Occupation

Abstracts
Posters
of a positive occupational identity and the role of staff
implementation in achieving this will also be explored.
References
Couldrick, L. (2003) Personality Disorder: a role for Occupational
Therapy. In: Coul ick, L. & Al ed, D. eds. Forensic Occupational
Therapy. London: Whurr, pp. 207–220
Department of Health (2007) Best practice guidance
specification for adult medium secure services: Health Offender
Partnerships 2007. London: DH
Department of Health (2002) Mental health policy
implementation guide – national minimum standards for general
adult services in psychiatric intensive care units (PICU) and low
secure environments. London: DH
Duncan, E. (2008) Forensic Occupational Therapy. In: Creek, J. &
Lougher, L. eds. Occupational Therapy and Mental Health. 4th
ed. Edinburgh: Churchill Livingstone Elsevier, pp. 513–534
Livesley, J. (2003) Integrated Modular Treatment for Personality
Disorders Cost Effective Evidence-Based Treatments
Keywords
Forensic practice, Practice development, New or emerging roles,
Inter-agency
Contact E-mail Addresses
debbie.brennand@merseycare.nhs.uk
Author Biographies
Debbie Brennand, Senior Occupational Therapist working within
a forensic setting on the Offender Personality Disorder Pathway.
Previous experience in Personality Disorder services within high
and medium secure health. Particular interest in the contribution
and benefits of Occupational Therapy within the Personality
Disorder client group.
Sally Laws, Occupational Therapist working within a forensic
setting on the Offender Personality Disorder Pathway. I am
passionate about the value engagement in meaningful
occupation can have on restoring purpose and value for an
individual and am currently developing my own practice through
training in mindfulness.
P48
Improving practice standards in forensic mental
health
Lycett H, Oxford Health NHS Foundation Trust
The College of Occupational Therapists endorses the use
of professional standards (COT, 2011) and the Forensic
Occupational Therapy (OT) service within Oxford Health NHS
Foundation Trust wanted to ensure these standards were
embedded in practice. Audit is a recognised quality improvement
tool (NICE, 2002) and an initial audit against the existing OT
Care Pathway, highlighted inequity in the way standards were
being applied. An action plan was developed, but a second audit
revealed little improvement.
The most concerning gaps related to the absence of initial
interviews, treatment plans and a lack of routine outcome
measures. The service formulated an action plan to address
these gaps. This included redesigning the OT care pathway to
include treatment planning and stream lining the process to
provide greater clarity, including the development of a decision
making tree.
The service also implemented the Vona Du Toit Model of
Creative Ability (Du Toit, 2009) and the new care pathway was
shaped around the core components of this model, with a view
to supporting OTs to embed an evidence base into their practice.
The service commenced a programme of monthly audits to
support the process of ensuring these service standards were
adhered to and things rapidly improved.
Staff gave positive feedback about the process and comments
included ‘it’s made me re-focus back on what I should be doing’,
‘it’s helped me to prioritise my work more effectively’ and ‘I feel
like what I do is now more focussed on OT’. For service users
there is now greater consistency of service across the wards and
a clear, transparent process information they are all given on
admission.
Standards of practice underpin quality service provision and
need to be built into clinical practice. Audit is a useful tool for
enabling this, supporting OT staff to prioritise their work, whilst
creating a transparent process for service users.
References
College of Occupational Therapists (2011) Professional Standards
for Occupational Therapy Practice. College of Occupational
Therapists. London. England.
Vona Du Toit (2009) Patient Volition and Action in Occupational
Therapy. 4 th ed. Vona and Marie Du Toit Foundation. South
Africa.
NICE (2002) Principles for best practice in clinical audit. Radcliffe
Medical Press Ltd. Abingdon. England.
Keywords
Forensic practice, Practice development, Practice – present and
future, NHS
Contact E-mail Addresses
helen.lycett@oxfordhealth.nhs.uk
Author Biographies
Helen Lycett has worked in forensic mental health for most of
her career. She is passionate about service development, and
strives to ensure that her service delivers the highest quality
assessments and interventions to service users. Helen has
special interests in service user involvement and vocational
rehabilitation.
P49
Grabbing the opportunities: there is nothing
occupational therapists can’t do
Nicklin E, Tozer S, Barnet, Enfield and Harringey Mental
Health Trust
The North London Forensic service has developed considerably
in the last 10 years and now has 198 inpatient beds and a
number of community services. Since the service was established
OT has been a core part of service provision but has grown
exponentially as service needs and the commissioning landscape
as developed (Heath and Social Care Act 2012). Over the past 8
years the authors have restructured the department significantly
through continual skill mix reviews and have an effective staffing
structure with 41 posts ranging from 8b to B3.
Following a period of building a solid foundation for the core of
the OT work across services, leaders have had a long term vision
to develop the remit of OT in forensic services in non-traditional
areas. At the heart of this is the belief that OT has a unique
contribution to make in all areas of mental health practice. They
have sought out new opportunities for OTs through involvement
in achieving KPIs and CQUIN, bidding for new services and
creating innovative practice models. This reflects the current
drive in the NHS, with non-traditional roles, teams and structures
being championed (NHS Five year forward view 2014).
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