In early 2018 the Isle of Wight Council tendered for bidders to take on the statutory Community Occupational Therapy service across the Island.
The service includes receiving all referrals for Community Occupational Therapy, triaging, screening, and undertaking all assessments and case management for community occupational therapy referrals across low, medium and high need criteria. The service also includes working with the Council’s Blue Badge team to provide the face to face assessments for the Blue Badge service.
We were successful in our bid and took over the service on the 1st August 2018. As part of the bid we case managed 400 assessments from the existing IOW waiting list from within our mainland clinical resource. This enabled the IOW service to progress without the concerns or constraints that a large waiting list would normally bring. An NRS Clinical Manager was assigned to the IOW contract in order to effect change and development.
Our initial strategy was to support the IOW OT staff during the transfer process to provide as much stability as possible. Significant time was given to the team from the HR, IT and Project Management Departments, as well as Clinical Services. This ensured systems and processes were unaffected and our customers continued to receive a high quality service. Within a couple of months, the outcome of the transfer process was that the team was stable and service was continuing as normal. This was a successful outcome for the NRS IOW team, it’s customers, and the wider NRS family.
The next stage of the process was to look at the strengths and weaknesses of the team and its service, in conjunction with the tender specification and to consider quick wins and long-term improvements and efficiencies. Changes were introduced to the referral pathways, the triage and duty systems, the allocation system, the Prison Service assessments, and the customer service advisor role. This has resulted in ensuring the team receives the right work and assessments can be delivered in a timely fashion. Where customers are not Care Act eligible, signposting has been provided. Additional posts have been created to meet the demands of the service, including paediatric and Blue Badge OTs.
Future service initiatives include the appointment of a Housing OT to work alongside Housing and Renewal to do the case management work of major adaptations, which will allow the community OTs to concentrate on undertaking initial assessments.
These changes have been spearheaded by a Lean Thinking approach and evidence based practice. So far the results are good. Waiting times for assessments have been reduced from 38 weeks to 11 weeks in less than 3 months. Recruitment and retention of staff is robust and staff report that they “enjoy working for a private company” and “feel liberated”. Our Partners on the island have reported that they feel the community OT service has done a “180 degree turn” and the service is “more accessible and easy to communicate with”.