children have a mental illness, and a third of prisoners are looked after children; and 4 per cent of the population have a personality disorder and

childhood maltreatment and supervision neglect increase the risk of personality disorder.

The rates of mental illness in the population are generally stable, but there will be increasing numbers of people with dementia because of the ageing population. Risk factors that reduce mental capital and wellbeing are summarised as debt, unemployment, poor housing, lone parenthood, victimisation, and experiences of abuse.

Moving from the evidence in the Foresight report to practical action will be vital as there are significant social and economic costs of ignoring mental wellbeing. So can OTs use these research findings for everyday practice?

The report and the event held by the Inclusion Institute make several suggestions:

●● be alert to the risk factors to mental capital and wellbeing with any group you work with;

●● early intervention with children is vital to establish resilience including treatments for emotional, physical or sexual abuse;

●● flexible working patterns for adults can promote work/life balance and prevent absenteeism or presenteeism;

●● protect the mental capital of older adults through exercise and learning from middle age;

●● use social prescribing to facilitate activity and social connection, eg time banks, exercise, green activity, arts;

●● carry out lifestyle interventions to target alcohol use and hazardous drinking;

●● early intervention with adults to decrease the risk of job loss and unemployment particularly between primary care and the employer;

●● strengthen parenting capacity and increase in peri-natal mental health services;

●● checking children, adults and older adults have a secure foundation through income maximisation, housing, literacy and numeracy skills;

●● promote meaning and purpose through employment, social participation, networks and personal development;

●● using interventions that address both physical and mental health needs together;

●● preventing and addressing violence and abuse; and

●● tackling all forms of stigma and discrimination.The Inclusion Institute is

currently writing a guide for commissioners of health and social care services to help them develop the mental capital and wellbeing of local populations. With our inherent understanding of the inter-relationship between how we spend our time and our health and wellbeing, occupational therapists can be key to deliver the results of the Foresight Report.

●● Genevieve Smyth, COT

professional affairs officer for

mental health and learning

disabilities. For more information

please contact: genevieve.smyth@

cot.co.uk

Mental capital and wellbeing

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£2 million has been allocated by Council to conduct major building work on COT’s headquarters in London.

£1.5 million is needed for essential building work, including replacing all heating, lighting, and air conditioning systems, as well as ageing windows, and lift and front doors. An extra £500,000 was authorised by Council to reconstruct the ground floor to offer better facilities, build a roof terrace to provide an extra venue for use, and improve the façade.

The building is the largest tangible asset that the organisation owns, and COT has a long-term obligation to maintain and improve it. Over the last few years, the building has steadily deteriorated, with the original heating and ventilation systems and lift door

mechanism reaching the end of their working life.

Plans for the reconstruction of the ground floor – which are being improved to become more DDA (Disability Discrimination Act) compliant – will include new AV technology in the three meeting rooms, to allow members to access events online without visiting the building.

The funding for the project comes from existing reserves built up over a number of years from surpluses created by advertising revenue. The funding has been capped at £2 million to prevent overspends, with the essential building works taking priority.

The ground floor reconstruction, roof terrace and improved façade were approved to stop any further deterioration in the infrastructure of the building, and to add to the

building’s value. These essential maintenance works also give the organisation the opportunity to undertake a space planning exercise to help with future proofing and improving the College’s professional image.

While the work is being done, COT’s headquarters will be temporarily relocating to 160-166 Borough High Street, a few doors down from its main premises. However, all telephone and email addresses will remain the same and post to the normal address will be redirected, although members are asked to be patient during the move in case of any unexpected problems.

Members will not be able to visit the temporary headquarters other than the library, which will operate at a reduced size. It is hoped that

while the work is being carried out and no meeting rooms are available, meetings can be organised elsewhere around the country.

The move is currently scheduled for the middle of April, and the return to the revamped building is scheduled for autumn.

Future proofing headquarters

COT is delighted to announce the award of three fellowships, to Dr Sarah Cook, Paraig O’Brien and Professor Gaynor Sadlo, and two honorary fellowships to James Leckey and Dr Frances Reynolds, in recognition of the outstanding contribution they have all made to the profession during their career.

These awards are the highest honours that COT can bestow on one of its professional members and on non-OTs.

Dr Cook is senior lecturer at the Centre for Health and Social Care Research, Sheffield Hallam University. She is committed to the development of OT practice, particularly in the field of mental health, and she is a wonderful ambassador for COT and the profession. Her leadership as educator, researcher and author is widely acknowledged by her peers and she gives her time generously in supporting colleagues’ research.

The involvement of people who use mental health services is paramount in her research and her work.

Paraig O’Brien currently works as the housing adaptations liaison manager, DHSSPS/NIHE in Northern Ireland. He is held in high esteem by colleagues and service users whom he puts at the heart of his work. His professional leadership and collaborative approach to partnership working with colleagues in health, social care and housing is highly valued.

His research and his work on policy have had a tremendous impact nationally in many areas, but more specifically in housing. In addition, his contribution to the work of the COT Specialist Section – Housing has been valued for many years.

Professor Gaynor Sadlo is renowned nationally and

internationally as a leader in OT education and for her significant contributions to the profession and its members. She has led the way in the implementation of problem-based learning in the UK and has contributed to the development of the European Master of Science in Occupational Therapy. She is an experienced researcher whose findings have been published, disseminated and implemented and an inspiration for others to undertake research.

James Leckey, founder and CEO of James Leckey Design Ltd, is the first industrialist to be nominated for an honorary fellowship. He was honoured for his work in designing equipment for children with disabilities, which is used on a worldwide basis, and for enhancing the working practices and education of OTs. He is a committed ambassador for the profession

nationally and internationally. In addition, he is an innovator, an advocate for continuing education and research and development and an active supporter of charitable organisations.

Dr Frances Reynolds is a senior lecturer in health psychology at Brunel University. She has provided a major contribution to the education of OTs and OT students through her teaching and authorship. She has generated solid evidence for practice and an important resource and support for the profession through her extensive research, most notably in creativity, occupation and chronic ill health.

The awards will be formally presented to the new fellows at the COT’s annual conference in Brighton in June 2010, and a full write-up on the awardees will appear after the presentation in BJOT.

COT fellowship awards 2010

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Chairman’s view From vice-chairman Sara Blackbourn

I am delighted to inform you that a good number of applications were received for consideration for this year’s merit awards. This is only the third year these awards have been given so they are still a relatively new initiative.

The merit awards are open to all members of BAOT with a minimum of two full consecutive years of membership. This includes student and associate members as well as practitioners, researchers, managers and educators. The only criterion for the award is that nominees are recognised by their peers in the occupational therapy community for excellence in their sphere of work.

So if you know someone who meets this criterion all you have to do is nominate him or her on an application form, which you get from COT. Remember, this award is open to all members of BAOT.

Applications are independently scored and then discussed by the awards panel, members of which are all members of council. This year’s applications ranged from therapists who are designing and undertaking new and innovative ways of working, to therapists who are teaching and supporting students in the UK and overseas. The successful nominees will receive their award at this year’s annual COT conference in Brighton.

If you are thinking of nominating someone for a merit award then I would recommend that you: provide actual examples of their contribution to occupational therapy, do not just state that they do; use the full word count allowed within each of the five sections and for the supporting statement; use a variety of evidence in each section; illustrate the challenges

they have overcome and the partnerships that have been formed; demonstrate a political awareness of their contribution in the wider world of healthcare; and make sure that the verifier

knows what is on the application form, as they may be contacted to confirm their support of the application or to give further information.

On a different note, I am very pleased to inform you that council has approved some additional spending to enhance COT headquarters. For those of

you who know the building you will appreciate that this is a long overdue piece of work.

Early proposals include reconfiguring the downstairs accommodation to enhance flow and space utilisation, significant improvement to the pavement level façade to improve the image and market the profession more explicitly, utilising the roof space over the existing ground floor extension, and finally, if there is any money left, then to ‘tidy up’ the front of the building above street level (see page 14).

This is an exciting project and while council is mindful of the expenditure in the present financial climate it was agreed that the benefits of this work outweigh the risks and will undoubtedly benefit the profession, the members and the staff who work at headquarters. We will keep you posted on progress.

Sara Blackbourn, COT vice-chairman, can be contacted by email at: [email protected]

Merit awards 2010 agreed by council

‘The merit awards are open to all

members of BAOT with a minimum

of two full consecutive years of

membership.’

The United Kingdom Occupational Therapy Research Foundation (UKOTRF) is delighted to announce that council, at its October 2009 meeting, agreed further funding for the UKOTRF to support the OT research agenda and to build research capacity within the profession.

The new support will double the funds that have been available from COT, and will offer up to £200,000 a year for five years commencing in 2011. This excellent news represents a real investment in the future of the profession, funding much-needed research to develop the evidence-base that underpins both professional practice and

the commissioning of occupational therapy services. Look out for information about the 2011 funding round that will be accessible on the website from July.

The UKOTRF would like to take this opportunity to thank all those who supported its range of activities during the last year by: applying for the available funding grants and supporting applicants; supervising UKOTRF grant-winning PhD students; advisory group members; attending or speaking at our the UKOTRF events; attending the fund-raising lunch at COT’s annual conference; donating speaker fees; individual donations; and

external sponsorship from the Institute of Social Psychiatry and Pressalit Care Ltd.

COT hopes that more members will support the valuable work of the UKOTRF during the forthcoming year. Two events that are already planned include ‘Outcome measures and effective practice’, a one-day workshop being held at COT on 11 March. Contact [email protected] for further information. Dr Diane Playford, COT honorary fellow and PhD supervisor for two of the

sponsored research projects, will be the speaker at the UKOTRF lunch at conference this year on 24 June in Brighton. For more information contact: [email protected].

Great news about funding

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COT has worked in partnership with the Department of Occupational Therapy at Coventry University in conjunction with the Health Design and Technology Institute to develop an online learning tool in assistive technology.

The Assistive Technology Learning Tool (ATLT) has been designed to enable participants to develop a greater awareness of what electronic assistive technology (AT) is and how it can offer choices for individuals to maintain or improve their health and wellbeing.

The ATLT has been developed to support the learning needs of OTs and related personnel who come into contact with service users that might find assistive technology useful.

The tool provides an interactive online learning environment that offers the opportunity to gain an understanding of AT by exploring:

●● six case scenarios; ●● resources such as videos, presentations and reading materials; and

●● critical questions to encourage participants to expand their knowledge and understanding of AT by exploring potential solutions to each case scenario. The tool covers a range of

electronic AT, including stand alone AT, systems such as telehealthcare, lifestyle and activity monitoring,

environmental controls, communication devices and smart technology.

The ATLT will enable participants to:

●● demonstrate an increased awareness and define elements of AT;

●● reflect on their own capabilities and skills with regard to delivery of AT to meet specific individual needs; and

●● engage effectively with the current local and national AT agenda.The fee for the tool is

normally £100 (incl. VAT), but

a limited number of BAOT members will be eligible for a discounted rate of £50 (incl. VAT). Once activated the site will be available for 60 days and it is estimated that the tool will take 20 hours to complete. The tool will be available early 2010, please email: [email protected] to join a waiting list.

Further details can be found on the iLOD section of the COT website and at: wwwm.coventry.ac.uk/HLS/OT/AT/Pages/ATonlinelearningtool.aspx and a short video at: www.youtube.com/watch?v=4idJFwunTT4.

New online assistive technology learning tool

The second occasional paper has recently been published on COT’s interactive learning opportunities database – iLOD. You can find it in the CPD tools area of iLOD (which is accessed by members on the website www.cot.org.uk).

Occasional papers have a

clear set of proposed learning outcomes,

which state what you can expect to have

gained after reading and discussing them. There are questions to prompt reflection and debate throughout. The papers are designed to be engaging so that they can be actively read and considered by individuals or groups. If you wish, you may use the questions provided to review your understanding at the end.

This second paper, entitled Professional Suitability, provides an overview of this issue and discusses the concepts of professional suitability, good professional practice and professional unsuitability. Occasional papers are a new series of resources that will help members keep up to date on topics in an easy and effective way.

Please contact COT with feedback on occasional papers, or ideas for future ones, by emailing: [email protected].

Professional suitability

Casual vacancies on councilFollowing the resignation of the current council member, associate members,

for professional reasons, a new member is needed to provide council with

advice and expertise with regards to occupational therapy support workers.

The candidate must be a BAOT associate member in good standing.

As this vacancy arises outside the formal nomination process, it will be a

casual post with a 15 to 16 month term of office, starting in April and

ending at the 2011 AGM. Casual members are considered as trustees/

company directors with all the implications this entails and have the same

voting rights as other council members.

If you are interested in being nominated for this post, please contact

Dominique Le Marchand for more information and a nomination form

on tel: 020 7450 2317 or email: dominique.le.marchand@cot.

co.uk.

Deadline for return of nominations is Tuesday 6 April 2010. Council will

hold a ballot the following week to elect the new member.

Note: Any person considering this post should gain the support of

their manager so that he/she is aware of the time away from work

which the responsibility of holding a national office involves.

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The American Geriatric Society (AGS) and the British Geriatrics Society (BGS) have recently published updated guidelines aimed at preventing falls in older people.

The online guidelines recommend a multi-factorial fall risk assessment for all older adults who have had a fall, who have been identified as having gait and balance problems, or who report difficulties with gait or balance. The guidelines include a clinical algorithm that outlines step-by-step, recommended evaluations and interventions. For older adults who have fallen or report gait and balance disorders, the guidelines recommend a fall risk assessment.

The draft guidelines were peer reviewed by a number of

organisations with special interest and expertise in the prevention of falls in older people. COT is very grateful to Kate Robertson who provided feedback to the AGS/BGS on behalf of the falls forum of the COT Specialist Section – Older People.

Following the release of the updated ABS/BGS guidelines, NHS Quality Improvement Scotland published its full version of the resource, Up and About: Pathways for the prevention and management of falls and fragility fractures. ‘Up and About’ is a reference resource for those involved in the planning, development, evaluation and delivery of services, which aims to prevent and manage falls and prevents fragility fractures.

It identifies all services, agencies and organisations potentially involved in falls and fragility fracture prevention and management. The resource includes examples of best practice from across Scotland and information on the older person’s perspective.

The document was developed as part of a two-year programme at NHS QIS on the prevention and management of falls and is available to download at: www.fallspathway.nhshealthquality.org. The AGS/BGS online guidelines are available at: www.americangeriatrics.org/education/cp_index.shtml.

New resources for falls prevention in older people

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In 2003, I moved to Nigeria to work with a charity which rehabilitates people with mental illness in a residential setting. The residents of the centre are all found living destitute on the street and invited to come voluntarily to the centre. They are involved in a programme of therapy and treatment and their

families are found. My anticipated role of supervising rehabilitation at the residential settings changed soon after my arrival due to other staffing adjustments, and this perhaps

typified my experience of life in Nigeria; plans change.

One day I was showing round some visitors who gave funding for the vocational training workshop. Their donations covered the costs of the vocational tools given to residents from the centre as they were discharged and sent home

to their families. One visitor asked ‘how many of your residents are still working after being discharged?’. This was to become my research question.

In 2005, I was awarded a grant from the Institute of Social Psychiatry to carry out a research project into the outcomes of the vocational training workshop. The research commenced in 2005, with a cross-sectional survey of all residents discharged in the past three years to identify their current worker roles. The findings were published in WFOT Bulletin in November 2008. This was followed by a longitudinal study, which tracked all the residents discharged during one year over an 18 month period. This has recently been submitted for publication.

As the date which I said the research would be complete neared I realised the many

obstacles which I had not anticipated; rainy season making roads impassable for home visits, fuel prices rocketing and then fuel scarcity delaying the long journeys needed for conducting interviews. With the end of my tenure at the project I moved away to another part of Nigeria, and overseeing data gathering from afar was by no means simple.

I do not believe I was naïve in my approach to three years volunteering in rural Africa; I had travelled extensively in Africa. I felt confident in skills of problem solving and flexibility from practising occupational therapy in Europe. I was however more acutely challenged than I could ever have imagined through my work in eastern Nigeria and experiences of research.

●● Polly Eaton

The flexibility of distance learning

I was keen to develop my skills and knowledge in OT, both on a practical and academic level. I had been working in intensive physical rehabilitation for just over two years at the time and found it a very stimulating post clinically and an environment which supported and encouraged learning at every level. The distance learning course was modular, allowing a wide choice of topics that could be tailored to the individual’s interests and practice. Consequently, I was able to study in depth several clinical and organisational issues relevant to the unit, and so inform and help improve practice in areas such as outcome measures, ergonomics, occupational science and

evidence-based practice. The flexibility of distance

learning was also vital for me in combining my studies with full-time work and family life. I could not foresee when I started that my studies would coincide with some very difficult experiences in my personal life, including the serious illness and death of my mother. I was very grateful for the support received from my tutor which enabled me to complete the degree, albeit later than anticipated.

When it came to choosing a topic for my final independent study project, I wanted to do a piece of work that would not only fulfil the academic requirements, but achieve something worthwhile for the team. In

exploring a new approach to the involvement of patients in quality improvement, I was able combine these aims, although with hindsight it did necessitate compromises affecting both the academic and organisational aspects of the project.

I have learnt and achieved many things through my studies, including deeper knowledge and skills, the acquisition of broader viewpoints and more inquiring approaches and contributing to developments in practice and service improvements.

Therefore, the benefits have been not only to me as an individual therapist but to the service and profile of OT within the trust. The award of the scholarship was an important

factor in these achievements; initially providing the security of funding some early modules, but later as a motivator during the difficult times. When even my own optimism and determination and the support of those around me did not seem quite enough, it was always at the back of my mind that I did not want to disappoint those who had enough confidence in me to make the award.

