OTalk

#OTalk Research – Tuesday 5th October 2021 – How can we use new research to address the unmet need for rehabilitation in people with long-term conditions?

This week’s chat will be co-hosted by @NIHRevidence and @lindsaybearne a Senior Research Fellow in Knowledge Mobilisation at the  NIHR Centre for Engagement and Dissemination, . 

In 2017, WHO launched the Rehabilitation 2030 initiative, which laid out the increased need for rehabilitation due to an ageing population and increasing incidence of people with multiple long term conditions. They urged governments to improve their rehabilitation offerings. 

However, since the COVID pandemic,  rehabilitation services have decreased. This has affected people with long-term conditions, diminishing their health and wellbeing.  A group of charities and professional bodies have teamed up (called the Community Rehabilitation Alliance) and, together, they have called for a new national strategy for rehabilitation

We, at NIHR Evidence, have  collated some of the evidence on innovative approaches to rehabilitation for people with long-term conditions that have been published as NIHR Alerts. Our Collection, authored by Professor Lindsay Bearne, explores some new ways  to deliver rehabilitation effectively and cost-effectively. It  includes studies exploring telerehabilitation, workforce innovations by involving other staff members, and novel training for professionals. The Collection argues that implementing new research will enable us to ‘Move forward stronger’ to address the unmet need for rehabilitation. 

Why not join this week’s #OTalk to share your thoughts on how we can draw on new research to optimise rehabilitation delivery for people with long-term conditions. And discuss how innovative approaches could meet the needs of individuals in an effective and cost-effective way. 

The questions

In the #OTalk discussion we will use the following questions to structure the discussion but please feel free to join in with other questions and perspectives:

  • What are the key challenges to delivering person-centred rehabilitation? 
  • How can new ways of working, such as training non-specialist staff or telerehabilitation, help address the unmet need? 
  • What research is needed to help improve rehabilitation services? 
  • What do you think governments and policy makers need to do to address the unmet need for rehabilitation?
  • How do you access rehabilitation research evidence? 

Resources

POST CHAT 

Host:  @NIHRevidence and @lindsaybearne  Support on OTalk Account: @Preston_jenny
Evidence your CPD. If you joined in this chat you can download the below transcript as evidence for your CPD, but remember the HCPC are interested in what you have learnt.  So why not complete one of our reflection logs to evidence your learning?

HCPC Standards for CPD.

  • Maintain a continuous, up-to-date and accurate record of their CPD activities.
  • Demonstrate that their CPD activities are a mixture of learning activities relevant to current or future practice.
  • Seek to ensure that their CPD has contributed to the quality of their practice and service delivery.
  • Seek to ensure that their CPD benefits the service user.
  • Upon request, present a written profile (which must be their own work and supported by evidence) explaining how they have met the Standards for CPD.
OTalk

25th October 2021 #OTalkTurnsTen – Help us Celebrate 

This October 25th 2021 #OTalkTurnsTen Can you believe it? We have a number of things lined up to celebrate, including a few surprises, and we require the OTalk community to help with three of them. 

  1. Share why you love #OTalk #OTalkTurnsTen
  2. Bake #OTalk a birthday cake and share it #OTalkDoesBakeOff 
  3. Apply to become a member of either the #OTalk team or the #OTalk Research team #BecomeAnOTalkTeamMember

Share the Love #OTalkTurnsTen

Can you tell us what you like about #OTalk and why you engage?   We would love the community to share this, in tweets, video clips, or even a blog post, feel free to share on any of our social media platforms, using the hashtag #OTalkTurnsTen from now until our Birthday on 25th October.  

So start thinking and start sharing your memories and thoughts,  here are a few suggestions to get you started. 

  • What do you love about #OTalk? 
  • How did you find out about #OTalk?
  • What is your most Memorable #OTalk chat?
  • What has #OTalk meant for your career?
  • Have you ever had a light bulb moment during #OTalk?
  • Have you ever hosted a chat? What was that experience like? 
  • Have you met any of the #OTalk team in person?  Share any pictures/videos.
  • Have you ever been put on the naughty step for forgetting to include the hashtag?
  • Did you come to one of our meetup events at a conference, what was it like?

Remember when sharing always include  #OTalkTurnsTen   By sharing you are giving @OTalk_ permission to use content*



Bake #OTalk a Birthday Cake #OTalkTurnsTen #OTalkDoesBakeOff

As the Great British Bake Off has returned, and has the cheek to air during our time slot, Tuesdays 8pm, we would love you to make @OTalk_ a birthday cake. We are looking forward to seeing how creative the OTalk community is at this meaningful occupation.  The #OTalk team will be sharing their efforts too, trust us there will be some funny ones.  

So get baking and don’t forget to share your images (no matter the outcome, it’s the processes that are important) on social media used the three hashtags #OTalkTurnsTen #GBBO #OTalkDoesBakeOff

By sharing you are giving @OTalk_ permission to use content*



Become an #OTalk or #OTalk Research Team member #OTalkTurnsTen #BecomeAnOTalkTeamMember

#OTalk is a free resource for the community and is run by volunteers.  #OTalk aims to remain a free resource, and anything that team members might get involved in that has a cost attached is self funded by that member.  It can be a demand on your free time, but it’s worth it, and it can be fun. Plus as a team we have always supported each other.  

