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Royal College of Occupational Therapists warns of 'dehumanising effect' of care services

The Royal College of Occupational Therapists has launched its second substantive report, ‘Living, Not Existing: Putting prevention at the heart of care for older people in Northern Ireland’ as part of its Improving Lives Saving Money campaign to tackle unprecedented pressure on the social care system.

In its report the Royal College of Occupational Therapists (RCOT), which represents 32,000 occupational therapists working across the health and social care sector in the UK and 1,000 in Northern Ireland, calls for an end to the postcode lottery for access to occupational therapy in Northern Ireland.

This will give older people back their dignity and help the health and social care system in Northern Ireland work better and be more efficient.

Centre-stage in the report are a series of recommendations that would see Local Commissioning Groups identify a named person to action and report on outcomes in three key areas:

  1. Health and Social Care Trusts, GPs and GP Federations must design services to make sure occupational therapists are based within primary care to delay or prevent the need for care and support.
  • Occupational therapists should be based within GP practices or multidisciplinary integrated teams embedded in GP surgeries so that primary care patients have timely, direct access to occupational therapy
  • Care coordination roles should be open to occupational therapists.
  1. The Public Health Agency, Local Commissioning Groups and Integrated Care Partnerships must work together to ensure that person-centred approaches are developed in social and community care using occupational therapists to ensure all older people live independently for as long as possible in their communities.
  • Occupational therapists should be able to take on leadership roles to provide expertise and mentoring to providers of community services as well as improving accessibility to resources and services for those with complex needs
  • Occupational therapists skills to be used to train carers and community workers to encourage a person-centred and enabling approach to care and support.
  1. The Department for Communities, local councils and community planners, and Health and Social Care Trusts should formally develop partnership agreements across local housing, health and social care sectors to ensure all older people have access to occupational therapy, irrespective of their social-economic conditions and location.
  • Resourcing occupational therapy services sufficiently so that they can take referrals from all sections of society
  • Providing access points to occupational therapy advice for community teams, such as home care, as well as providing public information on ageing well and adapting the home to meet changing needs
  • A dedicated occupational therapist to provide a point of reference and expertise on housing adaptations for disabled people in each Trust.

Kate Lesslar, RCOT’s Northern Ireland Policy Officer, said: “We do not want a society where people talk of simply existing and not truly living.

“Too many health and social care services tell people what social care they will get based on what it is most efficient to provide instead of asking what they really need, leading to costs arising elsewhere in the health and social care system.

“The Royal College of Occupational Therapists argues that doing the right thing for individuals can actually reduce their need for expensive long-term care by enabling them to stay as active, independent and safe as possible in the community.

“Occupational therapists are in a unique position as the only professional group qualified to work across health and social care services, allowing them to understand how people are already managing the consequences of frailty and ill health inside and outside of hospitals.

“Our new report shows that in Northern Ireland there are some really innovative examples where the intelligent deployment of occupational therapy services has enhanced the lives of older people through better care while delivering significant cost savings for the taxpayer.”

The evidence base for the report was taken from a series of case studies that demonstrate how, with the enhanced support of occupational therapists, older people can receive better and tailored support that saves money for the taxpayer.

To read the Living, Not Existing: Putting prevention at the heart of care for older people in Northern Ireland report and case studies, go to



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