●● Catherine Whitmarsh

In 2005, Catherine Whitmarsh was awarded The HSA Charitable Trust Scholarship Award towards the funding of an MSc in OT

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Polly Eaton received a grant in 2005 from the Institute of Social Psychiatry to conduct research into the outcomes of vocational training

Research in Nigeria

COT awards for education, research and CPDThese are summary reports from recipients of COT awards for education, research and CPD

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Two new employment relations guidance briefings have recently been published.

Briefing 120: Applying for a ‘non-traditional’ role – some points to consider. The NHS and local authorities employ the majority of occupational therapy staff, however the COT has been considering how the profession can do more to expand into other areas of society, including community settings such as schools, vocational rehabilitation centres, hospices, residential homes and prisons, as well as the independent sector.

This briefing aims to offer advice to members who are

considering applying for, or are being recruited to, a ‘non-traditional’ role.

Briefing 119: Generic working: a guide for BAOT/Unison stewards. Occupational therapists and support workers taking on generic roles is becoming more frequent throughout the UK, in both in the NHS and social services. This guidance aims to assist OT stewards and Unison branches with negotiating over proposals to move toward generic working.

You can download these briefings from the policy and practice section of the COT website: www.cot.org.uk.

Personal care and personal budgets continue to be in the spotlight for occupational therapy staff. Government plans to provide free care at home for those most in need via the Personal Care at Home Bill are being put under intense scrutiny and many health and social care organisations have raised serious concerns that the proposals are flawed.

Although many would support the principle, Unison fears that the government’s calculation of the numbers of people with critical needs and the funding required to provide them with personal care fall far short of the mark. Unison is also concerned that the bill fails to consider the future needs of the social care workforce.

As part of the union’s campaign to address concerns around personal care, Unison has commissioned research on how personalisation combined with current underfunding in social care may affect the workforce, public services and the quality of social care provided in the future.

We intend to use the report as part of an ongoing wider publicity campaign to highlight our concerns and set out our recommendations to create a social care service that is fit for the 21st Century and addresses the challenges currently facing social care.

Unison has also raised its concerns about the development of direct payments for the NHS

– part of the government’s policy to bring in social care-style personal health budgets – in its response to the government consultation Direct Payment for Healthcare.

Unison’s response highlights a number of potential difficulties and problems, including those around the scope and take-up of direct payments, privatisation and marketisation, top-up payments and staffing issues.

Version 16 of the NHS Terms and Conditions of Service handbook has now been issued. Key amendments to the handbook include a new annex containing frequently asked questions and a new part five on equal opportunities.

OT stewards working in the NHS are encouraged to download a copy from the NHS Employers’ website at the following link: www.nhsemployers.org/PayAndContracts/AgendaForChange/Pages/Afc-Homepage.aspx. Please ensure that you replace your copy of the handbook with version 16 and bring the new version to the attention of your stewards and the human resources team in your organisation.

New guidance on generic working and ‘non-traditional’ roles

Personal care under scrutiny

New version of NHS terms and conditions handbook

Local government unions representing 1.6 million workers in England, Wales and Northern Ireland, including occupational therapists and occupational therapy support workers, are outraged at the announcement by local government employers that members will face a pay freeze in 2010/2011.

Unison, UNITE and GMB public service unions submitted a pay claim in October last year for 2.5 per cent or £500 on behalf of local government staff, but the employers are threatening to freeze pay without negotiation.

The unions are calling on the local government employers to think again, saying that local government workers will struggle to afford basic essentials, with nearly 3 per cent inflation rendering the pay freeze a real terms pay cut. The unions are calling for them to make a reasonable offer, saying that there is room in council budgets to give decent pay to hard working council employees who have kept local communities together through the crisis and who are already covering posts left vacant by wide-spread redundancies.

To read more about Unison’s ongoing campaign to protect members’ pay, conditions and pensions and to campaign against further redundancies or cuts go to: www.unison.org.uk/localgov.

Local government unions condemn pay freeze

Upcoming regional OT stewards’ forum meetings●● Eastern region, 24 March 2010. Contact Claire Williams: [email protected]●● South East, 31 March 2010. Contact Diane Houlihan: [email protected]

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Social support and a sense of belonging is being offered to carers and people with dementia in the form of a café at Thatcham, Berkshire, which launched in February. Beechcroft older adults community mental health team opened its doors at The Thatcham Memorial Hall last month for this new initiative, for which OT Sara Johnson is pleased to have taken on the role of clinical lead.

The dementia café is a chance for those affected by dementia, their relatives and carers, to meet together in an informal setting in order to socialise, unwind and receive support and advice. Being able to relax and enjoy a cup of tea, sandwiches and cakes in a friendly environment allows everyone to be far less self-conscious of the problems faced by dementia sufferers. Everyone who is affected by or has an interest in the disease is welcome at the café.

The concept was first introduced in 1997, by Dr Bere Miesen, a psychologist specialising in the effects of old age. He noted that people treated dementia as a taboo subject and rarely talked about it or the effect it has on them and their families. Creating a relaxed environment where people could meet and share experiences helped them to alleviate and de-stigmatise the illness.

The Thatcham dementia café runs on the first Thursday of the month and has a specific structure based on an annual programme of themed topics, which provide psychological education in the form of talks and discussions. Focus is placed on responding to the emotional and isolating consequences for carers and families and individuals have an opportunity for informal chats with professional carers and medical staff about issues they face.

People sit at tables with colourful teapots, flowers and candles. Hot drinks and sandwiches are served and there is a lively buzz of conversation and laughter. Music playing softly in the background makes the scene feel like any ordinary café – thereby demystifying the dementing process.

Many people withdraw from social activities because of dementia. At the café everyone is aware of the illness so people do

not have to worry or feel embarrassed.

The café really does have a multidisciplinary approach with a skill mix ranging from band three to band seven, with input from support workers, medical secretaries, community psychiatric nurses, occupational therapists and speech and language therapists – the café has received an enthusiastic response and Beechcroft staff have agreed to devote their time to running the cafe every month.

This is a good example of meeting policy objectives, such as the National Dementia Strategy. Funding for the café comes in the form of a carer’s grant, which covers the cost of hiring the hall, refreshments, administration and paying for outside presenters.

Currently 700,000 – or one person in every 88 in the UK – has dementia, and new forecasts predict that by 2051, 1.7 million people in Britain will have dementia (BBC news) with one in

three people being affected either as patient or carer, highlighting the need to respond to the changing needs of an ageing society.

There is positive psychological, emotional and social support systems provided by the dementia café – without which many people may be feel isolated. This benchmarking initiative meets and addresses the needs of people at all stages of dementia and is an appropriate way of reducing stigma and carer stress and replacing these with important feelings of belonging, acceptance, acknowledgement and recognition.

●● Sara Johnson, OT, Beechcroft

Day Hospital

Next month, OTnews will run a special focus issue looking at the National Dementia Strategy one year on, and examples of good practice from throughout the UK.

Dementia café – all in the same boat

Dementia café: Staff use the kitchen

Sara Johnson

www.BAOT.org.uk

Participate “Get involved and join your local BAOT community group. You’ll meet your local peers, share best practice, increase your networks and further your professional development, too.”Beriah Chandoo, Senior Membership Officer

Your professional

body…it’s simply

indispensable

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As clinical specialist for Motor Neurone Disease Scotland, part of my role is home visiting and local education sessions. I cover the north of Scotland area, including the large cities of Aberdeen and Inverness, as well as very remote communities. The area is a similar size to Switzerland and there has been a 50 per cent increase in caseload, and no additional clinical specialist staff.

A number of patients already embrace text and email, as a way of keeping in more regular contact with me and to feel less isolated. This, along with a chance discussion regarding my concerns about the reduced service, led me to contact Cathy Dorrian, service development manager with The Scottish Centre for Telehealth, based at Aberdeen Royal Infirmary.

Eighteen months later, I am now using telehealth as an integral part of my job, in three main ways.

Patient’s home to clinical specialist: A small desk-top videoconferencing unit is set up

in the person’s house and is connected to the home broadband router. At a simple functional level the person presses the ‘on’ switch then the pre-set phone number. This links them in to me on the hospital site and we can start our meeting.

Patient travelling to their GP surgery or local hospital: The person travels to their nearest videoconferencing facility. Cathy organises a technician or a staff member who is familiar with the system to dial the phone number and they link into our meeting.

The advantages of both of these systems include less or no travel for the patient and their carer. Fewer appointments are cancelled and can be carried out when there are adverse weather conditions or if the person or their carer feels unable to make a long journey for an appointment. Local staff can be involved in part, or all, of the meeting to discuss current issues.

More regular face-to-face interactions can now be

completed due to staff travel-time savings. I have found it to be especially useful for picking up problems early, such as weight loss and breathing difficulties. It is more inclusive than a telephone call as, often, when speech deteriorates telephone discussions can become limited to carers only.

Case conferences, training and team meetings: Once a meeting time is agreed the details are passed to my telehealth colleagues, who organise the ‘bridge’ so that when I dial in, I wait until my colleagues join me by dialling in from their local site.

This not only saves travel and parking time for all involved, but training and case

conferences have higher attendances.

In the near future, the service will be expanded further to include remote access to the motor neurone disease multidisciplinary clinic (MDC). Recent research has shown access to specialist motor neurone disease services and to MDCs can increase patient survival.

We aim to conduct research in the near future to find out whether this is an effective tool and whether professionals, patients and carers feel comfortable using it. Initial findings are positive.

●● Dianne Fraser can be emailed

at: [email protected]

When asked if I would consider accompanying a team to Ukraine to volunteer as an occupational therapist, I jumped at the chance. Organised by the charity Mercy Project, a small multidisciplinary team of four were to conduct a series of visits to children with disabilities over a period of six days.

Only being 18 months into my occupational therapy training, I prepared myself for the challenge ahead. I was able to fundraise via charitable trusts and donations from friends. With the money collected I bought various aids to living, such as rubber matting and pipe insulation, which can be cut to modify hand held utilities. With some imagination, the pound shop can be a great resource.

Not yet having had a paediatric placement, I also read up on common conditions affecting this age group, especially cerebral palsy, with which I knew we would come into contact.

In a country where access to healthcare can be limited, and where occupational therapy is not widely recognised, the parents were very grateful for any advice we could offer. The main challenge was only being able to visit families once, with only a brief description of the child’s

disability beforehand, plus having to do everything through a translator. When feeling frustrated that I could not offer more, I had to keep

remembering that giving a little is better than not giving at all.

The main learning curve for me was how important it is to make information and resources as accessible as possible. I also experienced the art of ‘making the most of what you have’; causing me to wonder how much equipment goes to waste in the UK that does not meet out health and safety standards, but that would be appreciated elsewhere?

Finally, I realised that the interpersonal skills that OTs are taught, such as active listening and empathy, are greatly appreciated where individuals are stigmatised, both home and aboard.

●● Laura Tyndall, OT student,

Sheffied Halam University

Telehealth as an additional tool

©istockphoto.com/Donald Erickson

©istockphoto.com/Sean Nel

Volunteering in Ukraine

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The campaign for greener healthcare’s ‘Green OT’ network

Since August 2009, the ‘Green OT’ network has attracted over 150 members to the mailing list, ranging from practitioners and academics, to learners and researchers. The network is for OTs interested in environmental sustainability in the practice of occupational therapy and the mailing list is the forum for sharing ideas and getting support.

The Green OT team is fully committed to communicating the importance of sustainable development and issues about climate change to the occupational therapy profession nationally. More details about our work, blogs, and a podcast can be found at: www.greenerhealthcare.org/category/tags/occupational-therapy.

Articles about the Green OT network have previously featured in the July and October 2009 issues of OTnews. During 2009, we made some really good links with the occupational therapy academic establishments and delivered a number of presentations and workshops on the topic nationally, including at COT.

The Green OT network was also invited to present at a variety of university conferences, including the University of Plymouth’s Centre for Sustainable Futures, and at Oxford Brookes University.

In November last year, delegates attending the first Student Occupational Therapy Links Scotland (SOTLS)

national conference (see page 23) explored the issues during workshops entitled ‘Climate change: what’s it got to do with occupational therapy?’

At the Climate Summit in Copenhagan, in December 2009, a statement by the Green OT network was presented by the Climate and Health Council, of which the Green OT network is a member, giving added strength to the voices of the health community at the negotiations.

Three abstracts from Green OT were accepted for the COT’s annual national conference, to be held in June 2010 at the Brighton Centre. We will be presenting one paper and delivering two workshops covering the following topics: ‘Sustainable global wellbeing: a proposed paradigm shift for occupational therapy’; ‘Greening occupational therapy practice’; and ‘Sustainable occupation in action’.

Ben Whittaker, OT, has submitted an opinion piece to the British Journal of Occupational Therapy, proposing a paradigm shift to sustainable global wellbeing. We are keen to hear from other OTs who have had related abstracts accepted at occupational therapy or other

conferences, in order to pool this knowledge and promote awareness.

In April 2010, the Green OT network will have a presence at the College of Occupational Therapists Specialist Section – Mental Health conference in Birmingham, delivering a workshop where we will be exploring links between mental health and ‘green’ occupational therapy practice.

So, ‘what’s good for the climate is good for health’. The Green OT network is now a member of the Climate and Health Council. The website is full of well-argued and interesting information. Take a few minutes to visit the website and sign the Council’s pledge: www.climateandhealth.org/.

Additionally, there are now 92 NHS organisations getting active in the 10:10 campaign. If you want to see if your trust is signed up, see the full list on the 10:10 health page at: www.greenerhealthcare.org/1010-health. In collaboration with interested OTs, we aim to develop a specific OT 10:10 actions checklist. This will hopefully be a useful tool enabling practitioners to take action quickly and easily.

Email the Green OT network at: [email protected] or [email protected].

●● Tamara Rayment, OT and

project co-ordinator of the Green

OT network.

www.BAOT.org.uk

Your voice“We influence government policy and produce College-driven strategies... As a BAOT member, you have a voice. Please use it. Together, we can make a difference.“Peggy Frost, Practice Development Manager

Your professional body… it’s simply indispensable

©istockphoto.com/Jan Will

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A team of people from the North West region have swum 22 miles – the distance of the English Channel – in aid of Aspire and raised £965 in sponsorship. Four people from the wheelchair service took part over a 12-week period. Pictured right, (left to right), are Emma Grace, receptionist, Joan Smith, OT,

Peter Powell, repair service supervisor and Yvonne Baron, wheelchair service manager, who all work within the wheelchair service at NHS Central Lancashire. The sponsorship raised will go towards any of the ongoing Aspire projects such as assistive technology, research or short-term supported living

for individuals discharged from spinal injury units.

Alternatively, it may help with human needs grants for things like lightweight wheelchairs, or other specialist equipment.

Student Occupational Therapy Links Scotland (SOTLS) is a student-led organisation that was established in 2009 by a collective of fourth year OT students at Queen Margaret University (QMU), Edinburgh.

SOTLS’s objective is to organise an annual conference to be hosted by one of the three Scottish Universities (QMU, Robert Gordon University and Glasgow Caledonian). On 21 November 2009, SOTLS hosted the first conference at QMU, adopting the theme ‘Contemporary issues in occupational therapy’.

The notion of hosting this event was conceived by Camilla Leslie, after she attended an occupational therapy meeting that was organised and facilitated by students while on an ERASMUS exchange in Portugal. Inspired by the autonomy and enthusiasm that they displayed towards their learning, Camilla decided that she would like to bring this to Scotland.

Following experiences of attending a European Network of Occupational Therapy in Higher Education (ENOTHE) meeting in Berlin the previous year, Alexandra Moss and Jenni Arnot felt inspired to join Camilla in her venture when she returned. Later in the process, when it was recognised that more people were needed, Jessica Holland and Nadira

Karim joined the team. As a result, in the spirit of the year’s European theme of ‘Creativity and innovation’, the SOTLS event was founded.

SOTLS aims to unite students from the three Scottish universities offering occupational therapy degree courses, to promote discussion and raise awareness of contemporary issues in occupational therapy practice and education in Scotland, and to communicate new ideas and create innovative directions for the future of our profession.

The event exceeded all expectations, successfully bringing together over 200 individuals – students, lecturers, academics and professionals – generating an atmosphere of lively discussion and debate, where people could network and form new friendships both professionally and socially on an equal level.

In establishing the event, the SOTLS team came across many challenges, the biggest of which was limited funding opportunities. In due course, sponsorship was propitiously sourced from Wiltshire Farm Foods, Aqua Joy, Motability and ROMPA, and other means of support was benevolently offered by QMU, COT/BAOT and the wider OT community. With the collaboration of these parties and the positive enthusiasm of the SOTLS team,

the financial obstacle was overcome.

On the day, the SOTLS opening keynote lecture was delivered by Anne Lawson Porter, formerly COT head of education and learning. During her address, Anne evoked the essence of her Casson Memorial Lecture and asked us to explore the future of OT in ‘Spanning the boundaries in occupational therapy’.

Hanneke Van Bruggen, director of ENOTHE, closed the event with a complimenting and inspiring keynote lecture, ‘Contemporary issues in occupational therapy in a diverse Europe – together we can crack the nut of an occupationally just Europe’.

Arguably the most innovative part of the day was the use of the online programme WIMBA, which allowed one of our presenters, Dr Barbara Thompson, to attend the event virtually from her home in New York, while simultaneously using power point and facilitating a workshop via webcam.

The feedback from the delegates was overwhelming. Fulfilling the vision of SOTLS was a great challenge and a

fantastic learning experience for the team. We believe that with a realistic, clear creative vision, supportive working relationships and positive drive and ambition we can actively lead our profession forward by organising events such as this. With firm foundations laid by the team, the team now invites students from any of the three Scottish universities to organise the next SOTLS event.

●● Camilla Leslie, Alexandra

Moss, Jenni Arnot, Jessica

Holland and Nadira Karim. If you

are interested in organising a similar

event, do not hesitate to email:

[email protected] for further

information.

