The Disability Profile of Adults Who Receive Adaptive Equipment from Local Authority Occupational Therapy Services

National policy has voiced high aspirations for the future of adult social care. The vision is of a more personalised approach to service provision, with service users given greater choice and control, a new emphasis on early intervention and prevention, and the delivery of services closer to home (Department of Health [DH] 2005, 2006a, Her Majesty's Government 2007). The introduction of a new Common Assessment Framework, which challenges organisations to redesign local systems around people's needs and, wherever possible, enable them to self-assess, is central to these ambitions (DH 2008). The pace at which this agenda can be delivered, however, is likely to depend, at least in part, on occupational therapists' enthusiasm for such initiatives, for despite representing just 2% of the social care workforce, occupational therapy staff manage around 35% of all referrals to local authority social services departments (Department of Health and College of Occupational Therapists [DH and COT] 2008). Furthermore, although the expectation is that self-assessment will provide faster, easier access to services, freeing professional staff to work with complex cases (

Section: Discussion Towards a Greater Understanding Of Self-assessmentmentioning

confidence: 94%

An Evaluation of the Use of Self-Assessment for the Provision of Community Equipment and Adaptations in English Local Authorities

Tucker

Brand

O’Shea

et al. 2011

“…This is important as continuing to use equipment for too long can reduce function and create dependence on its use, whereas stopping use of equipment too early can increase the risk of injury (Neville-Jan et al 1993). Kiefer and Emery (2006), Brittle et al (2007) and Khan et al (2009) identified the need for evidence to support practice and the efficacy of Occupational Therapists issuing adaptive equipment following total knee replacement. This is supported by a Cochrane Review which recommends that further study is required on the effectiveness of specific rehabilitation interventions and components following lower extremity joint replacement (Khan et al 2009).…”

Section: Occupational Therapy and Adaptive Equipmentmentioning

confidence: 99%

The use of adaptive equipment following total knee replacement

McNaught

Paul

2015

Key Findings:Although there were no differences pre-operatively or on discharge in pain and function, patients requiring adaptive equipment following total knee replacement had significantly worse pain and function six weeks post-operatively. What has the study added:Patients issued with adaptive equipment following total knee replacement will require to use it for a minimum of 4 weeks. 2 Abstract PurposeThis study evaluates the need for adaptive equipment following total knee replacement. There are no recent studies to guide Occupational Therapists in the optimum time adaptive equipment is required following total knee replacement. MethodA non-experimental, concurrent mixed methods approach was used. The study population was patients attending for total knee replacement at a large general hospital. Outcome measures were the Oxford Knee Score, the UK Functional Independence Measure and a weekly diary. Results19 patients were included in the study. Following assessment 53% (N = 10) required adaptive equipment following total knee replacement. No significant difference was found in pre-operative pain or function scores, gender or surgical pathway when comparing those who did and did not need adaptive equipment post-operatively.Patients who required adaptive equipment post-operatively had significantly worse pain (P = 0.030) and function (P = 0.040) at six weeks post-operatively and had significantly longer in-patient stay (P = 0.041). ConclusionAlthough there are resource implications patients requiring adaptive equipment following total knee replacement should be assessed by Occupational Therapy staff six weeks post-operatively to ensure optimal functional outcomes following surgery.3

Equipment Provision by Local Authority Occupational Therapy Teams Using the Fair Access to Care Services Eligibility Framework: A Vignette and Interview Study

Sackley

Lett²,

Littlechild

2009

Self Cite

The provision of adaptive equipment to older people living at home maintains and improves independence and reduces health and social care costs (Logan et al 1997, Mann et al 1999). Physical disability is the best predictor of adaptive equipment use (Tomita et al 2004). Despite legislation that attributes the statutory responsibility for such services to local authorities (National Health Service and Community Care Act 1990), the Audit Commission (2000) has found that provision is inadequate and geographically variable. Questionnaire and interview studies have shown that provision is influenced adversely by inconsistencies in referral mechanisms, eligibility criteria and funding (Cowan and Turner-Smith 1999, Carpenter et al 2002). This led to the first national eligibility framework for adult services and, in April 2003, Fair Access to Care Services (FACS) (Department of Health 2002) was implemented. The assessment criteria focused on the person's autonomy, health and /or safety, management of daily routines and /or the person's ability to maintain meaningful participation in family or community life, all considered vital aspects of independence. The eligibility framework is graded into four bands, which describe the seriousness of the risk to independence for the individual or other consequences if needs are not addressed. The four bands are summarised as follows