#OTalk Research 4th August 2020

The Top 10 research priorities for occupational therapy in the UK.

This week’s #OTalk is hosted by the Royal College of Occupational Therapists (RCOT). On Monday 27th July 2020, the RCOT/James Lind Alliance Priority Setting Partnership, which has been running over the past 19 months, culminated in the final workshop to agree the Top 10 research priorities for occupational therapy in the UK, which is the focus of this week’s #OTalk.

The chat will be co-hosted by @JoWatson22, @RCOT_Jenny and @DrGillianWard

Way back in June 2017, RCOT hosted a symposium to launch a Research and Development (R&D) Review, which involved a comprehensive review of all of RCOT’s R&D related activity. The primary outcome was the publication, last November, of the new RCOT Research and Development Strategy 2019-24. Throughout the many opportunities to engage with occupational therapists as part of the R&D Review, there was a resounding message highlighting the value of, and desire for, a revised statement of research priorities for occupational therapy in the UK. 

In March 2019, we launched the RCOT/James Lind Alliance (JLA) occupational therapy priority setting partnership. The JLA is a non-profitmaking organisation whose infrastructure is funded by the National Institute for Health Research. It brings together patients, carers, healthcare professionals and the public in Priority Setting Partnerships (PSPs), to identify and prioritise ‘uncertainties’ or ‘unanswered questions’ that they agree are most important in a particular area. The central focus of the JLA’s robust and high-profile methodology is on giving equal voice to professionals and those who access services and their carers, which resonates strongly with the fundamental person-centred philosophy of occupational therapy. 

More information about the approach taken to identify the Top 10 is available in this short video and via the PSP webpage on the RCOT website. However, to summarise:

  • 2000+ questions were submitted by 927 participants in our opening consultation survey, which ran between August and November in 2019.
  • The PSP Information Specialist reviewed all of this data and developed overarching summary questions agreed by the Steering Group to capture the essence of the individually submitted questions they represented.
  • The Information Specialist then reviewed the available research evidence to make a judgement about whether any of the questions had already been fully answered. None of them had.
  • The initial prioritisation survey ran between February and May 2020. People with lived experience of occupational therapy services, occupational therapists themselves and others working alongside them, were asked to identify up to 10 of the long-list of 66 summary questions that they considered the most important for research to answer. 
  • Using the data from the second survey, we were able to calculate the rank of each of the 66 questions according to respondents with lived experience of occupational therapy services and according to those with a professional perspective. 
  • With a clear difference between the questions prioritised by the two groups, the Steering Group took the decision to ensure that the 10 top-ranked summary questions identified by each group were included in the short-list of 18 questions that was developed (there being a small degree of overlap between the two groups).

 

On Monday 27th July 2020, we held the final priority setting workshop which bought together ten occupational therapists and ten people with experience of accessing occupational therapy services or their carers, to work collaboratively to consider the short-list of 18 summary questions and agree the Top 10 research priorities for occupational therapy in the UK. 

RCOT will be officially announcing the Top 10 on Thursday 30th July. From that date, you will be able to access the Top 10 here

Each priority is best thought of as a summary question within which there might be multiple research question focused on an array of practice areas and contexts, and addressing an array of specific issues and uncertainties.

RCOT Res Aug
The questions forming the basis of the #OTalk discussion are:

  1. What are your initial thoughts about and reactions to the Top 10? 
  2. How might they apply to your area of practice?
  3. What might you do to help begin to address the priorities?
  4. As part of informing our next steps, what might RCOT do to support you to take the actions you’ve identified? 

 

The new Top 10 priorities set the research agenda for occupational therapy in the future and will help to focus attention on addressing the unanswered questions that matter most to people accessing and delivering occupational therapy services. We very much look forward to hearing your thoughts.

#OTalk 28th July 2020 – Recovery Through Activity

This weeks OTalk will be hosted by Jess Powell @JessOTpowell. 

Seen as an ideal pre discharge intervention as it helps individuals to connect with their local community, engage in activity in a supportive environment and to learn new skills that they can continue to use after being discharged from mental health services.

Recovery through activity is based on the Model of Human Occupation and is fully endorsed by Royal College of Occupational Therapists. The intervention comprises 12 sessions delivered once a week over 12 weeks, encompassing activities across social, leisure, work and spiritual areas of life .Participants are encouraged to explore new activities and utilise these as a basis to build their confidence, overcome personal barriers and develop new interests. 