From student to leader

Swimming for spinal injury support member achievements MEMBERS

The SOTLS team

Delegates in the QMU lecture hall

The campaign for greener healthcare’s ‘Green OT’ network

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Like thousands of others, do you put off work you dislike until the last minute? Do you crave distraction rather than face the arduous task of

writing a lengthy report, or arranging yet another difficult and complex assessment? Yet you would be surprised to know that there is no better time than now to finish that all important paperwork and collate those performance indicators (PIs).

The current financial challenges facing health and social care demands increased productivity and quality for all public services and who better to assist in this process than allied health professionals?

AHPs are the perfect tools for commissioners to engage and respond to the commissioning agenda. Due to our diverse backgrounds, training and expertise, not to mention flexible and adaptable approach, the new age and strategic employment of AHPs is upon us.

As an OT working in adult social care services, the concept of outcome-focused care is nothing new. Needs assessment, intervention and access to essential resources and services has always been at the heart of occupational therapy, alongside the systematic production of evidence-based practice.

It was no surprise, therefore, to a community-based practitioner like myself, to be involved in a pilot commissioning process that resulted in a comprehensive audit of residential and nursing care providers. What was as a surprise, however, was the initiative by Caerphilly County Borough Council to implement an ongoing commissioning strategy that included occupational therapy as a permanent feature within its team plan.

Two years on and the commissioning strategy and role of occupational therapy within Caerphilly County Borough Council continues to develop. The evolvement and deployment of new monitoring systems

within the commissioning team has resulted in the emergence of a new ‘contract monitoring team’ – a group of officers whose role is to monitor the quality and efficiency of services and measure performance against statute law, local authority contract and care standards, National Institute for Health and Clinical Excellence (NICE) guidance and good practice guidelines – of which I am now employed.

As a team we sit within commissioning and are integral to the collaborative operation of adult social care services. Partnership working and the commitment of both Caerphilly County Borough Council and Aneurin Bevan Local Health Board (LHB) have resulted in a dedicated workforce, whose aims are to ensure service user safety and the ongoing provision of essential care services.

Through continued monitoring and promotion of service user independence and choice we provide a mechanism for feedback and review, via jointly agreed objectives between contracted providers, the local health board, Local Authority Care and Social Services Inspectorate Wales (CSSIW), Protection Of Vulnerable Adults (POVA), community adult teams and locally agreed adult health and social care processes.

To my knowledge, never before has a local authority taken such strides to involve and include AHPs in its commissioning agenda. The continued development of this new occupational therapy role is both challenging and rewarding, but there is still a long way to go improving communication and bridging the many gaps between existing services and identified future services.

And who better to raise the profile of commissioning than occupational therapists? After all, assessment, education and support for service users, their families and providers to access essential resources,

increased awareness of safe and productive working systems, ongoing support and advice for provider practice development are key elements of commissioning and fundamental to all OTs.

The changing focus on increased accountability and financial challenges of today’s climate determines much of my role is absorbed in working with recalcitrant providers and the lack of stringent national minimum standards and statutory guidance concerning equipment, documentation, care practices and the environment.

Acknowledging the potential to influence and change the system rather than pump increased resources into it is key. Better quality service does not necessarily mean increased care costs. Evaluation, education, promoting independence and prevention are fundamental to the success of any service, least of all commissioning.

So I call on any budding entrepreneurs, professional enthusiasts and kindred spirits in the commissioning or care industry to come forth with your questions, ideas and indeed any information you may wish to impart about new and innovative practice concerning commissioning operations.

I am especially interested to hear from anyone who has had experience of formulating joint health and social care strategies and protocols, such as manual handling, clinical leadership, collaborative working or community equipment, or indeed anyone with a vested interest in promoting better quality care services. All contributions are welcome. Unlike that troublesome report, please do not put off your contacting me until a later date.

●● Nicola Carlyle, senior practitioner OT,

Commissioning Team, Directorate of Social

Services, Caerphilly County Borough Council.

Email: [email protected] or tel: 01443

86449

Those all important

performance indicators

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As OTs working in the field of adult learning disability, recent service development has hinged on the recommendations of

Equal lives: review of policy and services for people with a learning disability in Northern Ireland, published in September 2005.

This review of policy and services for people with a learning disability insists that: ‘The model of the future needs to be based on integration, where people participate fully in the lives of their communities and are supported to individually access the full range of opportunities that are open to everyone else.’

Fast-forward to 2008 and 2009, and referrals to the OT service, adult learning disability team, within our trust have become increasingly peppered with requests for road safety assessments. These assessments are needed to ensure that clients are safe to access work placements, local leisure facilities, the pharmacy and/or GP surgery, to name but a few.

Although we had drafted a road safety protocol in previous years, the reconfiguration of our local health trust in 2008, and the increased demand for assessment and training in the whole area of travel, prompted us to revisit that protocol.

Our process is as follows: ●● referral received; ●● referral prioritised; ●● collect relevant information, for example visual/hearing skills or mental health issues;

●● initial interview and gain consent; ●● cognitive assessment, to ascertain the client’s skill level in terms of visual and auditory memory and problem-solving;

●● decision to go ahead with assessment; ●● actual road safety assessment (supervised);

●● training programme (if deemed appropriate);

●● unsupervised road safety assessment (observed);

●● report and recommendations; and●● multidisciplinary team meeting to discuss

findings and decide on outcome.

We pooled information from a range of resources and adapted it accordingly to meet the needs of our client group. We drew up an assessment form, information-gathering checklist, consent form and report template.

Our training programme is not static or rigid, but can be adapted to meet individual needs, and again, has been devised using a range of reference material.

Alongside the review of our own practice, we saw this as an opportunity to also involve other service providers and adopt a partnership approach to the whole area of road safety for people with a learning disability.

The local MP for the area and a roads service representative were made aware of local problem spots regularly encountered by our clients. We also meet with the local road safety education officer, who completes the road safety training programmes within the primary school sector.

Information and views were exchanged and there are future plans for further collaborative working with selected groups of our clients.

The process has not been without its difficulties, however. What warrants informed consent? Clients needed to know that the assessment may, depending on the findings, have negative implications in terms of their freedom and independence. Only by explaining fully the possible consequences could we obtain informed consent.

Who decides if the client is safe to travel independently? The need for a multidisciplinary meeting was written into the protocol from an early stage. The OT brings the assessment findings to a team meeting, a team discussion, and ultimately a team decision is made based on those shared findings.

Can the assessment findings be transferred to all situations? On our report template we use the following statement to

clarify the boundaries of the assessment findings: ‘This report is based on the client’s road safety for the specific route stated and, as observed on the day of assessment only’.

Are there exceptions? We have had requests to assess clients who have been independent in this area for years. When assessed, they usually are competent and have a good understanding of the inherent dangers associated with the roads.

We follow up on these ‘independent users’ with the Horizons training programme. A multidisciplinary team meeting convenes to agree that the client is as safe as intervention allows in terms of travelling independently.

How do we protect ourselves professionally? By drawing up our protocol, and related assessments, forms and templates, we hope to formalise our approach to this area of work. By bringing our findings to a multidisciplinary team forum and sharing the ultimate decision-making process with others, particularly in those borderline cases, we are helping to protect ourselves as individual therapists.

In conclusion, it is great to see our clients ‘out and about’ a lot more now. There are great rewards to be had in terms of client freedom and independence. It is worth persevering, perfecting our skills as therapists and negotiating those twists and turns of the process for the sake of our clients.

ReferenceEqual lives: review of policy and services for people with a

learning disability in Northern Ireland, September 2005.

Available at: www.rmhldni.gov.uk [accessed 18/02/10]

●● Paula O’Neill, OT, and Colette Hughes, OT,

Southern Health and Social Care Trust

The twists and turns of road safety assessmentsPaula O’Neill and Colette Hughes explain their road safety assessment protocol

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The idea for a ‘breakfast club’ at the Thorneywood Adolescent Unit in Nottingham came from an article called ‘Rise and shine it’s breakfast

time’ in Occupational Therapy News (Buchanen et al 2007). At this time, specialist OT Samantha Jacques-Newton and dietician Claire Knight looked at using their skills to meet the needs of their own client group, which is comprised mainly of people with eating disorders, and a small number of other young people with psychotic and depressive symptoms.

A literature review was undertaken around the importance of breakfast. Haley and Mckay (BJOT 2004) state that OTs have used cooking widely to address a range of issues, including skill development to support independent living, providing a leisure or work activity. They also say that this activity further adds to the social engagement with others.

On the adolescent unit, the breakfast club helps by making eating and food preparation a more sociable occasion. The naturally occurring conversation in the group and at the table also helps distract those with eating disorders from focusing solely on their food. Haley and Mckay (BJOT 2004) also state that baking improves concentration, increases co-ordination and builds confidence.

In further studies, Mee and Sumsion (2001) and Chugg and Craik (2002) show that engagement in meaningful occupation with people with enduring mental health illness living in the community aided their recovery. Their findings suggest that engagement in occupation can increase motivation and meaningfulness through reinforcing an individual’s sense of purpose.

These authors identified that engagement can re-establish old habits or form new ones, and help people to learn how to cope with

challenges when things go wrong. They experience success that increases self-esteem, self-motivation and improves the sense of self.

Kremer et al (1984) state that cooking can provide patients with an end product – an activity that is age appropriate and culturally appropriate and, because cooking is understandable, it is seen as meaningful and of value. The impact of occupation was considered and how using cooking with people with eating disorders can address many issues that impact on their functioning.

Martin (1998) states that the OT helps patients with eating disorders to prepare for daily living experiences and works with them on choosing and purchasing food and cooking of meals. This author also says that OTs help with the distorted views and behaviours that surround the preparation and eating of food.

A proposal with the evidence base was discussed in a staff meeting and participants thought that it was a good idea. An information leaflet was developed for the adolescents on the unit, who were also invited to attend the first group. With consent, the leaflet was also given to parents and carers to keep them informed of their son/daughter’s care. This involved the parent/carer in the process, so that they did not feel that their role as parent/carer was being undermined.

A budget was set of £15 a week to feed 12 residents plus three staff. This was not always easy to adhere to, but some shrewd shopping from the adolescents meant that this budget was met. During holidays the budget was increased to allow residents to have breakfast off the unit. The rationale was to allow residents the freedom and initiative to organise their own and others’ breakfast and learn about the value and cost of items.

The following aims for the group were used:

●● pride in achievements – to build, improve, develop and learn skills to support the transition from adolescent to adult;

●● use budgeting skills, and record and use a calculator (or maths in their heads) and have total responsibility for the £15 budget;

●● negotiate with others; ●● belong to a fun group; ●● have choice and make decisions over what you eat (this is the only time they do this as other meals come from the main kitchen);

●● have a breakfast food, which you enjoy; ●● share your culture, around types of breakfast you have in your family; and

●● reduce institutionalisation, by eating different foods at different times and trying new things, cooking for everyone on the unit, going out to purchase ingredients, and making/researching recipes.Prior to joining the group, all adolescents

had a dietary assessment as well as a functional assessment and mini kitchen assessment. Physical observations were monitored, and their mental state assessed on the day.

All residents on the unit, following a clinical discussion, would attend if they were physically well enough to stand and mobilise

The development of a

breakfast groupon an adolescent unitSamantha Jaques-Newton charts the development of a ‘breakfast group’ for young adolescents with eating disorders

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in the kitchen and go shopping (young people of very low weight would not attend for two weeks or eat the breakfast, that is, re-feeding syndrome), cognitively able to ensure their safety and that of others, and a risk assessment had been completed.

Each aspect of the activity was graded to try to meet the needs of individuals and to make sure as a team they could all be included.

A clear document of why the OT would facilitate the group was given to staff and explained to the young people on an individual and group basis. This process broke down each component into areas such as rationale for taking part, cognitive skills that would be required and activities of daily living skills.

A plan of what would happen at each stage was also completed. Participants’ ideas would be shared and appropriateness of choices and decisions would be discussed with the multidisciplinary team, with cost, places to shop, a list of prices to compare and advice to shop wisely covered.

Then risks to observe were discussed. The method included: get recipe; go shopping; and using the budget sheet to give everyone in the group a responsibility for that week, eg budget, cook, clean and set table etc. Finally, a list of ways to grade that section of the task was looked at, for example, level of support to calculate budget and amount of time in shop or walking around, due to physical activity levels with eating disorder patients.

This process continued with further discussion about what breakfast patients would have, going out, shopping, cooking and a de-brief group, with the chance to discuss issues that arose and thoughts such as ‘did you enjoy it?’ and ‘how easy was it to cook?’

A breakfast club ideas list was created, with anything from teacakes, pancakes to homemade bread and homemade granola. We discussed different cultures and devised a list split into places such as France (croissants, French toast and crepes), Sweden (meats and cheese and muesli),

Ireland (soda bread) and Spain (bread and oil, doughnuts dipped in sugar and coffee).

Some ideas for the future include patients making their own jam, after picking fruit, having a café for a full English breakfast and eating breakfast in the community.

A breakfast list was placed on the dinning room notice board, set for four weeks. This would include ‘swops’ for residents with an eating disorder, for example, instead of cereals and toast, it would be cereals and muffin. These would then act as a resource to give to parents when their child was ready to go home and try eating new things, or changing their dietary needs.

A focus group was held to evaluate the group after six months and an evaluation form was sent out to all adolescents that had left the unit, but had participated in the group.

The feedback was that they found the group useful: ‘I could eat at Starbucks with friends...’; ‘I liked the choice and freedom around making one meal, it felt more normalI’; ‘I learnt that I want to work in catering, and as a result of getting a reference from the OT, I have worked voluntarily in a large kitchen – now that I’m 18 and work in a café I’m waiting to go to catering college’.

Not so positive feedback included the comments that ‘it should not only be breakfast, but other meals’ and that ‘sometimes it felt like a really big challenge’. It was at times difficult to motivate some of those with eating disorders to participate, as eating and cooking to them was something of an anathema. The plan is to continue with the group, because of its success.

ReferencesBuchanan A, Gow A, Storie A (2007) Rise and shine, it’s

breakfast time, Occupational Therapy News, 15(2): 32-33

Chugg A, Craik C (2002) Some factors influencing occupation

engagement for people with schizophrenia living in the

community. British Journal of Occupational Therapy 65(2),

67-74

Haley L, Mckay E (2004) Baking gives you confidence: users’

views of engaging in the occupation of baking. British

Journal of Occupational Therapy 67(3) 125-28

Kremer E, Nelson D, Duncombe L (1984) Effects of selected

activities on affective meaning in psychiatric patients.

American Journal of Occupational Therapy 38(8) 522-28

Mee J, Sumsion T (2001) Mental health clients confirm the

motivating power of occupation. British Journal of

Occupational Therapy 64(3) 121-28

●● Samantha Jaques-Newton, specialist OT,

Thorneywood Adolescent Unit, Nottingham.

Email: [email protected]

‘On the adolescent unit, the breakfast club helps by making eating and food preparation a more sociable occasion. The

naturally occurring conversation in the group and at the table also helps distract those with eating disorders from

focusing solely on their food. ’

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The art group is based at the Charleston Centre in Paisley, Renfrewshire and was recently involved in the 2009 Scottish

Mental Health Arts and Film Festival. The group produced a banner, which featured as part of the ‘Picture Yourself Well’ exhibition. The banner was the culmination of a 10-week collaborative project involving work on a large-scale floral design.

There were many positive outcomes achieved from this project and from last year’s group, which had also produced and exhibited artwork in the previous year’s festival. The art group focuses on joint working, hence the ‘group’ project idea. This process helped build clients’ confidence, as they were encouraged to share ideas and play a part in contributing towards an end goal (the banner).

The experience of running the group and seeing participants’ confidence grow was very satisfying. Contributing towards something tangible that they could see develop over the weeks helped many realise their potential and feel a sense of mastery. Praise from each other helped meet their esteem needs, receiving recognition for the hard work and the valid contribution that each had made.

The group helped several participants rekindle their interest in art, form friendships and take up other creative activities, which they continued out with the group. It also fostered social skills via the natural process of discussion, requiring participants to make decisions about the overall look and design of the banner.

This process also generated much discussion around recovery and how involvement in the arts made them feel. This gave them the idea of incorporating text, deciding that the artwork would be further

enhanced by a quotation. They selected a beautiful quotation from the artist Georgia O’Keefe, which is painted cascading down the centre of the banner.

The quote reads: ‘I found I could say things with colours and shapes that I couldn’t say any other way… things I had no words for’. These words seemed to embody participants’ feelings about art, providing them with an alternative outlet for personal expression.

Clients took pride in seeing the end result on display in the exhibition, thus seeing their efforts realised. Over the two years that the art group has been run, client feedback has been very positive regarding participation in the art group. Comments have included: ‘It helped me to mix with new people and feel better about myself’; ‘Creativity has helped me come alive since I’ve been ill, but this

allowed me to concentrate on some very positive aspects of my life’; ‘Helped me put things in perspective and it was good to work with others’; ‘Gave me a sense of purpose’; ‘It is good to see people who are ill doing “normal” things regarding expressing themselves’; ‘We can be part of society with or without mental health issues’; and ‘We have just as much to offer as anyone else’.

The art group is an example of a therapeutic intervention that reflects the importance of providing services that ‘respond to people’s leisure, cultural and wider social needs’ (Scottish Executive 2003). In line with the recovery approach the group aims to ‘focus on the strengths of individuals, rather than their problems and on their contribution to recovery’.

By providing ‘services to promote personal growth and development’ (Greater Glasgow Modernisation Plan 2007), such as the art group, group members are ‘supported to live well in the presence or absence of illness’ (SAMH 2007). The banner was exhibited in a well-used centrally located community café – the WRVS café in Paisley – and had much exposure over the two-week period, receiving 1,520 visitors.