The #OTalk research team currently has only two members who work solely on identifying hosts and curating 12 research chats a year on the 1st Tuesday of the month.    There is some admin involved including posting blog posts and communicating with hosts, plus supporting the monthly chat.  You will not be required to do every month as this will be shared with other research team members. You will be given some mentoring to start with. If you’re interested in research and have some basic knowledge of Twitter and other platforms this might be a perfect voluntary role for you.  It’s a great opportunity for you to develop your networks within the research community too.

The #OTalk team currently has 6 members,  this team might be a little more demanding on your time.  Jobs that the team shares include; . 

  • Maininting the blog/website
  • Managing the email account
  • Managing and liaising with those that offer to host
  • Posting blog posts 
  • Collecting data and transcripts of chats
  • Taking it in turns to support the weekly chats
  • Liaise with anyone contacting the team via Twitter, Facebook, Instagram and email
  • Promoting #OTalk at events e.g. manning a stall and/or running workshops or giving presentations about #OTalk and social media as a CPD and Therapeutic tool, when invited to do so at OT events across the UK. This is self funded. 
  • Working with stakeholders such as The RCOT and The OT show on projects.

So if you’re a fan of doing lots of work, just for the joy of it; think of yourself as an OTGeek; want to network more;  and develop your organisational, social media and tech skills then you might just be a good fit.  We will of course give guidance and support. 

Send us an expression of interest by email here. otalk.blog@gmail.com

Lastly we have a few other surprises in store; including a 10th Birthday Gift for you, but more about that later! We can’t wait to see what you come up with!!!!

*By sharing posts using any of these hashtags  #OTalkTurnsTen #GBBO #OTalkDoseBakeOff  You are consenting to the OTalk team using what you have shared, to promote our birthday.  We do not keep any personal information, but will search social media for your posts using the hashtags and share them across all of our platforms.

OTalk

#OTalk 28th September 2021 – Thermoregulation for wheelchair users: preventing problems with heat and moisture

This #OTalk is hosted by @WheelAir_

Overheating, over-sweating and excessive moisture build-up are common complaints among wheelchair users. Either due to a medical condition or restrictive seating configurations, many wheelchair users struggle to control heat and moisture levels in the seat contact areas.

At WheelAir, we feel that there is a general lack of understanding and awareness of how heat and moisture complications manifest and how serious an issue thermoregulation can be for wheelchair users.

Overheating

The body uses four mechanisms to maintain thermoregulation: conduction, convection, radiation and evaporation. However, for people with sweating dysfunction, caused by a spinal cord injury for example, no evaporation heat loss can take place. Such overheating drastically heightens the risk of developing heat stress or fatigue, as well as other issues such as heat-induced seizures and muscle spasms. Having to “just deal with” overheating and warm environments can, therefore, be very dangerous for wheelchair users if precautions aren’t taken.

Over-sweating and moisture build-up

Similarly, over-sweating or excessive moisture build-up can have serious consequences for wheelchair users. This is because the skin microclimate – that is, the temperature, humidity and airflow next to the skin surface – is an indirect pressure ulcer risk factor. Temperature and humidity affects the structure and function of the skin, lowering possible damage thresholds for the skin and underlying soft tissues. Even for people who are unable to sweat, such as those with a complete SCI, excessive moisture build-up is a problem. Even when not sweating, the skin releases moisture automatically through a much more passive process called transepidermal water loss (TWL). This is an unavoidable process and, of course, TWL increases when someone is sitting all day.

Research on heat and moisture

The team at WheelAir has spent the past 5 years researching heat and moisture to better understand how to recognise symptoms. We have now created a clinical assessment toolkit to improve the efficiency of evaluating heat and moisture risks for wheelchair users. The toolkit is designed to better inform and educate those involved in the decision-making and reimbursement processes, such as OTs, about the prevention or treatment of heat and moisture related complaints, such as pressure injuries or skin rash.

We want to facilitate OTalk to discuss these newly devised clinical tools and hear from OTs about their experiences of handling heat and moisture issues for wheelchair users.

About WheelAir

The WheelAir system is the first temperature control system designed to fit any wheelchair. All of our products are designed to disperse air evenly across the wheelchair contact area to lower the user’s core temperature and keep the skin dry and clean.

The very first WheelAir was brought to life in 2015 by our Managing Director, Corien Staels, as her final university project during her textiles degree after her university tutor, who was a wheelchair user, told Corien of the problems associated with overheating. Intrigued, Corien wanted to know more and discovered that overheating in a wheelchair is not only very uncomfortable, but also potentially dangerous. She learned that people were using ice-packs and water sprays to keep cool and it seemed ridiculous to her that in this day and age, there wasn’t a technological solution. And so she came up with the WheelAir concept – a simple idea that has already made a lot of impact. Ultimately, WheelAir’s vision is to create a world where every wheelchair user feels comfortable and in control of their temperature.

