Occupation

Abstracts
Posters
Author Biographies
Sarah Cambridge is the Principal Occupational Therapist
for Devon County Council (DCC) with responsibility for the
professional practice of DCC Occupational Therapists, the
Community Equipment Service and strategic input into Early
Intervention services. She has over 34 years’ experience, in
general medicine, psychiatry and latterly in Social Care both as a
practitioner and Senior Manager.
Ian Deakin has operationally managed the Devon Community
Equipment Service since 2002 when he successfully integrated
the health and social care equipment services into a fully
integrated and jointly commissioned service, for which he won a
national DoH award. Prior to 2002, he gained 17 years valuable
experience with an international company working in overseas
engineering project procurement and in logistics management
roles.
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Saying no to equipment in care homes? Good for the
budget or a step too far?
Cambridge S, Deakin I, Devon County Council
This abstract will describe the learning, experience and outcomes
for one integrated community equipment service where a
decision was made not to provide stock equipment to care
homes. Around £750,000 of stock equipment was on loan in
care homes, which was a financially unsustainable position for
the joint commissioners. The challenge facing commissioners
was to ensure that the equipment needs of the most vulnerable
individuals in the community could continue to be met within
the current financial constraints. The previous equipment in
care homes policy allowed for an up to six week loan period,
intended to support rapid hospital discharge or care for a time
limited period where a resident was acutely unwell. The loan
period was not being adhered to by either the providers or
the prescribers and repeated attempts to retrieve equipment
failed, placing extreme pressure on the budget. The majority of
the equipment requested was dynamic alternating mattresses
and electric profiling beds. Following legal advice regarding
organisational responsibilities, the decision was made to update
the policy to clarify the expectation for homes to provide the
equipment to meet the needs of residents (Department of
Health 2003) unless they required bespoke equipment provision.
The updated policy was communicated, with a two month
lead-in time, to all providers via the countywide network and to
all prescribers. Following implementation in January 2015 there
has been a programme to retrieve all stock equipment from
care homes. No equipment was removed without an alternative
being in place. This updated policy has generated challenges
for and from prescribers, commissioners and providers. Since
implementation it has not been necessary to purchase any
new profiling beds or dynamic alternating mattresses due to
the volume of equipment collected and significantly reduced
demand. Spend has reduced by £100,000 a month, a trend it is
anticipated will continue for a total of 10 months.
References
Department of Health (2003) Care Homes for Older People.
National Minimum Standards and Care Homes Regulations
2001. London TSO
Keywords
Managers, Service improvement or transformation, Impact of
policy, Inter-agency
Contact E-mail Addresses
sarah.cambridge@devon.gov.uk
Author Biographies
Sarah Cambridge is the Principal Occupational Therapist for
Devon County Council (DCC) with responsibility for professional
practice of DCC Occupational Therapists, the Community
Equipment Service and strategic input into Early Intervention
services. She has over 34 years’ experience, in general medicine,
psychiatry and latterly in Social Care both as a practitioner and
Senior Manager.
Ian Deakin has operationally managed the Devon Community
Equipment Service since 2002 when he successfully integrated
the health and social care equipment service into a fully
integrated and jointly commissioned service, for which he
won a national DoH award. Prior to 2002, he gained 17 years
valuable experience at ICI plc in overseas engineering project
procurement and in logistics management roles.
P74
Developing and integrating an AMPS pathway into
routine practice in NHS Fife
Sanders D, Curnow E, NHS Fife
Over the past several years Fife’s Mental Health OT Service
has been committed to intergrating the Assessment of Motor
and Process Skills (AMPS) (Fisher and Bray-Jones 2014) as its
core functional assessment to maximise its use as an outcome
measure and inform effective and clear intervention pathways.
AMPS is the recognised functional assessment tool of choice by
the Scottish Mental Health Head OTs from the nationally agreed
baseline assessment toolkit (2012), to both inform equitable
clinical practice and establish national data on thereapeutic
outcomes for research and clinical development purposes.
AMPS UK and Ireland provided, via their 2014 research and
development award, funding for a member of staff to attend
the AMPS-II training and subsequent work to develop an
understanding of current practice to allow development of
an effective treatment pathway to guide clinical practice in an
evidence based and consistent manner following the framework
within the Occupational Therapy Intervention Process Model
(OTIPM) (Fisher 2009). This work then led to an intervention
pathway for staff to follow, which in turn has provided a
structure for measuring the outcomes of interventions.
The results of a literature search by the local OT Research and
Development Officer found little work had been reported within
the context of intervention pathways, specifically within mental
health.
The poster presentation will focus on the process,
implementation and outcome of this work, including:
• Manual review of data and intervention selection.
• Establishing a baseline of current practice.
• Creation for piloting of a clear and concise clinical pathway
linked to the Occupational Therapy Intervention Process
Model.
• Review and amendments to the pathway.
It is expected that this work will positively benefit the client
experience with selection of evidence based interventions
resulting in improved outcomes. This in turn will provide services
with a rich seam of consistent data to contribute nationally to
inform future research.
References
Fisher AG (2009) Occupational Therapy Intervention Process
Model – A model for planning and implementing top-down,
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