The venue is also a valuable source of information for other community activities, groups, local events and other mainstream services and as such encourages social integration. Choosing a popular venue meant that a wide cross section of the community saw the exhibition, which sought to raise public awareness of the arts in recovery.

The art group is an example of the important relationship between occupation, health and wellbeing and a belief in the potential of people with mental health problems to learn and grow (COT 2006).

ReferencesScottish Executive (2003) National programme for improving

mental health and well being action plan 2003-2006.

Edinburgh, Scottish Executive

Greater Glasgow Modernisation Plan (2007)

Scottish Association for Mental Health (2007) Evaluation of

recovery approach report. Glasgow, SAMH

College of Occupational Therapists (2006) Recovering ordinary

lives. The strategy for occupational therapy in mental health

services 2007-2017. A vision for the next ten years.

London, COT

●● For further information contact

Barbara Philipsz, senior OT, community

rehabilitation service, Charleston Centre, Paisley,

Renfrewshire, or email: barbara.philipsz@renver-

pct.scot.nhs.uk

As an OT working in a community rehabilitation service, Barbara Philipsz runs an arts and crafts group, as part of a group work programme aimed at adults with mental health needs. Here she shares some service user feedback

The role of art in recovery

Powerful words: the art group’s banner expresses their feelings

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20-22 April 2010NEC Birmingham

Supported by: Organised by:

• More than 360 specialistexhibitors

• More free CPD educationalseminars and practicaldemonstrations forprofessionals

• New inspirational features

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Whether you are a carer, OT,nurse or any other type ofhealthcare professional, expectmore career development fromNaidex 2010.

expect more at Naidex 2010with essential CPD educationThe UK’s largest disability, homecare and rehabilitationevent extends its portfolio of seminars, demos andnetworking opportunities for healthcare professionals

Register for free at –www.naidex.co.ukor for more informationtel 01923 690 656Priority Code E301

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20-22 April 2010NEC Birmingham

Supported by: Organised by:

• More than 360 specialistexhibitors

• More free CPD educationalseminars and practicaldemonstrations forprofessionals

• New inspirational features

• Larger showcase of innovativeproducts to test and compare

• Unparalleled networkingopportunities

• Open 10am daily with easyaccess and free admission

Whether you are a carer, OT,nurse or any other type ofhealthcare professional, expectmore career development fromNaidex 2010.

expect more at Naidex 2010with essential CPD educationThe UK’s largest disability, homecare and rehabilitationevent extends its portfolio of seminars, demos andnetworking opportunities for healthcare professionals

Register for free at –www.naidex.co.ukor for more informationtel 01923 690 656Priority Code E301

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Over recent years, occupational therapists have been encouraged to start ‘asking the work question’. As we do so, we

discover how multi-faceted the process of returning to work can be; the most seasoned practitioners will at times feel challenged to identify and address all relevant factors, whether physical, psychological, social, organisational or economic.

Based on the authors’ experience with people who suffer from chronic symptoms (eg chronic pain), it is often psychological and motivational factors, not physical status, that determine whether employment is secured or not. While a sole focus on the individual cannot solve all workplace and

systemic issues (Fear 2009), OTs can draw on two models to help clients open the door to a world of possibility and opportunity; the Stages of Change Model (Prochaska and DiClemente 1984) and the Parachute Approach (Bolles 2010).

Psychologists Prochaska and DiClemente recognise the psychological and motivational aspects involved in making a significant behaviour change. Their Stages of Change Model has been adopted by Franche and Krause (2002) as a theoretical foundation for their ‘Readiness for Return-to-Work Model’.

This model suggests that our clients may be in any one of five stages of ‘work readiness’:

●● (one) in the pre-contemplation stage, the individual may not be interested in or has discounted their ability to work;

●● (two) in the contemplation stage, they are considering employment but have not started to pursue it;

●● (three) in the preparation stage, they may have decided to work, but do not yet possess the required skills or resources;

●● (four) in the action stage, they are ready to work and are actively seeking it; and

●● (five) in the maintenance stage, they are working and sustaining their position. Based on these models, various

standardised measures can be used to assess an individual’s work readiness, such as the Readiness to Return to Work Scale by Franche et al (2007). More importantly though, OTs can ascertain which stage of change the client inhabits by listening closely to what they are saying, or not saying.

Typical work-related statements include: ‘I will never work again – my family and my consultant agree’ (pre-contemplation); ‘I’d love to work again, but I’m not sure anyone would employ me with my condition’ (contemplation); and ‘I’m looking forward to working again one day, I just need to manage my condition better first’ (preparation).

Two case vignettes can illustrate this further:

Contemplation Case one: Anna (aged 38), a former school secretary, suffered from Ehler’s Danlos Syndrome and stated: ‘I’d love to work but will never be able to hold down a job’. Her symptoms of extreme pain combined with frequent joint dislocation persuaded the occupational therapist to agree.

However, during a vocational group exercise, Anna suddenly exclaimed: ‘I know – I want to work as a secret agent!’ Although this appeared to be an ‘unrealistic’ option, Anna’s subsequent on-line enquiries

Vocation unwrapped: motivating clients to return to workMarietta Birkholtz and Cara Lovell look at the factors that influence people’s ability to get back to work after accident or illness, focusing on specific return to work models that can help occupational therapists to help clients arrive at their chosen vocation

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revealed that a government agency was specifically seeking to recruit female staff with disabilities.

In keeping with the preparation stage, Anna has since doubled her efforts at physical rehabilitation so that she can join the agency’s training programme and secure employment.

Preparation Case two: Les (aged 24), formerly a decorator, and father of a two-year old daughter said: ‘I enjoy the employment training, but I don’t know what I want to do yet. Also, when I get into a bad mood I find it hard to complete the training days.’

Further exploration revealed that three areas needed addressing to help Les sustain his motivation and enter the action stage more fully: guidance to identify his favourite career interests; child care to cover training days, the lack of which had angered him; and cognitive strategies to manage low mood triggered by memories of previous failure.

Les’ situation shows how the Stages of Change can help us identify specific intervention to facilitate progress to the next stage.

While the Stages of Change model can help OTs assess work readiness per se, Richard Bolles’ Parachute approach offers practical tools to support clients in manifesting their desired career or vocation.

His best-selling careers guide What colour is your parachute? holds relevance for return-to-work programmes and rehabilitation settings alike (Birkholtz 2009). Bolles (2010) suggests that people will wholeheartedly search for and sustain only those types of work that correspond with their favourite skills and interests.

Regardless of the job market, and particularly in a recession, the parachute approach advocates an inventory of seven areas:

●● favourite skills;●● favourite fields;●● core values;●● preferred people environment;●● favourite working conditions;●● desired responsibility and salary; and●● preferred location.

In combining these seven areas, creative and affirmative options can be identified without being limited by so-called disabilities, or by ‘what it says on the CV’.

This is how two clients fared after identifying their favourite skills, fields and location. Pete, aged 46, and a participant of a vocational module in a condition management programme said: ‘I found this tremendously rewarding. It gave me a good insight as to where I would like to go with job searching… I would love to train as a radiographer’. He moved from pre-contemplation to contemplation and preparation.

Agnes, aged 32, three months after completing a pain management vocational module said: ‘…after not having a proper job for five years, I now have the job I want. I applied for a disability researcher training scheme with a TV production company, and I got it…’ She had moved from action to maintenance.

In summary, the combined use of the Stages of Change model and the parachute approach seems to access clients’ motivation to return to work, and can help them arrive not only at a job, but at their vocation.

This is good news for time-poor occupational therapists, case managers or vocational specialists who would like to address their clients’ vocational needs in a succinct, yet life-affirming manner.

ReferencesBirkholtz M (2009) Reviving the root of vocation. RehabReview

Newsletter, October 2009. Available from: www.

rehabwindow.net/Display.aspx?id [accessed 15/02/10]

Bolles R (2010) What colour is your parachute? Ten Speed

Press, Berkeley

Fear W (2009) Return to work revisited. The Psychologist, 22(6)

502-503

Franche R and Krause N (2002) Readiness for return to work

following injury or illness: Conceptualising the

interpersonal impact of health care, workplace, and

insurance factors, Journal of Occupational Rehabilitation,

12(4): 233-256

Franche R, Corbière M, Lee H, Breslin C, Hepburn C (2007) The

Readiness for Return-To-Work (RRTW) scale: Development

and validation of a self-report staging scale in lost-time

claimants with musculoskeletal disorders, Journal of

Occupational Rehabilitation, 17(3) 450-472

Prochaska J and DiClemente C (1984) The transtheoretical

approach: Crossing traditional boundaries of therapy; 1st

ED. Dow Jones/Irwin: Homewood

●● Marietta Birkholtz, head of occupational

therapy and vocational lead at RealHealth

London, and Cara Lovell, lead occupational

therapist at Royal National Orthopaedic

Hospital, Stanmore. Email: Marietta.

[email protected] or Caralovell@

inbox.com

‘...it is often psychological and motivational factors, not physical status, that determine whether employment is

secured or not.’

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Why is work important and why should we support people working? Work contributes to adult identity

(Dyck 1995), confers financial benefits (Cantanzaro et al 1992) and can improve health and life quality (Aronson 1997; Waddell and Burton 2006). There are 6.8 million disabled people of working age in Britain – one fifth of the total working age population – but only 51 per cent are in work.

Recent government initiatives have been targeted at supporting these people to return to work, yet it is unclear if these initiatives help people with long-term neurological conditions. The national service framework (NSF) for long-term neurological conditions highlights the need for services that enable people with long-term neurological conditions to enter work, education or vocational training, remain in or return to their existing job or withdraw from work at an appropriate time.

Although there is a growing consensus and evidence base about the benefits of vocational rehabilitation services, there is increasing concern they are inaccessible for people with long-term neurological conditions, many of whom fall into ‘hard to reach’ groups.

As a profession we are very aware of the growing agenda to provide vocational rehabilitation services. However, before we can look to improve services and ensure it is not a postcode lottery for our service users, we need to start with understanding what is already provided. As part of a government-funded two-year research project (National Institute for Health Research), work is underway to map current service provision.

Existing vocational rehabilitation provision for people with long-term neurological conditions in England is patchy and services are poorly defined. Some are NHS led, some are linked to JobCentre Plus and others operate in the private or voluntary sector.

New guidelines call for partnership working between health and social services and statutory (JobCentre Plus) and

voluntary services to bridge service gaps and ensure that people can access services when they need them. However, it remains unclear to what extent existing services fit with these recommendations, or meet the differing needs of people with long-term neurological conditions.

The purpose of this study is to identify and describe vocational rehabilitation services currently available to people with long-term neurological conditions in England and consider the extent to which they fit published recommendations. This is a two-year project entitled ‘Mapping vocational rehabilitation services for people with long-term neurological conditions’, led by Dr Diane Playford, honorary fellow of the COT, at the Institute of Neurology, University College London, and Dr Kate Radford, from the University of Central Lancashire.

The study will use a combination of quantitative and qualitative methodology and will take place in three stages. The first two stages, which have been started, include developing and using a questionnaire to map vocational rehabilitation services for people with long-term neurological conditions and explore current practice, identifying well established and emerging services and differences between general and specialist vocational rehabilitation services; probing perceptions about resources, barriers and facilitators.

This questionnaire has already been sent out and will continue to be sent to relevant health professionals. Descriptive analysis of all responses will be undertaken and results correlated.

The final stage will elicit, through qualitative interviews, barriers and facilitators to developing specialist vocational rehabilitation services within the NHS; map and report exemplars of good practice and develop mechanisms for sharing knowledge about what makes vocational rehabilitation services effective and why. For more information see: http://www.ltnc.org.uk/research_files/mapping_vocational_rehab.html.

The findings from the different stages of the project will be synthesised to provide a

full research report. This report may form the basis of a paper for publication, which may incorporate anonymised quotations from staff. The study will result in:

●● bench-marking evidence on the implementation of the NSF QR6 (Vocational Rehabilitation) in England;

●● a directory of vocational rehabilitation services for people with long-term neurological conditions, to enable service providers and commissioners to network and potential services users to identify services appropriate to their needs; and

●● an online forum for sharing knowledge and expertise about vocational rehabilitation for clinicians. It is easy to see that this is an essential

piece of research, which will equip both professionals and commissioners. If you or your service provides any level of advice or help with returning to, or remaining in, work and/or education to people with long-term neurological conditions, please email Ali Gibson at: [email protected] and provide us with your name, full postal address and a telephone number, so that we can contact you and send out a questionnaire.

ReferencesAronson KJ (1997) Quality of life among persons with multiple

sclerosis and their caregivers. Neurology, 48(1): 74-80

Catanzaro M, Weinert C (1992) Economic status of families

living with multiple sclerosis. International Journal of

Rehabilitation Research, 5(3): 209-18.

Department of Health (2005) The National Service Framework

for Long-Term Conditions

Dyck I (1995) Hidden geographies: the changing lifeworlds of

women with multiple sclerosis. Soc Sci Med, 40(3): 307-20.

Waddell G, Burton AK (2006) Is work good for your health and

wellbeing? Department of Work and Pensions

●● Joanna Sweetland, research OT, Institute of

Neurology, London

Vocational rehabilitation survey –

we need your helpResearch OT Joanna Sweetland poses the question: Vocational reha-bilitation for long-term neurological conditions – what is really out there?

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The Model of Integrated Vocational Rehabilitation was developed during the final year of a four-year part-time occupational therapy BSc

(Hons) degree at the University of Essex, from an amalgamation of an academic assignment and hands on practice development.

While participating in setting up a work-based learning programme within a community-based forensic service for adults with learning disabilities, some with co-morbid mental illnesses, I was also working on an assignment that included identifying a model of practice relevant to an emerging area of occupational therapy practice.

Researching the two projects identified that although each existing model of occupational therapy practice has its own merits, no one model fully fitted the client group within this vocational rehabilitation setting. Ross (2007) also identified there is no ‘one size fits all’ framework and goes on to suggest the use of a combination of models.

It was felt that this idea could be developed further by reviewing and identifying relevant aspects of current models and adding aspects specific to this area of practice in order to produce a new model. The Model of Human Occupation (Keilhofner 2008) and The Canadian Model of Occupational Performance (Ross 2007)

had many relevant aspects, which subsequently inspired the following person centred model.

The model illustrated The resulting ‘person-environment-occupation-performance’ model follows the occupational therapy contemporary paradigm, which values occupation and advocates ‘the integration of individuals into life through meaningful occupation’ (Duncan 2006).

The model (see diagram) places the client firmly at the centre, as advocated by the Valuing People white paper (DH 2001) and shows the workplace collaboration taking place between the

Developing a newmodel of practiceAndy Smith, support worker and student, shares his work on developing a model of integrated vocational rehabilitation, as part of his academic studies

Strengths/needs ●● the client has individual strengths and

needs (bio-psychosocial) the strengths will

be identified and will be used to address

any assessed needs.

Skills●● skills the client already has and those that

will be developed (work-based,

educational, social).

Habits ●● already formed and new habits to be

acquired.

Roles●● help organise use of time and place an

individual within the social structure (Ross

2007) .

Motivation ●● goal setting; and●● past experiences (positive and adverse).

Culture ●● beliefs;●● core values;●● upbringing;●● family influences and dynamics; and●● spiritual.

Occupational participation ●● refers to engagement in work, play or

activities of daily living that are part of a

person’s socio-cultural context and that are

desired and/or necessary to wellbeing

(Keilhofner 2008).

Policies●● government;●● local;●● social;●● legal; and●● ethical.

Multidisciplinary team●● collaboration between the multidisciplinary

team.

Therapist ●● skills; ●● knowledge; ●● therapeutic use of self; and ●● experiences.

Theories/evidence based practice (best

practice)●● current evidence based practice; and●● relevant theories (dependent on client needs).

The following expansion of the concepts used within the Model of Integrated Vocational

Rehabilitation aims to aid the understanding and usability of the client centred model.

Further expansion of the model

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client (in red), the therapist, the multidisciplinary team and outside agencies (in yellow); the progression outwards then demonstrates the continuing client journey.

Each of us strives, throughout our life, to achieve a balance of meaningful and purposeful work, rest, self-care and leisure (Ross 2007). Rest, self-care and leisure are not directly addressed by the model, but are

perceived to be influenced and are reflected in the client journey (outwards).

Limitations and future development The model was developed primarily for use with people with mild learning disabilities and or a co-morbid mental illness within a work-based vocational rehabilitation environment, although it is envisaged it can

be used with a much wider client group, and within other areas of practice.

Although the model has been used successfully in relation to this programme, it will need to be used by others to fully evaluate its relevance and usability. With this in mind, further expansion of the components of the model have been compiled and are outlined in the box below.

Outside agencies ●● any outside agencies involved with or used

by the service, eg: further education college;

Connexions; learning disability/mental health

service providers; social services; Job centre

plus; advocates.

OT process ●● information gathering;●● assessment;●● treatment formulation; ●● treatment implementation;●● review; and●● discharge/referral.

Frame of reference ●● this is determined by client need, and could

include elements from one or more of the

following: client centred; cognitive;

psychodynamic; learning/teaching;

developmental; biomechanical; or

compensatory/adaptive.

Assessment●● problem analysis;●● initial assessment will identify areas of need

and strengths;●● followed by more focused assessment on

identified area of need; and●● followed by continual evaluation.

Activity analysis ●● the use of activity analysis to grade the

activity and/or adapt the environment to suit

the individual current abilities as well as to

encourage growth.

Relationships ●● the development of relationships through an

increased network of friends.

Lifelong learning●● the continued increase of life skills as

confidence and experience grows.

Community participation ●● joining of clubs, comities and

organisations widening participation and

contribution to their community.

Work ●● advancement into a wider range of work

opportunities which include, paid work,

volunteer work and any other meaningful

occupation.