In the recent draft Nice Guidelines reference was made to a lack of evidence to support key interventions to support the recovery for people with mental health problems. 

The guiding principle is that it is possible for people to regain a meaningful life despite managing a long term mental health condition. 

This intervention would contribute to the evidence base appertaining to this principle.

Question 1 :Have you used recovery through activity in your setting? If not why not? 

Question 2 :how can we show case, case formulation within MDT to encompass recovery through activity 

Question 3: How should we measure the success recovery through activity? 

 Question 4: How can we make recovery through activity a Nice recognised intervention 

#OTalk 21st July 2020 – Improving BAME Representation in OT – #OTalk Diversity in OT Series (UK Focus)

With the #BlackLivesMatter movement sending ripples around the world on top of the #COVID-19 pandemic, efforts to adjust to the ‘new normal’ are underway and the #OccupationalTherapy profession is no exception. Over the years there has been repeating and intermittent awareness of the need to increase inclusive representation within the profession. Talk needs to be followed by action, and more needs to be done in order to lead to sustainable change. We need to address the systems and processes that make real lasting change difficult. It is not just about making people who don’t usually represent the typical presentation of an #occupational therapist, fit the mould, but about embracing the diversity and strengths that widening access and participation has to offer our profession, and more importantly the people we serve. Moving forward we need to continue to build alliances within the professional membership, regardless of skin colour and ethnicity, to have a depth of impact in change. We can do this as a profession with the help of local activity, diverse local champions, diverse local leaders and @theRCOT.

 

This #OTalk presents an opportunity to share our thoughts on this subject, in light of the recent #BlackLivesMatter events and the public health report highlighting that #BAME (Black Asian Minority Ethnic) communities are disproportionately affected by the COVID-19 pandemic.

 

We would like to emphasise (and for the RCOT to take note) that focus on the BAME community should be regularly reviewed and discussed. This will keep the subject an explicitly ever present agenda for the profession in order to challenge and change structural based inequality. We also acknowledge that while the term BAME can be problematic, it can be helpful for exploring issues of representation. If in doubt ask the person their preferred term of reference.

 

This discussion on occupational therapy and UK-based BAME communities is part of an #OTalk series on topics of diversity. Other topics to be explored later include: Disability (including Neurodiversity), LGBTQIA+ and Gender Issues.

 

Some preliminary groundwork in preparation for this series is encouraged:

 

  • Look Deep. Acknowledge any privileges you may have. This resource on Privilege and Intersectionality may help: https://guides.rider.edu/privilege
  • Come to the chats with an open mind and heart and be prepared to feel uncomfortable – it is through discomfort that we can begin to make the necessary changes.
  • We need to unite to be actively against (anti) any forms of prejudice / oppression.
  • As always, respect each others’ views and acknowledge that there will undoubtedly be differences of opinion.
  • Develop an awareness of microaggressions and be mindful of how they may impact the colleagues you are interacting with on this topic: https://www.vox.com/2015/2/16/8031073/what-are-microaggressions
  • Accept that you will make mistakes and if these are pointed out, reflect on them and make the necessary changes.
  • Be clear about the differences between Inequality, Equality, Equity, and Justice. Check out this graphic created by @lunchbreath based on Shel Silverstein’s The Giving Tree.

Questions for the #OTalk chat will be as follows:

 

1 A) How ethnically diverse do you perceive our profession to be now? B) Has this changed over the course of your time as an OT? (Q Hosted by @Occ4LifeLtd)

2 A) Why would we want to encourage more people from BAME backgrounds to enter the profession? B) Does the OT staff group in your area represent the population you serve? (Q Hosted by @sherriikapp)

3 A) What racial / cultural discrimination have you experienced, seen or even perpetrated (even unconsciously)? B) What did you do about it? (Q Hosted by @KwakuOT)

4 A) What barriers do BAME occupational therapists face for progression into roles in leadership, academia and research? Please refer to the list of questions prepared by @HannahtheOT https://twitter.com/HannahtheOT/status/1267852336443150341 (How many Black lecturers / placement educators / managers have you had? Can you name 10 Black OTs you’ve worked with throughout your career? Can you name 10 white OTs? Name an OT theory, model or standardised assessment developed by a Black OT? How many articles/books have you read that were written by a Black OT?) (Q Hosted by @MwelaSihle)

