Purpose
The Occupational Therapy (OT) service at Leicester City Council (LCC) faced some difficulties when they were working with a person who required Physiotherapy (PT) input in the community. Namely the long waitlist for input and an inability to establish a person’s baseline level of mobility when this was needed before recommending care packages, equipment or adaptations. The impacts on LCC were an increased need for formal care, equipment and adaptations as well as increases in OT staff’s workloads and/or delays in picking up new cases. Additionally, the cost to the person is highlighted as delays in accessing PT input can lead to further deterioration in their abilities (dependence) and/or the need to wait longer for equipment/ adaptations which may put them at risk.
Enabling someone to be able to make and transport a meal can save two 30-minute calls per day at £15/hour leading to a saving of £5460/year.
On care costs alone, the 12-week pilot saved more money for the LA than the cost of the one FTE PT position.
Approach
A 12-week pilot of PT input in the health transfers and contact and response teams was conducted. An experienced Physiotherapist was recruited to setup the service in conjunction with the principal OT. Referral criteria, pathways and assessment forms were created for the service launch. The service was launched, and education given to the respective teams regarding the criteria and referral pathway.
To evaluate the service, we collected the following data:
- PT outcome measures – walking speed, balance and goal attainment.
- Current care needs and cost. Final care needs and cost of the person’s care needs following PT input
Current need for major adaptations. Final need for major adaptations following PT input.
Outcomes
The pilot led to the following positive outcomes:
- A reduction in people’s care needs
- A reduction in people’s need for major adaptations.
- Improved balance and walking speeds leading to increased independence in mobility, ADLs and community participation.
- Improved independence leading to subjective reports of improved quality of life and feelings of empowerment.
- Faster decision-making timeframes for adaptations leading to a reduced wait time for people awaiting decisions and for staff who are assessing their needs.
- In addition, other staff from adult social care have expressed how having access to a PT/OT has enhanced their knowledge, decision making and improved the person’s journey.
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Cost and savings
One FTE (37 hours) PT position was created for the pilot.
Reduction of care costs.
For example, improving a person’s abilities from needing two carers to one carer leads to a reduction in cost from £476 to £238 per week saving £12,376/year.
Enabling someone to be able to make and transport a meal can save two 30-minute calls per day at £15/hour leading to a saving of £5460/year.
Reduction of the need for major adaptations.
This is a cash saving to the council as well as providing people with more activity during their day which should help to maintain/improve their physical abilities.
On care costs alone, the 12-week pilot saved more money for the LA than the cost of the one FTE PT position.
Implications
Direct employment of a Physiotherapist(s) by a local authority (LA) to offer targeted rehabilitation related to social care needs can lead to cost savings for the LA and improved outcomes for people accessing their services.
The PT service is ongoing in LCC and the initial scope of the input is being expanded. We are looking at areas to expand the service into based on feedback from staff, observation of cases and trials of input in other areas.
Other local authorities can consider adding this service and we know of one other LA that is looking to implement this into their service.
Top three learning points
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Funding acknowledgements
The pilot was funded by the local CCG through the Better Care funding pathway. |
Additional notes
For further information about this work please contact Mark Adams.