Education ●● continued education, ether leisure based

(arts, languages, sports) or academic

(literacy, numeracy, trade qualifications

[bricklayer, plumber).

Hobbies ●● increased motivation to participate in

leisure and hobbies.

Education Relationships

Hobbies

Communityparticipation

Lifelonglearning

Work

occupational performance

occupational performance

Policies

Culture

Motivation

OT

proc

ess

Activity analysis

Occupat

ional

partic

ipat

ion

Frames of reference

MD

T

Therapist

Person

Outside agencies

Theories/EBP

Skills

Habits

Stre

ngth

s

Needs

Cognitive Affective P

hysic

al

ReferencesDepartment Of Health (2001) Valuing people:

a new strategy for learning disability for

the 21st century. Crown Copyright

Duncan E (2006) Theoretical foundations for

occupational therapy, internal influences.

In Duncan E (Ed) Foundations for practice

in occupational therapy, 4th Ed.

Edinburgh: Churchill Livingstone.

Keilhofner G (2008) Model of Human

Occupation, Theory and Application 4th

Ed. Philadelphia: Lippincott Williams and

Wilkins

Ross J (2007) Occupational therapy and

vocational rehabilitation. Great Britain: TJ

International

●● Andy Smith, OT assistant and

OT student, Partnerships in Care,

Learning Disability Services. Email:

[email protected].

uk or tel: 01379 749900 (ext

13694)Model of Integrated Vocational Rehabilitation: by Andy Smith

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Mental health recovery focuses on people claiming or reclaiming purpose and meaning in their life, even

within the limitations caused by mental health symptoms. It suggests that rather than being cured, a person learns to live with their mental illness, while maintaining an independent and healthy lifestyle (SRN 2009).

Every person’s experience of recovery is unique, as recovery means different things to different people. A number of key components are important to recovery, self determination, empowering relationships based on trust understanding and respect, meaningful roles in society, and elimination of stigma and discrimination (National Mental Health Information Centre 2009).

The team comprising of OTs and nursing staff at the Ayr Clinic include exercise in the form of walking groups as a means of aiding individual recovery. Our walking groups aim to help clients to develop a healthier, more active lifestyle, promoting positive mental health.

Walking is the most popular physical activity undertaken for pleasure and fits well with the strategy for occupational therapy and mental health (COT 2006). It is being increasingly recognised that walking is an excellent means of improving physical and mental wellbeing.

The walking groups are one of many components of our service, which tie in with the recovery-based approach that the Ayr Clinic adopts. When people see the benefits of their bodies becoming more active and physically fit, it helps them feel better about themselves. This in turn keeps them focused on something other than symptoms of their mental illness.

Staff and patients believe that walking plays an important part in both physical and mental health recovery. The walking group

provides valued activity, a sense of structure today, together with the opportunity of being involved in a community-based intervention, which clients can continue on discharge from the unit.

Walking group aimsThe Ayr Clinic is a low secure mental health unit operated as part of the Partnerships in Care group. Within the Ayr Clinic there are two male wards and one female ward, each with their own weekly three-hour walking group run by the OT department. The walks take place in a variety of locations throughout Ayrshire, incorporating both beach and countryside walks, and are chosen in advance by the patients during interactive group planning sessions.

At the end of the walk the patients go for a coffee in a café close to where the walk has taken place, or for the more remote walks take flasks of soup that they have prepared prior to the walk. The universal aims for the walking group include:

●● promoting physical exercise as part of a healthy lifestyle;

●● providing structure to the day and valued occupation for patients who enjoy walking and being in the outdoors;

●● assisting in social inclusion for patients by going to local cafés and walking in community areas;

●● improving social and interpersonal skills through communication with other group members during planning sessions, while making soup and throughout the walking group;

●● increasing confidence in the community through improving skills such as money handling, road traffic skills, interacting with the public and reading maps.Some of these aims will apply to all

patients, however some will only apply to

patients who have a particular deficit in that area. In addition each patient has collaboratively agreed individualised goals that they aim to achieve through participating in the walking group.

Client reported outcomesWithin the Ayr Clinic the walking groups are a popular activity with clients keen to attend on a weekly basis. On average, five clients attend each group. In order to evaluate the sessions those who regularly attend the walking groups were asked about their feelings towards, and opinions of, the group. This centred on what they felt they achieved from attending the group and whether they felt the group had any impact on their mental and physical wellbeing.

Overall the feedback from clients has been positive:

●● ‘I seem to get more confident every time I go out, I feel less paranoid’;

●● ‘It gets me out into the environment and into every day life again and used to what’s expected of me in the community and what would be acceptable behaviour’;

●● ‘It gets me off the ward. You feel free, no locked doors, it improves your mental health’;

●● ‘Fitness levels improve’; ●● ‘[It’s] also helping me to lose weight and stay healthy’;

●● ‘The beautiful scenery… exercise and the scenery, I enjoy them both. It gets me out and about for a bit’; and

●● ‘Engaging in conversation with the group and the nice scenery… I like the countryside’.

The way forwardAs the walking groups appear to be contributing to our client’s recovery there are plans being put in place to further develop them. This involves more emphasis on grading the walks from short, slow paced walks to more advanced, longer walks. A service user’s physical abilities will be assessed and an appropriate level of walk will be identified for each individual.

Walking on the road tomental health recoveryNatasha McKendrick, May White, Susan McCutcheon, Laura Craig and Audrey Davidson outline how a walking group within a low secure mental health setting helps patients on their road to recovery

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The unit has on loan a step-o-meter pack from the Paths for All national charity (Paths for All 2009), which promotes walking for health and supports people to become more active in and around their local communities through the development of a network of multi-use paths in Scotland.

The step-o-meters have begun to be used by each service user to document the number of steps taken while participating in the walking group and allows patients to

monitor and build on their physical abilities.

The steps will be recorded in the individual’s walking diaries and the recording will be compared with the number of steps taken from a normal day staying within the unit. This will give the service users a sense of achievement when they see the differences in the number of steps taken and how taking part in physical activity such as walking can contribute to a healthier more active lifestyle.

ReferencesCollege of Occupational Therapists (2006) Recovering ordinary

lives: The strategy for occupational therapy in mental health

2007-2017. A vision for the next 10 years. COT, London

National Mental Health Information Centre (2009) http://

mentalhealth.samhsa.gov [accessed 10/02/10]

Paths for All (2009) http://www.pathsforall.org.uk/ [accessed

10/02/10]

Scottish Recovery Network (2009) Raising expectations and

sharing ideas for mental health recovery. SRN, Glasgow

●● Natasha McKendrick, May White, Susan

McCutcheon, Laura Craig and Audrey

Davidson, OT team, Ayr Clinic, Partnerships in

Care. For more information please contact Jean

McQueen, head OT, at email: jmcqueen@

partnershipsincare.co.uk

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Paths for All, in partnership with Living Streets Scotland, last year commissioned Scotland’s first-ever national opinion survey into public attitudes to walking and public space. The two organisations want to understand what issues matter most to the public and what potential barriers stop people from walking more and becoming a healthier society.

This survey was designed to add to an existing body of knowledge regarding walking habits and issues in Scotland and was conducted on behalf of the organisations by the Progressive Partnership. Information from the research will be used to inform strategy in the future.

The data was gathered using the Scottish Opinion Omnibus Survey. It is a telephone survey focusing on the entire Scottish population and involved a total of 1,001 national representative telephone interviews with adults aged over 18 across Scotland.

The survey concludes that there is already a significant amount of walking taking place in Scotland, but that the level of walking needs to increase and the number of people walking regularly also needs to increase. It shows strongly that with the right measures in place, numbers of people walking and the frequency of walking will increase.

However, for this to happen, Scottish and local government need to commit to a strategic approach to increasing walking and put the actions in place to support and develop walking in Scotland.

Visit: www.pathsforall.org.uk/about/article.asp?id=817&news=1 to download a copy of the survey results or visit: www.livingstreets.org.uk/scotland.

Walking and public space

‘Walking is the most popular physical activity undertaken for pleasure and fits well with the strategy for occupational

therapy and mental health.’

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‘Striding into the next decade – are we fit for purpose, fit for practice?’ was the ambitious title for the College of

Occupational Therapists Specialist Section – Children, Young People and Families’ (COTSS-CYPF) conference held in November 2009.

The long awaited two-day conference was buzzing as specialist section members enthusiastically shared their ideas and thoughts about the future of occupational therapy.

Liz Ricarby, from the charity YoungMinds, provided the opening address and presented the Young People’s manifesto, using a visual presentation of young people saying what they want from professionals in terms of dealing with their mental health issues. YoungMinds is committed to improving the mental health of children and young people.

The YoungMinds manifesto calls for training for school staff, for shorter waiting lists for assessments, for advocates to support young people, for experts to start listening, and for us all to make sure young people are not lost in the system when they reach 16 years of age. The manifesto has been supported by the College and can be found at: www.youngminds.org.uk.

The College’s manifesto is nearing completion and specialist sections have been supporting this through the specialist sections clinical forum. Delegates at the conference were asked to think about how they could influence politicians, especially those in the next government, by Greg Stafford, COT public affairs officer.

The COTSS-CYPF has many expert members and they supported the conference by presenting and running sessions. Topics were varied, but all demonstrated the commitment many occupational therapists give, not only to their clients, but also to the profession. There were too many to mention

here, so this is just a taster. The specialist section’s newsletter will give more detail.

Promoting good mental health through occupational therapy was the theme of several of the workshops, ranging from early interventions for those young people with psychosis, to youth offending and improving self esteem. We heard how narratives and stories have been used for many years to pass down creative ways of coping with life’s challenges.

Tracey Winsor and Louise Nicholl showed delegates how they used the six-part story method, developed by Mool Lahad, a drama-therapist, to help children and young people use different strategies to cope with the difficulties they are faced with.

Of course, not all presentations focused on mental health. Many children and young people use assistive technology and there was the opportunity to hear about Life at Leeds. Benita Powrie and Jennifer McAnuff highlighted how they strengthened occupation-focused practice by using innovative approaches to assessment and goal setting in a multi-agency process for the assessment and provision of assistive technology.

Outcome measures were the focus of Clare Wright’s workshop. The increasing requirement to demonstrate equipment effectiveness means it is important that therapists’ interventions also include evaluation strategies to demonstrate change and any outcomes that have been achieved.

Special seating is known for its complexity. There is a wide variation of client presentations and subsequent seating configurations to meet their needs and functional goals within the different environments in which seating systems are used. Two standardised measures that could be used to demonstrate effectiveness in seating were reviewed during the workshop; the Goal Attainment Scaling (GAS) and the

Psychosocial Impact of Assistive Devices Scale (PIADS).

Delegates had the chance to share their experiences about generic job titles. OTs bring their own professional skills to the roles of mental health practitioner, but are there long-term risks? For example, in one NHS trust, staff have been unable to support the undergraduate occupational therapy programme. They are not taking students on placement because they are not seen to have a professional responsibility or a contractual agreement to do this.

Paediatric occupational therapy is a speciality as broad and as varied as ‘adult’ occupational therapy provision. OTs are often poorly prepared for practice in paediatrics in the UK, and this provides challenges for workforce planning and establishing and providing comprehensive services.

Lynley Read’s suggestion for ‘Growing your own OTs’ aimed to develop foundation knowledge and skills for paediatric occupational therapists working in acute and community health care at the levels of band five and band six. A strategy was implemented that included semi-structured induction and training to develop core knowledge and skills for paediatric occupational therapy.

This was provided in-house, using a variety of learning and teaching styles. Costs were minimal. Band five rotations were set up to provide an introduction to paediatrics, and a pathway to band six posts was developed. Supporting students on practice placement also increased awareness of paediatric occupational therapy as a specialty.

Feedback from staff was positive and one third of band fives moved on to band six posts. This was an effective low-cost short-term solution, but developing paediatric OTs is an ongoing shared responsibility between higher education institutions, managers and clinicians.

Striding into the next decade – clowns and all

Peggy Frost reports from the recent specialist section annual conference, which tackled issues from promoting good mental health, early intervention and assistive technology to developing specialist knowledge and skills

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If you have waiting lists and are looking for different ways to reduce these, Lois Addy told delegates how using an asset-based approach to service delivery might help. Delegates heard how the asset-based approach shifts the focus from identifying needs and deficits, to identifying and mobilising strengths. She argued that this approach reduces dependence on professionals such as occupational therapists, it fosters inclusion rather than selected participation and utilises natural leadership.

Using an example of providing interventions with school pupils to improve hand writing, Lois described the process from assessing the children’s needs to identifying and using available assets including the school environment, the particular skills of parents, the skills and position of the school staff and class based learning.

Finally, delegates heard from Anne Lawson Porter, then COT head of education and learning, who brought us back to ‘Striding into the next decade – are we fit for purpose, fit for practice?’ Anne challenged delegates to think about the unique skills they provide to children and young people, about new and emerging opportunities and related this to her own experiences.

Throughout the two days there were opportunities to focus on service developments, integrated services, working in mainstream schools, and to consider occupational therapy for those with specific needs such as developmental co-ordination disorders.

For personal development, other workshops helped delegates consider how

they might submit a research proposal for ethical review, produce practice guidelines and meet the requirements of the special educational needs statementing process without compromising responsibilities to the children and young people.

As always, the conference was supported by an exhibition of equipment stands and a poster competition. There were opportunities to meet with like-minded occupational therapists at fringe meetings for COTSS-CYPF forums for acute, neo-natal intensive care unit (NICU), managers and child and adolescent mental health services (CAMHS).

And then there were the social clowns. If you thought, as I did, this was a silly idea, then I have to say, you and I were wrong. The clowns brought light-hearted humour at welcome intervals. They were sensitive to the audience, touched on small things and

made us all laugh. They brought just the right amount of humour and opportunities to reflect to the day in a sensitive and responsive way. A fantastic addition to the conference.

Before I finish, I would particularly like to mention the fringe meeting for autistic spectrum disorders (ASD). There was an overwhelming amount of enthusiasm for the COTSS-CYPF to set up a forum for ASD. If you would like to join this forum an email network will be set up in the first instance. Please email Helen Williams for more information at: [email protected].

The COTSS-CYPF welcomes new members. Information about joining is on the College’s website under COTSS-CYPF: www.cot.org.uk.

●● Peggy Frost, COT practice development

manager. Email: [email protected]

Clockwise from top left: Anne Lawson-Porter, Marg Dawson and the clowns

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A study day, ‘Healthy lifestyles: cycling and OT’, took place at COT headquarters in London on 19 January. It was led by Janet

Paske from Wheels for Wellbeing, a charity that supports disabled people to cycle in London. Delegates came from across Britain with a mixture of motivations for attending, ranging from general interest in cycling to wanting to find out how and why they should build cycling into their practice.

Those delegates already running projects wanted to network and expand what they currently do, with a particular emphasis on resources for people with physical impairment. Janet started from the premise that everyone can engage in cycling.

The day covered the wide range of cycles available, from trikes and handcycles to recumbents. Delegates heard about people with partial sight cycling on an athletics track, where they were able to follow the white lines and so cycle independently. An example was provided of side-by-side cycles where someone can learn to pedal gradually, which can lead them to cycle independently, whether on a trike or bicycle.

During the course of the day delegates shared their experiences, for example where

cycling had been a successful alternative to busy public transport for someone who had panic attacks on the train.

Delegates were provided with information on a number of grant making bodies and the range of support available to occupational therapy services wanting to access support or financial support to start projects. Sports development officers, cycle officers and ‘healthy lifestyles’ teams employed by local authorities can be useful contacts to make, with knowledge of funding opportunities and other sport opportunities aimed at people with special needs.

Ben Whittaker, of Greenerhealthcare, demonstrated how cycling could help meet the legal commitments to reduce CO2 production in the UK, as well as improve public health and particularly help public bodies including the NHS meet their carbon reduction plans.

Janet Paske and a number of delegates have joined a group on Linkedin.com open to BAOT members called ‘cycling in OT’. For more information contact Lee Roach on tel: 0207 4505471 or email: [email protected].

●● Lee Roach, COT membership development

officer

On Wednesday 21 October 2009, in the beautiful surroundings of the Mill Hotel in New Lanark, OT

Catriona Hutcheson and Hazel Ferguson, activity co-ordinator, facilitated a COT study day. The theme of the day was using occupational therapy to facilitate group activities for service users with sensory and physical impairment.

The presenters, Kathy Murray, occupational therapy assistant, Charlotte Macintosh, head occupational therapist, Rab Wilson, creative writing fellow and Barbara Brown, senior occupational therapist, travelled from across Scotland to share their knowledge and expertise.

The event was well attended with delegates from as far afield as Stoke-on-Trent and North Wales. A mixture of presentations and practical workshops, which included simulation of sensory and physical impairment, were well received

Healthy lifestyles:cycling and occupational therapy

Facilitating

group activities

Lee Roach is promoting cycling as a way of achieving a healthier lifestyle for disabled people

Catriona Hutcheson reports from a study day to facilitate group activities for service users with sensory and physical impairment

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by the delegates; 96 per cent rated their day positively.

The study day commenced with an introduction to groups and group dynamics, the therapeutic use of creative writing and adapting group activities. Bill Horrigan, an art college tutor, joined the facilitators to offer practical workshops in the afternoon. Delegates used aids to simulate the experience of sensory impairment whilst participating in creative group activities.

The format of the day was highly praised, and comments included, ‘...good mix of presentations and interaction’, and ‘...found the whole day very interesting and educational’. The overall response from the delegates was overwhelmingly positive, and virtually every delegate reported a positive, enjoyable and informative experience.

COT is running another study day entitled, ‘Delivering effective groups in London’ on 17 March 2010. If you are interested in attending please contact Beriah Chandoo on tel: 02074505474 or email: [email protected].