5 A) What responsibility do you / will you take for exploring and educating yourself on issues of race and culture? B) What is one change you can make tomorrow? (Q Hosted by @LecturerMish)

 

Some useful resources: 

 

*Will COVID-19 be a watershed moment for health inequalities: https://www.health.org.uk/publications/long-reads/will-covid-19-be-a-watershed-moment-for-health-inequalities

 

*AHP Leaders Podcast: Changing the Culture of Conversations (featuring AHP leaders from across the UK)

https://www.youtube.com/channel/UCb722uXf9XJpegA_d-ApBUg

 

*The OT & Chill @ot_chill podcast, Episode 11 – L . O . V . E – Let’s Talk About Race #BLACKLIVESMATTER: https://open.spotify.com/episode/4sPh0qghwAiozaXLSM0re2

 

Akala deconstructs race, class, and Britain’s modern myths | Unfiltered with James O’Brien #32 https://www.youtube.com/watch?v=atfVUgyEIOI

 

Dr Karen Whalley Hammell WFOT Congress 2018 keynote ‘Building globally relevant occupational therapy from the strength of our diversity’ https://www.youtube.com/watch?v=9WipUPXx_Kk&t=7s

 

*George Floyd, Minneapolis Protests, Ahmaud Arbery & Amy Cooper | The Daily Social Distancing Show https://www.youtube.com/watch?v=v4amCfVbA_c

 

Hey White Therapist! Here’s where we start! https://courses.clearlyclinical.com/courses/free-ceu-racial-awareness

 

Why I am no Longer Talking to White People About Race by Renni Eddo Lodge: https://www.theguardian.com/world/2017/may/30/why-im-no-longer-talking-to-white-people-about-race (this is the preview article for the book)

 

Guidance for white allies who are trying to help https://ladders4action.org/news-blogs-videos/blog/do-no-harm/

 

Why “I’m not racist” is only half the story by Robin DiAngelo https://www.youtube.com/watch?v=kzLT54QjclA (a good summary of her book ‘White Fragility’)

 

 

 

A few real life scenarios to get you thinking:

 

In one occupational therapist’s work place it was identified that approximately 50% of inmates in a prison setting are from BAME backgrounds, with only 10% accessing occupational therapy services. Many reported discomfort in accessing services as they felt that the staff body was not representative of their backgrounds and lacked understanding of where they were coming from.

 

A Black occupational therapist received comments from a supervisor which suggested that they were perceived as lazy and uneducated. This Black colleague felt they had to work ten times as hard as white counterparts and also sees white colleagues get away with things they are reprimanded for.

 

A white Muslim occupational therapist who wears a hijab went to an interview and saw visible shock on the interviewer’s face. Feedback suggests that she couldn’t have answered the questions differently but she wasn’t offered the job.

 

A Black student turns up to a university admissions interview wearing jeans – they demonstrate more knowledge and insight than a white student who comes wearing a suit or smart attire. Which applicant gets awarded a place on the programme?

 

This #OTalk session and blogpost was made possible through the contributions of:

 

Sihle Mwela @MwelaSihle

Kwaku Agyemang @KwakuOT

Jo Bresi-Ando @otStones

Musharrat Ahmed-Landeryou @LecturerMish

Elaine Rutherford @Cariad_OT

Jou Yin, Teoh @teohjouyin

Grace Chikelu Amamilo (not on Twitter)

Kirsty Stanley @Occ4LifeLtd or @kirstyes

Somia Jan @SomiaOT

Carolyn Connage @CarolynOT

Nichole Yam @nicholeyam

Ed Sum @musedNeuroOT

Sophia Awan @Sophia OT

Yasmin Anisuddin Ward @Yazz_OT

Geraldine Kinkead-Richards @GeriLKR

Hannah Daisy @HannahtheOT

Simone Welch @Simzy_x

Ally Plusii @Ally56642911

Sheri Braimah @sheriefeb

 