●● Catriona Hutcheson con be contacted at:

[email protected]

The Council of Occupational Therapists for the European Countries (COTEC) was established in 1986, with the

purpose of co-ordinating the views of the national associations of occupational therapy within Europe. The aim of COTEC is to enable national OT associations in Europe to work together to develop, harmonise and improve standards of professional practice and education, as well as advance the theory of occupational therapy throughout Europe.

COTEC now represents 27 European countries and more than 120,000 OTs. The full council meets twice a year for two days to discuss and co-ordinate the work agreed in the action plan. Each member association takes the opportunity to host a meeting and in return we try to meet with the political figures within the country to support and promote the role of occupational therapy locally.

In October 2009, we met in Sliema, Malta, and the following key areas were discussed:

●● COTEC has applied to be a member of the European Health Forum to meet its aim of becoming more visible within the European Commission;

●● a draft document on occupational therapy for active ageing in Europe has been produced, one of many that are hoped to raise the profile of occupational therapy in the European countries;

●● the COTEC website is still new and developing, but has been a huge success so far. Further discussions are under way about whether it is viable to have it translated into different languages;

●● the COTEC code of ethics has been up dated and is free to view on the web site at: www.cotec-europe.org;

●● COTEC met with Malta’s health minister, who agreed to meet and consult with the Maltese Association of Occupational Therapists in the future;

●● COTEC is looking at a possible formal launch into the European Commission in 2011 and work is under way to look at the viability of this project; and

●● the ninth COTEC congress is to be held between 24 to 27 May 2012 in Stockholm.The council meetings are always busy

and I come home exhausted, but full of enthusiasm at the work that COTEC is achieving. My term of office finishes at the annual general meeting in June 2010, and I would encourage any member to apply for the position.

●● Kate Sheehan, independent OT and

delegate

Promoting the profession throughout EuropeKate Sheehan reports from the autumn COTEC meeting in Sliema, in Malta

COTEC council meeting in Sliema, Malta

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On 20 January, the Research Forum for Allied Health Professions (RFAHP) held a workshop to support members

from across the professions who are interested in applying for the grant schemes available from the National Institute for Health Research Clinical Academic Training Pathway (NIHR CATP scheme).

Hosted by COT, some 60 representatives from seven allied health professions attended a lively and informative day. Dr Elizabeth White, COT’s head of research and development and current chair of the RFAHP, welcomed members and visitors, providing a background to the development of the CATP and highlighting the crucial role that the RFAHP has played in enabling AHPs to access this scheme.

The first speaker was Jo Powell, a physiotherapist by background, who is now involved in running the CATP through her work for the NIHR Trainees Co-ordinating Centre. Jo gave an overview of the scheme, advising delegates of the remit of the NIHR and how the CATP scheme is being funded in addition to the traditional NIHR fellowships.

She provided useful detail of the four levels of fully-funded research training that are available – master’s in clinical research, PhD, clinical lectureship and senior clinical lectureship.

The next speaker was Lisa Hughes, a dietician by background and currently AHP

officer from the Department of Health. In focusing on the crucial role that service managers and clinical supervisors have in creating a supportive culture for research activity, Lisa provided a timely reminder to delegates that the policy context does shape the priority areas for research.

The morning session ended with a joint presentation by Lindsey Hooper a successful applicant for the 2009 NIHR clinical doctoral research fellowship and her supervisor Dr Cathy Bowen, both from the University of Southampton. Their presentation focused on submitting a successful application from the perspectives of the applicant and the supervisor, and they highlighted the need for rigorous preparation, the need to allow plenty of time to accrue the required signatures and to practise well if invited for interview.

The afternoon session commenced with a presentation by Professor Jackie Campbell, research officer from the Society of Chiropodists and Podiatrists, who sits on the CATP scheme implementation group and is an AHP panel member. Jackie provided

excellent advice on what makes a good application, focusing specifically on the doctoral and clinical lectureship levels.

The day closed with a final request from Jo Powell and Ann Deehan, research faculty manager from the Department of Health, for feedback from the delegates to inform the future development of research capacity building schemes.

The majority of speakers’ presentation slides can be shared with members, so if you are interested in receiving these, email: [email protected].

●● Dr Elizabeth White, COT head of research

and development, chair of the Research

Forum for Allied Health

Professions

The clinical academic training pathwayElizabeth White reports from the National Institute for Health Research Clinical Academic Training Pathway workshop

Sharing information

across boundaries A national workshop for AHPs, held in

London in November 2009, reflected on issues relating to improving cross boundary

flows of information to improve patient safety, service delivery and effectiveness of care. The

report and recommendations from this event will be relevant to OTs in leadership roles in England, and to

some extent in Northern Ireland, Scotland and Wales. Many boundaries that can impede information shar-

ing are found within the health and social care services in the UK. For example, between professions, care teams, care

services, care organisations, and countries.Some existing ideas and solutions to improve sharing of

information include: record standards; datasets; and clinical content assurance. The report contains a number of clear

recommendations for individuals and the professional bodies and organisations. Representatives are asked to:• consider the work of the Royal College of Physicians and Royal

College of General Practice in the next review of professional care records standards and incrementally move them towards integrated standards;

• work to accelerate the breakdown of professional boundaries; • promote the message that NHS CFH is looking to share good

practice and learning across country boundaries; • re-visit and reference the Learning to manage health informat-

ics publication to understand and influence the skill develop-ment in under and post graduate education; and

• feed back to professional bodies and organisations and use professional communication channels to raise the profile of the issues and work in progress. Irrespective of the imminent general election there will be

changes to the National Programme for IT in England that is progressively improving the information available to

support the transformation of care services in England. Improving the quality of patient information, facilitat-

ing the sharing of information, and enabling better use of patient information, are all central to further

improvements in the planning and delivery of care services in England.

The slides presented by the seven speakers and the report of the ‘Crossing

boundaries’ workshop, are available at: www.connectingforhealth.nhs.uk/

engagement/clinical/ncls/ahp.

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Gloucestershire’s social inclusion event was held in the presence of COT patron, HRH, The Princess Royal, in October last year, at

Gloucester Rugby Business Centre. Its aim was to foster a culture of social inclusion and mental health promotion in Gloucestershire through the launch of Gloucestershire’s social inclusion strategy.

The event emerged from the leadership of Gloucestershire’s Social Inclusion Executive Group and was sponsored by NHS Gloucestershire, Gloucestershire County Council and 2gether NHS Foundation Trust.

The programme was designed by service users, in partnership with 2gether NHS Foundation Trust and partner organisations. Participants from across stakeholder groups were invited and the event was a compelling driver for positive change in Gloucestershire.

Keynote speeches were provided by Paddy Cooney, director of the South West Development Centre, Sue Baker, director of Time to Change and Ian Mean, editor-in-chief of Gloucestershire Media. On behalf of Gloucestershire’s Social Inclusion Executive, Jan Stubbings, chief executive of NHS Gloucestershire introduced the social inclusion strategy for Gloucestershire. Suzie Wild provided the final words from a service user perspective by reading some bespoke poetry about social inclusion.

Eight workshops were delivered during the day, the content of which reflected themes of social inclusion. Each workshop was lead by a different partner organisation, including Gloucestershire County Council, NHS Gloucestershire, Gloucestershire First, The Alzheimer’s Society, Job Centre Plus, Cotswold District Council, Carer’s Gloucestershire and 2gether NHS Foundation Trust. Each workshop also had service users and carers to guide the

development and delivery and a representative of 2gether to support.

2gether chief executive Shaun Clee said: ‘The conference was not only an opportunity to publicly sign the social inclusion strategy, but marked the beginning of turning that strategy into a reality. Once in place, we hope that the plan will make social inclusion the norm within our communities not an exception.’

Nearly 200 people attended the day. Most delegates were from partner organisations in Gloucestershire and a large group of service users and carers also participated. Approximately 25 per cent were 2gether staff. Occupational therapists from across many organisations took a high profile in the days activities reflecting their commitment to the social inclusion agenda.

Feedback from the day was overwhelmingly positive. Of those who submitted their evaluation form (n=72) 97 per cent reported that they gained new information about social inclusion in Gloucestershire; 94 per cent felt that they had been able to review the progress of social inclusion in Gloucestershire; 93 per cent had generated new ideas through participating in the day; 96 per cent had strengthened existing connections with people and a similar figure had developed new connections. Perhaps of greatest importance was that 92 per cent had used the event to set their own actions to promote social inclusion into the future.

Reflecting on the event, Dr Jane Melton, 2gether’s director for social inclusion and consultant occupational therapist said: ‘This conference was a wonderful occasion, which celebrated the effort and commitment of many people, over a number of years and across organisations in Gloucestershire. It is fantastic that occupational therapy colleagues have embraced the need to focus on how communities can support recovery, integration and inclusion of the individuals with mental health challenges. We are really grateful to COT and its patron, HRH The Princess Royal, for supporting the event and giving it the high profile that it deserved.’

●● For more information visit:

www.2getherinclusion.nhs.uk

Promoting social inclusion in GloucestershireCOT’s patron, The Princess Royal, attended the social inclusion conference for Gloucestershire in October 2010

Photographed with HRH The Princess Royal are: (left to right) Shanette Bendall (2gether NHS Foundation Trust); Manish Jani (community development worker, 2gether NHS Foundation Trust); Helen Elliot (community matron, 2gether NHS Foundation Trust); Patrick Morris (manager; Gloucester Rugby Business Centre) Olly Morgan (Gloucester RFC Player)

Sharing information

across boundaries A national workshop for AHPs, held in

London in November 2009, reflected on issues relating to improving cross boundary

flows of information to improve patient safety, service delivery and effectiveness of care. The

report and recommendations from this event will be relevant to OTs in leadership roles in England, and to

some extent in Northern Ireland, Scotland and Wales. Many boundaries that can impede information shar-

ing are found within the health and social care services in the UK. For example, between professions, care teams, care

services, care organisations, and countries.Some existing ideas and solutions to improve sharing of

information include: record standards; datasets; and clinical content assurance. The report contains a number of clear

recommendations for individuals and the professional bodies and organisations. Representatives are asked to:• consider the work of the Royal College of Physicians and Royal

College of General Practice in the next review of professional care records standards and incrementally move them towards integrated standards;

• work to accelerate the breakdown of professional boundaries; • promote the message that NHS CFH is looking to share good

practice and learning across country boundaries; • re-visit and reference the Learning to manage health informat-

ics publication to understand and influence the skill develop-ment in under and post graduate education; and

• feed back to professional bodies and organisations and use professional communication channels to raise the profile of the issues and work in progress. Irrespective of the imminent general election there will be

changes to the National Programme for IT in England that is progressively improving the information available to

support the transformation of care services in England. Improving the quality of patient information, facilitat-

ing the sharing of information, and enabling better use of patient information, are all central to further

improvements in the planning and delivery of care services in England.

The slides presented by the seven speakers and the report of the ‘Crossing

boundaries’ workshop, are available at: www.connectingforhealth.nhs.uk/

engagement/clinical/ncls/ahp.

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I have recently started working as a member of a driving assessment service and am interested to find out what is happening within the wider occupational therapy community with regard to establishing an individual’s ability or potential to drive.

I have become aware of the Rookwood Driving Battery and the Stroke Drivers Screening Assessment for patients with acquired neurological disability, and would like to hear more

about how these, and other assessment tools, are being used within this area of clinical practice.

I would like to hear how practitioners and services use the results of such assessments within their decision-making processes and care pathways when identifying someone’s potential to learn, return or continue driving.

Liz Scott-Tatum, OT/mobility clinician, email: [email protected].

I have recently joined a child and adolescent mental health service. This service has never had an OT until now and alongside another fellow OTs, we have been employed in ‘generic specialist’ roles. Despite this, we are keen to increase the awareness of OT to the other practitioners and hopefully begin to develop an OT service. We are interested to hear from other OTs, who may be adopting MOHO as a model of practice.

Due to our very limited resources in developing this

service, we initially felt that we may like to focus on a particular age group (13 to 17 year olds), of which some individuals struggle to engage with therapies already offered. As we are starting from scratch and in the presence of many therapists with strong professional backgrounds, we were keen to use a model such as MOHO and explore MOHO assessment tools that can further enhance our practice.

I have started to look at some of the tools on the MOHO website and would welcome any feedback on the use of these

within CAMHS. Further to this, if anyone has any relevant research info/evidence to help support us in promoting OT in CAMHS, it would be most appreciated. We are planning on facilitating a presentation on occupational therapy and what it could bring to CAMHS, in a few months.

Please contact Claire Dowe at: [email protected].

Driving assessment

Use of MOHO in CAMHS

I currently work in an acute medical setting (extended recovery) and use the Mini Mental State Examination to screen patients showing signs of cognitive impairment. I would like to ask whether any practitioners know of other tools that are quick, easy to

administer and score, which I could investigate for use within the acute medical setting?

Please contact Simon White, OT, by email: [email protected] or tel: 01282 804113.

We are a group of OTs in the Midlands who meet monthly to share good practice, develop knowledge, skills and network, all with an interest in substance misuse.

We work in a variety of settings, including mental health and dual diagnosis. We are looking to recruit new members who would like to meet bi-monthly and ultimately hold a conference event. If you have an interest in this area please contact SallyAnn Summers by email: [email protected] or tel: 01636 670600, or Jackie Quenby at: [email protected] or tel: 0115 9485505.

I would be interested to hear from anyone that has used the ‘Recovery Star’ with clients. At a multidisciplinary team inpatient rehabilitation away day, our service discussed adapting this tool for use with our client base to use with other assessments and outcome measures.

Any information from mental health services that use this tool would be welcome regarding the pros and cons, particularly from inpatient rehabilitation.

Please contact Ruth Crowley at: [email protected].

Mini Mental State Examination

Substance misuse forum

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The ‘Recovery Star’ approach

Please send all professional networking entries to the editor by email or post (see page 3 for contact details)

clearly marked ‘professional networking’. Letters should be no more than 150 words, including contact

details. Please include your BAOT membership number (not for publication).

Professional networking requests are published in date order of receipt and there may be a wait due to

the number received. We regret that we cannot publish requests from student OTs.

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GThe band six project group at the National Hospital for Neurology and Neurosurgery (NHNN) is completing a project on how we, as OTs, now include computers in our daily practice with patients. We are looking at setting up a designated area for our patients to use computers with access to

appropriate equipment and develop a protocol, policy and competencies for computer use with patients (acute or rehabilitation).

Do you or other OTs you know have a protocol already in place for computer use within services and how are you addressing the use of computers with this or other patient groups? Please contact Felicity Bevell at: [email protected].

We are a group of OTs who are trying to find useful measures to help in the management of pain in dementia patients. We would be interested in hearing from other OTs who have used any tools to help in the management of pain with this client group.

Please contact Lisa Donnelly on tel: 0141 201 2446 or email: [email protected].

We would like to hear from OTs working in non-OT specific mental health roles. We are a small group of OTs working in primary mental health and have felt the Health Professions Council’s audit has highlighted our concerns about maintaining links with the OT community and professional identity.

We feel that it would help to share knowledge and ideas with other OTs in similar roles to enhance networking and development. If you are interested, or know of forums already in place, please contact Hazel Close at: [email protected] or Jose Williamson at: [email protected].

We are a group of occupational therapists working in an early intervention in psychosis team. We are currently developing a care pathway for the young people we work with, who have a diagnosis of bipolar affective disorder or a

suspected mood disorder. We are particularly interested in interventions that incorporate relapse prevention, coping strategies and lifestyle choices. We would be interested to hear from other OTs working in this area.

Please email Anna Paterson or Roger Collin at: [email protected] or [email protected].

I am an occupational therapist working in an outpatient chronic pain management team in Eastbourne and would be very interested in making links with other OTs working in this field.

I work alongside a physiotherapist and a clinical psychologist providing a group programme for individuals with long-term pain. I am particularly interested in finding out more about the outcome measures that other teams are

using and whether any specific OT outcome measures are

currently used.

Our team is also interested in developing a specific group for patients with fibromyalgia,

to compliment the existing pain management programme, and I would be keen to hear from other OTs who work with this condition, and whether a specific group for fibromyalgia has been developed in other areas. Please contact Rachel Reid at: [email protected].

Using computers in practice

Pain management tool

OTs in generic mental health posts

Early intervention in psychosis

OT in chronic pain management

We are part of a scoping group working towards integrating community equipment and wheelchair services for children in Kent. If you have experience of this process we would value pointers to help us move quickly and positively forward. Please email Gill Crouch at: [email protected] or Wendy Clarke at: [email protected].

We are a group of OTs working at The National Star College, a residential college for 16 to 24 year olds with physical and associated learning disabilities. The college is in Cheltenham, Gloucestershire, but our students come from all over the UK, as we are a national provider.

We are keen to contact any other OTs working in a similar field to provide peer support and share best practice. We are particularly interested in identifying assessment tools that are used, either standardised or non-standardised, and discussing the role of OT in student transition.

Please contact Emma Rose, head OT, at: [email protected] or tel: 01242 527631 (ext 4218).

Transforming children’s community equipment and wheelchair services

OTs in specialist education

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PROFILE retired members

PRO

FILE

JILL WILSON

Back in my day

I trained at Dorset House School of Occupational Therapy from 1956 to 1959. The school inhabited Nissen huts in the grounds of the Churchill

Hospital, Oxford. The syllabus included anatomy, physiology, psychology, general medicine, psychiatry and occupational therapy applied to physical and psychological conditions.

We had two lectures a day and the rest of the time was spent learning a multitude of crafts. We started with one week of cord knotting, followed by calligraphy, book-binding, spinning (including collecting sheep’s wool from the hedgerow, spinning, plying and dyeing it, using natural dyes) leatherwork, brush-making, metalwork, basketry, stool seating (cord and cane), rug making, art, card games, indoor activities and physical exercise.

We then chose our main subjects – mine were weaving, woodwork and embroidery – for six weeks each. We had one week of touch typing. We had a 60-minute lesson on ‘how to teach’; but I was sent out of the room for inadvertently being rude so I missed most of that.

Our hospital practice started in year one (one week physical, two weeks mental health). In the second year we had three practices of three months each; Kings College Hospital, The Maudsley and Bexley for me. In the third year, we had another three-month practice, but one could leave early when one had completed the required number of hours. While I lived in the nurses’ home at Bexley, I clocked up many hours playing badminton and assisting at dances arranged for the patients in the evenings, so I only did six weeks at St Helier.

My first post was as a basic grade OT at The Royal Hospital and Home for Incurables, Putney (£480 per annum). I was in charge of the heavy workshop. Many of the patients had been there for years and made tooled leather items, baskets and wooden objects. We were

almost a basketry factory as we cut bases from ‘five-by-five’ plywood sheets and sold them to other OT departments.

My job was mainly to ensure the materials were available for those who needed them, but also to encourage patients to find an activity they could enjoy doing, would exercise stiff joints and have a pleasing end result. Anything that a patient had not managed to do adequately well was undone by me before I went home, to ensure it was on the right track for continuing the next day. I also remember visiting a patient with multiple sclerosis, as she lay prone on her bed, and playing chess on a special upright board for 30 minutes a week. She told me what to do for her turn and I made the moves.

After two years I went to Canada and obtained a post at Vancouver General Hospital. I worked on the wards and in the department. Many patients had been drunken pedestrians and were confined to bed for several weeks in splints, braces and slings. One Indian man asked me for a length of two-by-two pine wood. He whittled a totem pole, which he gave me, and then started to take orders from other people.

In the department we had private patients with Collis fractures. I was instructed to assist a lady with the scarf she was weaving. In the middle of the morning I was sent off to coffee in the canteen and while I was away, the senior OT changed the instructions I had provided, concerning the RoM and positioning I was trying to encourage, which reduced my integrity as a therapist.

I then married and took 10 years off to raise my family. I returned to work in 1971, after completing a four half days revision course to update me in new trends in professional practice. I found a job in an orthopaedic rehabilitation hospital for nine hours (£8) a week. I was instructed to go to a ward to encourage a very elderly lady with severe arthritis with

Retired occupational therapist Jill Wilson reflects on her personal impressions of the profession since qualifying in 1959

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PROFILEretired members

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dressing practice – after several weeks we got nowhere and I eventually realised the inappropriateness of the activity; she would have been more activated by a game of dominoes or similar.

Around this time I came across ADL – aids for daily living – something I had not heard of before. I was asked to take a stocking gutter to a patient who had had a hip replacement; the demonstration I conducted was the first time I had handled the device and I had to work out how it was used as I went along.

I spent 15 years working with the elderly in day hospitals attached to general hospitals. We gave out activities to stimulate patients into using their limbs and minds. One gentleman peddled a bicycle, which generated enough electricity to keep the radio going while he listened to the racing results. Everyone was encouraged to join in with social groups or craftwork.

In 1985, I was asked to run the ‘stroke class’. I went on a one-day course to brush up my knowledge of neurology. I learnt about perception – vision (colour, space/location, shape), hearing, proprioception, sensations of touch, smell – and deficits – agnosia, neglect (inattention, hemikinesia), perseveration etc. I then threw out all my college textbooks on applied occupational therapy – I knew I had a lot to learn to catch up with modern methods of treatment.

By now, games had superseded craftwork. Patients did not stay in hospital long enough to do ‘activities’ but stimulation and encouragement in increasing muscle tone, stamina, concentration and ’ joie de vie’ were possible. The game of dominoes should never be underestimated – from selecting the correct box, emptying it on the table, taking turns to choose seven pieces each, deciding who has double six, concentration, selecting a suitable piece, taking correct turns and returning the pieces tidily to the box.

Playing the game standing up, at a high surface, on a wall for arm extension practice, on the floor with large pieces or selecting with sticks made for a wide range

of treatment potential – not for the C21 perhaps.

In 1989, my patients were brought by ambulance from the main hospital to the OT department (before the department moved to its new premises). The hospital OT saw her elderly orthopaedic patients gradually slowing down while waiting for transfer to rehabilitation units and felt they needed stimulation.

A game of indoor bowls was set up by the department OT. Leaders were chosen, teams selected and each patient took turns to stand and throw a bowl. Walking frames were permitted for support, and then everyone had to walk down the room to throw the bowls back the other way. Standing up, sitting down, balancing in standing position, walking and concentration were all required.

Stimulation from the group activity was obvious, patients’ spirits rose and they returned to their ward with smiles on their faces chatting away to each other. Only an OT trained in the 1950s could have had the nerve to organise that one.

By the 1990s patient choice and health and safety were buzz words. In the stroke class (1980s) we had always ensured each patient was transferred from their loungy wheelchair to an upright chair with correct cushion and footstool to suit each individual; the even posture aimed for would reduce spasticity and reduce pain.

Suddenly Bobath treatments and techniques went out of fashion. Patients refused to be manhandled from their wheelchairs, it appeared. Luckily this elderly OT retired 12 years ago, but not before she had made an inroad into the treatment of hyperventilation through relaxation and mindfulness.

ReferenceWilson, Jill (1997) Hyperventilation: A condition ‘begging for

recognition’. British Journal of Occupational Therapy,

60(12): 537-538

●● Jill Wilson (nee Thomson), head OT, Royal

Surrey County Hospital, Guildford, Surrey 1991

to 1997. Jill qualified in 1959 and retired in

1997

‘We had two lectures a day and the rest of the time was spent learning a multitude of crafts.’

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Do you want to help shape the research future of the profession?

The Research and Development Board is seeking a new member to join the Board from June 2010. All you need is a strong interest or experience in one or more of the following areas so that you can contribute to forthcoming R&D work priorities:

The Board meets three times a year (usually February, May and November) for whole day meetings in London. Travelling expenses are reimbursed. In between meetings, Board business is conducted electronically. There is a three-year term of office.

Board membership offers an excellent CPD opportunity and enables BAOT members to undertake a variety of activities on behalf of the College. These include representing the board at conferences and meetings, contributing to publications and events and commenting on consultation documents related to research, information management and library services.

It is the responsibility of the Board to advise Council on policy and to give a strategic steer to the work of the Research and Development Group.

• understanding of the R&D policy contexts in the UK;• strategic leadership, partnership and profile;• engaging with members and promoting relevant research opportunities;• building research capacity to increase our evidence base for practice; and• eHealth and knowledge management.

If you are interested in shaping the work of the Board then contact Lesley Gleaves, R&D administrator, on tel: 0207 450 2323 for an information pack.

The deadline for nominations is Friday 30 April.

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RecruitmentFor more information on advertising please contact Katy Eggleton

tel: 020 7450 2341

fax: 020 7450 2350

email: advertising@

cot.co.uk

Classified

scc rates:

Full display £43

Courses £23

The advertising deadline for OTN is the 14th of the month preceding.Later entries may be accepted by arrangement with the Advertising Manager.

The Ealing Paediatric Occupational Therapy Service, managed by Sidney Chu, has a national reputation for providing high quality and innovative services and is looking to recruit:

Ealing, Queen of the Suburbswww.ealing.nhs.uk

We are an equal opportunities employer.

Clinical Specialist Paediatric Occupational Therapist Ref: 686-1798

Salary: £42,252 - £49,852 inc. (Band 8a)

Location: Carmelita House, W5 and/or other locations

Advanced Paediatric Occupational Therapist Ref: 686-1803

Salary: £34,045 - £43,529 inc. (Band 7)

Location: John Chilton School in Northolt and/or other locations

The Ealing Paediatric Occupational Therapy Service is an integral part of the Ealing Service for Children with Additional Needs (ESCAN) which integrates different health, education and social services for children.

We are looking for two team players who have good communication skills, service development skills and practical experience in multi-disciplinary and interagency collaboration. The Band 8a postholder will need to have specialist clinical skills in working with young children with different special needs and lead the development of service in this area. The Band 7 postholder will need to have relevant clinical experience in working with children with physical disabilities and other conditions.

If you would like to talk to somebody about this vacancy then please contact Sidney Chu, Paediatric Occupational Therapy Service Manager on 020 8825 8766 or email [email protected]

For a full description and to make an online application please go to www.jobs.nhs.uk and enter the reference number.

Closing date: 25 March 2010

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www.BAOT.org.uk

Learn“CPD lies at the heart of good practice. Turn your dreams into plans to map your future. Tap into a range of e-learning resources and discover the range of OT courses and conferences to enhance your development.”Zoe Parker, Education Manager, Lifelong Learning

Your professional

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N213South Yorkshire Centre for Inclusive Living

Occupational Therapist37 hours per week £23’491 ~ £26’543 per annum

SYCIL is a Registered Charity based in Doncaster. You will be part of a vibrant & committed staff team who provide a comprehensive range of services aimed at maximizing, achieving and maintaining independ-ence for Disabled People.

Working within SYCIL’s Independent Living Unit you will be responsible for the provision of Occupational Therapy assessments, identifying and compiling comprehensive plans of support to maintain or increase a service user’s independence; work with the team to develop SYCIL’s Independent living Unit & OT services. You will be responsible for the supervision of SYCIL’s Basic Grade OT and any students that may from time to time be on work placement with SYCIL.

We offer a supportive working environment, regular supervision and opportunities for CPD.

The successful candidate will be able to demonstrate:• Recognised professional qualification in Occupational Therapy or

Physiotherapy • Working knowledge of issues around independent living• Good assessment & organisational skills• Experience of health & social care policy / local & national

agendas as they relate to Disabled People• Experience of working in partnership with other VCO’s &

statutory authorities• Experience of delivering on time and meeting targets• Vision• Articulate & persuasive

Closing date for applications (No CV’s) either hard copy or email is 17:00 Friday 26th March 2010.

For an application pack contact, Lynette Trepte:

Tel; 01302 892949Fax; 01302 885023Email; [email protected] also available from; www.sycil.org

SYCIL, M & M Business Park, Doncaster Road, Kirk Sandall, Doncaster DN3 1HR.Charity No. 1065630

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Occupational Therapist Ferndown

£28,636 - £33,661 Ref: 60012057The Physical Disability team is a dynamic and supportive team of Occupational Therapists and Social Workers. You will have a varied and stimulating caseload, with full supervision and support. We offer flexible working and access to appropriate training. We have positive relationships with our colleagues in housing and the PCT. You will carry out assessments and provision of equipment and adaptations to people of all ages. As a team we also carry out manual handling risk assessments.

Closing date: 1 April 2010

Dorset County Council

www.dorsetforyou.com/jobs We value diversity and

welcome applications from all parts of the community.

Improving the quality of life for people in Dorset, now and for the future

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Become a fan www.facebook.com/baotcot


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Want to reach our29,000 members?

tel: 020 7450 2341 or email: [email protected]


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Easy online orderingwww.nrs-uk.co.uk

email: [email protected]

Over 3500 Aids for Daily LivingOT Product Advisory Service48 Hour Delivery *Tel: 0845 121 8111

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Subscription enquiries?

Contact the Membership Department 020 7450 2348

Don’t throw your money down the drain!BJOT and OTN

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4 March 2010 Specialist seating, posture and pressure relief study days EdinburghThroughout 2010 CareFlex is holding free of charge study days for healthcare professionals in various locations across the UK. There will be two sessions provided on the day; session one being an introduction to specialist seating including: an informative chair set-up and pressure relief presentation, a full demonstration of the CareFlex seating range, a Q&A session and the opportunity to try all the CareFlex chairs. Session two is for those wishing to extend their knowledge to gain an advanced appreciation of specialist seating. A certificate of attendance and notes of the presentation will be sent to all delegates. Refreshments and buffet lunch will be provided. For full event details visit: www.careflex.co.uk/seatingstudydays. Times: Session one: 10am – 12pm, session two: 1pm – 3pm. Contact details: tel: 0800 0186 440. Email: [email protected]. Venue: March 18 – Northampton, March 23 – Carmarthen, May 4 – Reading/Slough, May 18 – Manchester, May 20 – Swindon. Cost: Free.

Series of training seminars beginning 8 March Seating matters WHY? Seating Matters LimitedMartina Tierney is the company clinical advisor and occupational therapist. The training will increase the awareness on the importance of individual assessment for clients with complex postural needs. Martina will assist the delegates to identify their top four goals of seating assessment and improve the delegate’s ability to match products with clients needs. Delegates will benefit from Martina’s wide ranging experience of being an OT and a chair designer. Venue: various venues throughout the UK. Cost: Free. Contact: Martina on tel: 028 777 666 24.

COT event10 March 2010 Masterclass Obesity management and health promotion in forensic settings COT, LondonThis masterclass addresses an issue that is high on the political and NHS agenda that OTs are in a prime position to influence. Participants will have the opportunity to examine the challenges of working with mental health service users who are at risk of developing secondary illnesses due to their lifestyle choices. It will focus on strategies to help find tangible solutions and achievable outcomes for change and development in practice. Attendance is limited to 30 delegates. Venue: College of Occupational Therapists, London. Cost: BAOT members: £120, non-members: £160. Contact: email: [email protected], tel: 020 7450 2337.

RESEARCH FOUNDATION EVENT

11 March 2010 UK Occupational Therapy Research Foundation: Outcome measures and effective practice COT, LondonThis event is aimed at OTs and other AHPs who wish to develop their knowledge of outcome measures and effective practice. Participants will hear from several experts on how outcome measures can be used for practice, research, service evaluation and service commissioning purposes. Delegates will learn how to develop skills in selecting and appraising outcome measures and how using outcome measures will routinely demonstrate the effectiveness of their practice. Venue: COT, London. Cost: members: £75, non-members: £110. Contact: email: [email protected], tel: 020 7450 2300.

COT event16 March 2010 Blueprint for the future: leadership of the profession – educator event COT, LondonThis leadership event is for OT academics and educators. It will explore the role education has in the development and support of the profession’s leaders of the future. The day will consider both the pre-

registration and post-graduate curricula seeking to share practical solutions for embedding leadership in the curriculum and will identify future actions for all those involved in the leadership and development of the profession. Cost: BAOT members: £90, non-members: £120. Contact: email: [email protected], tel: 020 7450 2300.

17 March, 2010 Delivering effective groups Study day and workshop eventOccupational therapists and OT support workers regularly use groups to deliver services and enhance the therapeutic experience. This study day and workshop event will highlight the benefits of using groups, the development of specialist groups, ideas on how to overcome barriers and practical afternoon workshops to consolidate learning. The day will be invaluable to OT support workers and technicians as well as OTs who are wanting to increase their knowledge and skills in running effective group sessions. Venue: COT, HQ London. Cost: members: £50, non-members: £90. Contact: Beriah Chandoo, Senior Membership Officer, tel: 020 7450 5474, email: [email protected]

COT event22 March 2010 SEN statements and tribunals: The science, legalities, and ethics COT, LondonThis event is for OTs working with children who contribute to SEN statutory assessments and tribunals in all settings. Providing factual information on the legal framework to enable OTs to understand the process. The day will review the impact of writing reports and explore the practical and ethical dilemmas OTs face. The day will be led by a barrister with experience in education law and tribunals. Topics included legal process, legal case analysis, writing reports for statement contributions and evidence for tribunals, perspective of a tribunal panel member, educational need, professional obligations. Venue: COT London. Cost: members: £125, non-members: £145. Contact: Clare Leggett, tel: 020 7450 23345, email: [email protected]

22 – 23 March 2010 Goal setting in interdisciplinary rehabilitation: evaluating client-centred outcomes Harrison TrainingDesigned to enable health and social care teams to implement a goal-oriented outcome evaluation system that clearly identifies meaningful outcomes that clients achieve over

the course of intervention. It focuses on setting, documenting and evaluating goals that are client centred and uses the WHO International Classification of Functioning as a guiding framework. Available in-service as well. Course ref: SP10. Cost: £308 + £46.20 VAT = £354.20. Venue: London. Contact: [email protected]; tel: 01225 309333, www.harrisontraining.co.uk

24 March 2010 Understanding how to implement the COPM into practice Harrison trainingThis course focuses on developing the expertise of the occupational therapist to support the use of the Canadian Occupational Performance Measure (COPM) in their practice. It explores the evidence base for the measure, the occupational performance process model, and refining skills in implementing the COPM as an assessment and outcome measure. Course ref: SP4. Cost: £172 + £25.80 VAT = £197.80. Venue: London. Contact: [email protected], tel: 01225 309333, www.harrisontraining.co.uk

25 March 2010 How does your engine run? The alert program for self-regulation SI Network UK and Ireland LtdThe Alert Program assists children who have learning difficulties and attention problems (as well as typical children) to understand the basic theory of sensory integration related to arousal states. Through the program, children learn strategies that enhance their abilities to learn, interact with others, and work or play and learn to monitor their level of alertness, improve in self-esteem and self-confidence. Suitable for teachers, parents, carers and health and social care support workers. Venue: Berkhamsted, Herts, HP4 1HE. Cost: BAOT members £320 and £25 for course handbook, non-members £345. Contact: [email protected]

25 March 2010 Personalisation, transforming community equipment services (TCES) and the law – A Michael Mandelstam course in Leeds Disability NorthThe course is in response to government proposals regarding radical future changes to the way in which social care and community equipment is provided. The potential effect on all – service users, local authorities, NHS Trusts and professionals – is considerable. This course will give an overview of the proposed changes, identify the

CPDEventsFor further information on advertising your course or event please contact Katy Eggleton on tel: 020 7450 2341 or email: [email protected]. Visit: www.cot.org.uk

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legal implications, highlight possible professional implications and provide an opportunity to raise and discuss issues/concerns in relation to practice. Venue: The Carriageworks, 3 Millennium Square, Leeds, LS2 3AD. Cost: £110 (plus VAT). Contact: Kevin Wright tel: 0191 284 0480, email: [email protected], website: www.disabilitynorth.org.uk

26 March 2010 Fatigue management for people with multiple sclerosis SSNP Oxford and London Regional GroupThis is a practical workshop using an evidence based approach for occupational therapists. Teaching by Sarah Daniels and Pip Wilford, occupational therapists from the National Hospital for Neurology and Neurosurgery, London. Please return application form and cheque payment to: Alison Bragg, Head OT, Oxford Centre for Enablement, Windmill Road, Oxford, OX3 7LD. Cheques should be made payable to: COT Specialist Section Neurological Practice. Venue: Oxford Centre for Enablement. Cost: £64 (£22 for SSNP members). Contact: [email protected], tel: (01865)737382.