One change our group thought was that RCOT could easily introduce is to appoint an Equality and Diversity Officer dedicated to organising research, study, networking and publicity events, and for influencing policy. A diversity mentorship / support scheme was also suggested to provide opportunities for people to discuss common issues. It would also be useful to have some dedicated webpage resources similar to those on the CSP website – https://www.csp.org.uk/workplace/equality-diversity. Do keep informed on the RCOT progress following the RCOT BAME Big Conversation – a summary of which will be posted on their new Equality, Diversity and Inclusion pages here – https://www.rcot.co.uk/equality-diversity-and-inclusion

 

Some immediate actions you can take: 

Vote for Dr Kee Hean, Lim @lim_hean to be member of the RCOT Council. He is the sole candidate to represent the BAME population and has a long, consistent track record of enabling equitable student recruitment and retention at Brunel University London. The Brunel University London student body has 30-50% BAME representation thanks to the efforts of Kee Hean and his fellow admissions tutor Dr Ayana Ifekoya. The Brunel University London occupational therapy team have a tweet thread documenting their recent efforts contributing towards Racial and Cultural Equity: https://twitter.com/OTatBrunel/status/1281145935502942209

Please consider answering the call for stories, poems, comics, etc for an eBook “We Are OT: a brief history and personal accounts of diversity in the profession of occupational therapy within the UK” to be published on World Occupational Therapy Day 2020. https://occupation4life.co.uk/2020/06/05/we-are-ot/

 

#OTalk 14 July 2020 – Exploring the impact of COVID-19 on occupational therapy practice.

This weeks #OTalk is being hosted by Katy Williams (@Katy_WilliamsOT) and Paul Wilkinson (@PaulWilkinson94) both of whom are part of the Year One: Thriving Not Surviving project team. Katy is newly qualified, currently working at Gloucestershire Royal Hospital on a rotational post. Paul is also newly qualified, working at South Tees Hospitals NHS Foundation Trust on a rotational post. We are both extremely interested in exploring the changes to practice which have occurred during the Covid-19 pandemic and their impact upon the profession moving forward. 

Unprecedented, unchartered, the new normal, phrases that have shot into common parlance over the last few months, along with key worker, frontline and hero. Behind every use of these words lies a personal story. Triumph in the face of adversity, tragedy, a story of renewal and even, at times, moments of laughter. Personal accounts of living and working through a unique moment in global history. A time we will undoubtedly start to mark as pre and post COVID. 

The media has been full of stories of the heroism of people working on the front line. The country has come together to support our courage, bravery and self-sacrifice. However, this generic narrative is challenged by many of the personal stories that are starting to emerge from those working in health and social care. 

Some occupational therapists have indeed experienced working ‘on the front line’ in life and death situations either in their role as occupational therapists or in roles to which they have been deployed.  Across the profession as a whole however, the experiences are more varied. 

None of us could have envisioned that one of the challenges of our career paths would be playing a role in a worldwide pandemic. Covid-19 has influenced services, procedures and the way we practice. Some of us have been continuing in our usual roles experiencing a reduced case load whilst others have started new jobs or rotated into new specialties. Those in managerial positions have been challenged by a level of logistics they may never have faced before and those leading our profession have been required to lead through completely uncharted territory. The majority of us have been required to adjust considerably our mode of practice. 

Whilst responding to the daily situation we continue to find ourselves in, it is easy to lose sight of the path travelled on a personal level. Due to the service focused values of health professionals the focus tends to be outwards with less attention being paid to self-care and personal wellbeing. Add to this the backdrop of responding to the impact of the pandemic on home life and taking time to reflect, make sense, heal and recharge, for many, has been at a premium.

We started working on the Year 1 Thriving Not Surviving project at the start of the pandemic. Many of our plans have had to be adapted but over the last three months but we have found support in sharing our COVID-19 experiences. It’s been interesting to learn how occupational therapists working in different environments and different parts of the country are responding to the pandemic. 

This led us to think about extending the conversation into an OTalk, which is what we hope to achieve in this talk. A chance for a community to come together and share this experience. The questions we will be exploring are:

  1. How has Covid-19 impacted on your role & the way you practice? 

  1. What have been your biggest challenges during Covid-19?

  1. What have you done to promote/manage your own wellbeing during Covid-19?

  1. What are the important things have you learnt about yourself and the way you practice during the COVID-19 pandemic?

  1. What changes to practice have occurred that you hope will remain?