25 – 26 March 2010 Goal setting in occupational therapy: evaluating client-centred outcomes Harrison TrainingThis course focuses on developing the expertise and confidence in using an outcome evaluation and documentation process for occupational therapy interventions. The focus is on setting and measuring client-centred, occupation-based goals within your practice setting. Course ref: SP2. Cost: £308 + £46.20 VAT = £354.20. Venue: London. Contact: [email protected]; tel: 01225 309333, www.harrisontraining.co.uk

29 March 2010 Embracing conflict Harrison TrainingThis is an essential training day for those interested in reducing the cost of conflict, improving communication and enhancing relationships. The approach used (Conversational Riffs) is innovative, highly practical, and easily adopted. A highly useful workshop that has application in wide variety of professional and personal situations. Course ref: M4. Cost: £172 + £25.80 VAT = £197.80. Venue: London. Contact: [email protected], tel: 01225 309333, www.harrisontraining.co.uk

COT event29 March 2010 Introduction to the professional network COT, London The content relates to communication level three, and personal and people development level two of the knowledge and skills framework. Tools for providing leadership and increasing the profile of the profession, opportunities for networking, questions and answers. Venue: John Harvard Library, Borough High Street, London. Cost: Free to all members active in BAOT/COT. Contact: Olivia Lokko, Membership Development Team Secretary, [email protected], tel: 0207 450 2368.

30 – 31 March 2010 Parkinson’s disease – latest evidence and Interventions Harrison TrainingThese are ‘stand alone’ days or available as a consecutive, two day course. The first day will present the latest research and theories related to Parkinson’s Disease (PD), and introduce techniques and strategies that OTs can use with their clients in everyday practice. The second day will cover the less understood problems associated with PD but which can have a significant impact on functional performance and daily life. Practical interventions and strategies for improved management will be gained from attendance. Course ref: PD1/PD2. Cost: £172 +VAT (one day) or £308 +VAT (two day). Venue: Newcastle. Contact: [email protected]; tel: 01225 309333, www.harrisontraining.co.uk

14, 15 and 16 April 2010 Housing adaptation and design coursesThese courses offer exciting opportunities to learn more about essential housing issues for older and disabled people. They explore key design and adaptation principles relating to the following: 14 April: reading and using plans/ramp assessment and design. 15 April: kitchen design/accessible lifts. 16 April: bathroom adaptation and design. Training is provided by TSA Training & Access Consultancy. For course outlines, fees etc, please contact Trish Sweeney, TSA Training & Access Consultancy. Tel: 07909 582491, email: [email protected], website: www.tsaconsultancy.com

15 April 2010 Bariatric workshop – advanced level DLFEssential for anyone who may work with people weighing over 191 kg (30 stone), including hospital and community nurses, occupational and physiotherapists, nursing home, day care and ambulance staff. This fully participatory workshop will address case studies sent in prior to the course, where possible. The day includes a theoretical overview of bariatrics, demonstration of equipment, and practical hands-on sessions involving a bariatric model. Venue: 380-384 Harrow Road, London W9 2HU. Cost: £180 + VAT. Contact: [email protected], tel: 020 7432 8010.

COT event15 April 2010 Introduction to the professional network COT, Edinburgh The content relates to communication level three, and personal and people development level two of the knowledge and skills framework. Tools for providing leadership and increasing the profile of the profession, opportunities for networking, questions and answers. Venue: Edinburgh – TBC. Cost: Free to all members active in BAOT/COT. Contact: Olivia Lokko, Membership Development Team Secretary, [email protected], tel: 0207 450 2368.

16 April 2010 COT Disability Forum: networking and learning event The Disability ForumThe University of East Anglia, Norwich, is hosting a networking and learning event with presentations focusing on the experiences of students with disabilities in the educational setting and practice placement education. The afternoon will be focused on discussions and networking, giving delegates the opportunity to influence the future direction of the Disability Forum. Venue: The Queen’s Building, School of Allied Health Professions, University of East Anglia, Norwich NR4 7TJ. Cost: £10. Contact: [email protected]

19 April 2010 Working well in palliative care – an introduction Harrison TrainingThis day will provide an introduction to the concept of palliative care and the role of occupational therapy within it. Using case studies and relevant examples from participants’ own practice, the contribution of occupational therapy within this specialist area will be demonstrated.

Course ref: PC01. Cost: £172 +VAT (one day) or £308 +VAT (two day). Venue: London. Contact: [email protected]; tel: 01225309333, www.harrisontraining.co.uk

19 April 2010 Grab rail workshop DLFA five hour session on choice, use, positioning and measuring for grab rails which will cover bathroom, toilet stairs and doors. The course will involve practical workshops and will increase confidence for all staff who work in the community when assessing clients. Venue: 380-384 Harrow Road, London W9 2HU. Cost: £100 + VAT. Contact: [email protected], 020 7432 8010.

19 – 21 April 2010 Understanding sensory processing disorders SI Network UK and Ireland LtdSensory processing disorders affect attention, learning and activities of daily living. Suitable for teachers parents carers support workers and therapists this course introduces an understanding of sensory processing and strategies that therapists trained in SI may use when working with individuals with SPD – poor attention and focus, co-ordination difficulties and challenging behaviours and addresses the needs of those who are supporting the individual alongside a suitably qualified therapist. Venue: Berkhamsted, Herts, HP4 1HE. Cost: BAOT-members £350, non-members £375. Contact: [email protected]

20 – 22 April 2010 NAIDEX National Exhibition Centre, BirminghamVisit the COT on stand F190 at this year’s exhibition. Naidex is the biggest and best opportunity to test, touch and compare the latest products and services to aid independent living. The exhibition also includes a CPD clinic and a full programme of seminars aimed at healthcare professionals. See www.naidex.co.uk for more information.

30 April 2010 Manual handling refresher course for independent practitioners Therapy Learning LtdUpdate your knowledge: incorporating legislation, theory and practical elements; high risk moves; care handling versus therapeutic handling and hands on practice with work settings equipment. As a sole trader, employer or employee it is your responsibility under the Health


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and Safety at Work Act 1974; Management of H&S at Work Regulations 1999 and Manual Handling Operations Regulations 1992, to make use of appropriate equipment provided in accordance with training and make ongoing individual risk assessments. 15 places. Venue: Disabilities Living Centre, Nottingham. Cost: £105 before 18 March 2010, £135 thereafter. Closing date: 15 April 2010. Contact: [email protected], 01159 250910, www.therapylearning.co.uk

4 – 7 May 2010 World Federation of Occupational Therapists 15th World Congress (WFOT 2010) Santiago, ChileThe 15th WFOT World Congress focuses on contemporary perspectives in occupational therapy and occupational science. Congress participants will participate in stimulating reflective dialogue about their practice and personal contexts as well as the emerging evidence which distinguishes Latin American practice. Cost: Please contact organisers. Contact details: tel: +61 2 8251 0045, email: [email protected], website: www.wfot.org/wfot2010/

COT event5 May 2010 Masterclass Occupational therapy for adult acquired apraxia NottinghamThis masterclass will be facilitated by Thérèse Jackson, consultant OT working in stroke services for the NHS in Scotland. It is intended to provide an up-to-date review of the evidence which informs current best practice for this client group and delegates will be able to bring issues and experiences from practice to discuss with the group and with an expert practitioner. It will be limited to 30 delegates. Venue: East Midlands Conference Centre, Nottingham. Cost: BAOT members: £120, non-members: £160. Contact: email: [email protected], tel: 020 7450 2337.

7 May 2010 Hoist and sling assessment and problem solving DLFA comprehensive one day course covering many of the ‘frequently asked questions’ including: choice, compatibility and postural assessment, a documented sling assessment process and design of hoist system layouts. Venue: 380-384 Harrow Road, London W9 2HU. Cost: £100 + VAT. Contact: [email protected], tel: 020 7432 8010.

14 May 2010 The OT Factor BAOT Eastern Regional GroupPresenters include students from UEA, staff from Essex University, clinicians and motivational speaker, Mike Brace, Vision 2020. This event is to illustrate that whatever the diversity of the intervention, there is always the ‘OT Factor’ – a must for all OT staff. Attendance is limited to 100 delegates. Closing date: 23 April 2010 for more information please contact Hazel Fox/Jackie Feltwell – 01245 318899). To book a place contact: [email protected]. Venue: Stansted Hilton, Essex. Cost: BAOT members £30, non members £50, students £20.

18 May 2010 Seating are we getting it right? COTSS – Children Young People and Families Wessex RegionExpand and update your knowledge on children’s seating. The study day includes sessions on best practice in children’s seating, seating assessment and prescription, outcome measures and presentation of two seating research studies. Facilitated by Clare Wright from Leckey, and David Porter Oxford Brookes University. Venue: Ashurst Education Centre. Cost £10 members, £20 non members. Lunch not provided. Contact: [email protected].

19 – 20 May 2010 Building solutions The Training Exchange Study Days Objective - to enable OTs and related professions to have an understanding of adapting homes. Reading plans; measuring and drawing scaled sketches. Effective team work in the building process. Understanding planning. Construction – building types; drainage and plumbing – inspection and assessment – key rules. Access/space standards in kitchens, bathrooms, bedroom etc in detail, plus legislation. Using case studies, practical workshops, interactive sessions. A comprehensive two-day course providing an 80-page resource pack .A foundation course for new and experienced staff. Used for OT staff induction by many Authorities over the last 11 years. For further information contact Sue Harrod, email: [email protected], tel: 01647 24627.

20 May 2010 Essential tax issues for independent practitioners Therapy Learning LtdAimed at independent practitioners starting out or settled in business:

understanding record keeping and tax; differences between sole traders and limited/unlimited companies; what can/cannot be offset against tax; insight into procedure for Inland Revenue Inquiry – dispel all fears. Queries answered throughout the day. The tax offset gained from attending this course is an investment into your future. Testimonial: ‘an informative and hugely valuable day’. All details at www.therapylearning.co.uk. Cost: £105 before 8 April 2010, £135 thereafter. Closing date: 6 May 2010. Contact: [email protected], 01159 250910.

20 – 21 May, 2010 5th annual Birmingham autism conference Autism Awareness Centre Inc. and Autism West MidlandsMarc Serruys – Autism and Vulnerability; David Ariss – My life with autism and Paula Aquilla, OT – The role of sensory processing in learning, behaviour and activities of daily life. Venue: Ramada Hotel and Resort, Penns Lane, Walmley, Sutton Coldfield, West Midlands. Cost: BAOT members: £180 one day; £265 two days, non members: £125 one day; £175 two days. Contact: Ian Carty, [email protected], tel: 0121 450 7576, fax: 0121 450 7581, www.autismawarenesscentre.org

20 – 21 May 2010 Sensory defensiveness: A comprehensive treatment approach Avanti Education sponsored by Fairplay Practice LtdPatricia and Julia Wilbarger present this workshop. It includes the latest research findings and clinical practice. Participants learn methods of assessment and the specific multi-dimensional treatment approach that has permitted dramatic changes in many sensory defensiveness behaviours. Treatment labs include training in the correct application of a deep pressure and proprioceptive technique – therapressure program. Applied clinically for paediatric, adult physical dysfunction and psychiatry. Venue: The Mermaid, Blackfriars, London. Cost: £450. Contact: Sandra de Wet, tel: 01892513659, mob: 07889363419 or email: [email protected]

7 -– 8 June 2010 Motivational interviewing a two day introduction COT-SSNP North Thames RegionThe training will be facilitated by Dr David Manchester who is a consultant neuropsychologist and clinical psychologist. Learning outcomes: why traditional approaches to increasing client motivation often

fail; the key therapy skills that significantly increase client engagement in treatment; what really strengthens behaviour change over time?; the major cognitive strengths nearly all clients retain, and how to use these to greatly improve client recall and learning. Venue: QEII Hospital, Welwyn Garden City, Herts. Cost: £250 (Places only secured with full payment) available only to COT-SSNP membership £250. Contact: Leonie Winstanley, [email protected], tel: 01438 781 075.

9 June 2010 Inclusive adaptations The Training Exchange Study Days Objective – to enable OTs and related professions to have an understanding of adapting homes looking at the perspectives of sight loss, deafness and learning disability. A unique one day course using practical workshops and case studies to promote understanding. The speakers include a profoundly deaf architect and a registered blind retired OT. Providing an invaluable insight into their personal experiences combined with their professional backgrounds. For further information, email Sue Harrod, email: [email protected], tel 01647 24627.

21 to 23 June 2010 Understanding and managing children with cerebral palsy and related conditions Kid Power Therapy and Training Co. LtdCourse Instructor: Dr Sidney Chu. This course is specifically designed for paediatric therapists and other professionals who work with children with cerebral palsy in different settings. After completion of the course, participants will be able to understand the contemporary approaches in the assessment and management of children with different types of cerebral palsy. This course is focus on the application of neurodevelopment treatment and 24-hour postural management programme. Venue: St. Andrew’s Church Centre, Mount Park Road, Ealing W5 2RS. Cost: £390. Contact: email: [email protected], website: wwwkidpower.webs.com (no dot after www)

24 June (pm only) and 25 June, 22 July (pm only) and 23 July, 26 August (pm only) and 27 August 2010 British Bobath Tutors Association (BBTA) introductory modules for occupational therapists National Hospital for Neurology and NeurosurgeryModules consist of theoretical and practical sessions and patient


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demonstrations. The normal movement module is a prerequisite for the basic bobath course. Study Days x three modules – module one ‘What is normal movement?, module two ‘Assessment and treatment of adults with neurological conditions (Part A) Module three ‘Assessment and treatment of adults with neurological conditions (Part B)’. Venue: National Hospital for Neurology and Neurosurgery. Cost: £450. Contact: Christine Stephens-Volante, tel: 0845 1 555 000 x 723476, [email protected], fax: 020 7692 2425.

30 June – 1 July 2010 Workplace disability management and vocational rehabilitation COTSS – Work Save the date. An outstanding opportunity over two days for new learning, debate and professional networking, targeting both OT VR experts and up-and-coming VR practitioners. Highlights include: keynote speech from Lord Freud; four hour VR training taster session; international academic debate about the future of VR; up to 14 VR workshops featuring brain injury, mental health, orthopaedic injury, amputation including employer and employee perspectives. Also: dinner, accomodation, awards and COTSS –

Work AGM. Venue: Nottingham University, Jubillee Campus, Nottingham. Cost: To be confirmed. Contact: [email protected]

13 to 16 July; 21 and 22 October 2010 + one additional day Sensory attachment intervention Adoptionplus LimitedEadaoin Bhreathnach will present this course which will be an integrative approach to self regulation and co regulation. It will include the process of sensory regulation, sensory discrimination, regulation of arousal states, and attachment. It is designed for OTs working in child and adolescent mental health and paediatrics. Emphasis will be on theory based analysis and practice. Therapists will be taught the use of profiles, assessment charts and treatment techniques. Venue: Adoptionplus, Moulsoe Business Centre, Cranfield Road, Moulsoe, Near Milton Keynes MK16 0FJ. Cost: £600 + VAT. Contact: Pat Gibson, tel: 01908 218251, email: [email protected]

2 – 3 November 2010 DFGs Fresh thinking in policy and practice The Training Exchange Study Days Objectives – to provide OTs with an

up to date, in-depth two day course on DFG policy/practice and legislation using cases and examples to aid understanding of a very complex area. Day one – The DFG process – Understanding the latest legislation and how best to use it. Looking at new and innovative systems. Debating case studies. Day two – Assessing for DFGs – what is necessary and appropriate. Translating the need into a specification. Working with other professionals (our responsibilities/their responsibilities) Presenting a successful case to panel. For further information email: Sue Harrod, [email protected], tel: 01647 24627.

Training ProvidersHarrison TrainingHarrison Training provides a wide range of courses, CPD, and training opportunities for occupational therapists, multidisciplinary teams, health and social care workers. Also consultancy services, eg, developing vocational rehabilitation pathways for services. In-house training is a cost-effective option, current courses or bespoke, for your own staff and/or to offer external places. Courses offered in areas such as: neurological rehabilitation; learning disability; mental health; CPD record keeping; environment and

housing; paediatrics; older people; stress management; vocational rehabilitation, palliative care, paediatrics, and leadership. Contact us to discuss your training needs and/or budget on [email protected] or tel: 01225 309333.

Courses in Housing Adaptation and Design TSA Training & Access Consultancy TSA delivers in-house training to occupational therapists and other housing professionals throughout the UK and Republic of Ireland. Courses cover a wide range of topics including bathroom adaptation and design, kitchens, ramps, lifts, wheelchair housing standards, Disabled Facilities Grants, reading and using plans, and technical considerations involved in adaptation work. Varying levels of skills and knowledge catered for. TSA also holds scheduled training courses at venues throughout the UK that individuals can attend. For training packs, costs or just a discussion, please contact Trish Sweeney, TSA Training & Access Consultancy, tel: 07909-582491, email: [email protected]

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otnews march 2010

Health & Medicine

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