QUESTIONS:

1. We have had a very hot summer, what symptoms have you seen for wheelchair user clients in the past few months? How have they been managing staying cool and avoiding overheating?

2. Similarly, have moisture related issues been more of a challenge during the hot summer months? Are people struggling with sweating too much, skin issues like rashes, and finding it difficult to stay cool and dry?

3. In general, what types of symptoms do you see with heat and moisture related issues for wheelchair users? How often do you see these as issues for wheelchair users?

4. If a client has heat and/or moisture related symptoms, what do you usually suggest for solutions?

5. How can training about overheating, sweat, and microclimate management improve for Occupational Therapists that work with wheelchair users?

POST CHAT 

Host:  @WheelAir_

Support on OTalk Account:  @colourfulot

Evidence your CPD. If you joined in this chat you can download the below transcript as evidence for your CPD, but remember the HCPC are interested in what you have learnt.  So why not complete one of our reflection logs to evidence your learning?

HCPC Standards for CPD.

  • Maintain a continuous, up-to-date and accurate record of their CPD activities.
  • Demonstrate that their CPD activities are a mixture of learning activities relevant to current or future practice.
  • Seek to ensure that their CPD has contributed to the quality of their practice and service delivery.
  • Seek to ensure that their CPD benefits the service user.
  • Upon request, present a written profile (which must be their own work and supported by evidence) explaining how they have met the Standards for CPD.
OTalk

#OTalk Tuesday 22nd Sep 2021 -The Role of Occupational Therapy in Primary Care Mental Health Teams

This #OTalk is hosted by Helen Parmenter and Cheryl Carr who are both occupational therapists working in primary care teams.

Increasing complexity is one of the major factors responsible for the rising workload in general practice (Baird et al 2016) and involves patients presenting with two or more health conditions which also interact with other social difficulties such as poverty, trauma, isolation etc.
Often these difficulties are considered in isolation when people try and access services meaning patients often fall through the gaps between specialist mental health services, social care and Improving Access to Psychological therapies with their management being held by their local GP.

As part of the NHS long term plan, which NHS England published in 2019, local areas are being asked to realign community mental health services with primary care networks, creating ‘new and integrated models of primary and community mental health care’ by 2023/24 (NHS England 2019, p 69) resulting in the establishment of primary care networks (PCNs).

A diverse range of mental health needs are seen in primary care, with general practices supporting people with a wide range of diagnoses and complexities, including people with psychosis, bipolar disorder, personality disorders and other needs. (The Kings fund, 2020 )

Examples of population needs may include:

  • People with complex needs that do not fulfil criteria for specialist mental health services
  • Child and adolescent mental health needs that do not fulfil criteria for secondary care services
  • Mental health needs among older people
  • People with long-term mental health conditions discharged from secondary care
  • People with persistent physical symptoms which impact on their mental wellbeing
  • Psychological needs of people with long-term physical health conditions
  • People at risk of suicide, but not in contact with specialist mental health services

With the establishment of the PCNs, an increasing number of roles are emerging for occupational therapists to work within these newly established teams which often comprise of a mix of GPs, social prescribers, peers support workers, coaches, counsellors and psychological practitioners.

Within primary care mental health services occupational therapists are involved in activities such as
-Risks assessments for acute distress
-Personalised care planning for self-management
-Patient activation to achieve personal goals
-Social prescribing, and signposting or referral onto recovery support and services
(RCOT)

With services in their infancy and roles being developed in practice with opportunities to shape our own unique contribution, we look forward to hearing form the wider community about their thoughts about how occupational therapists can develop this opportunity to promote their skills to others, identify gaps, develop new ways of working and become imbedded as partners in their local communities.

Questions that will be discussed during this #OTalk are:

  1.  What help or support do you wish patients had in primary care mental health services?
  2.  What key skills can OTs utilise to be most effective in their roles?
  3.  How can OT’s be effective and timely with complex presentations?
  4.  What might be the best ways for OTs to demonstrate their outcomes to others both within the GP surgeries and beyond?

References;

Baird B, Charles A, Honeyman M, Maguire D, Das P (2016). Understanding pressures in general practice [online]. The King’s Fund website. Available at: http://www.kingsfund.org.uk/publications/ pressures-in-general-practice (accessed on 21st July 2021).
The Kings Fund (2020). Mental Health and primary care networks: understanding the opportunities. The Kings Fund website. Available at: https://www.kingsfund.org.uk/publications/mental-health-primary-care-networks (accessed 26th July 2021)

NHS England (2019). The NHS long term plan [online]. NHS England website. Available at: http://www.longtermplan.nhs.uk/publication/nhs-long-term-plan (accessed on 20 July 2021).

RCOT. Occupational therapy in primary care. RCOT website Available at: https://www.rcot.co.uk/occupational-therapy-primary-care (accessed 20 July 2021)

POST CHAT

Host:  Helen Parmenter and Cheryl Carr

Support on OTalk Account: @helenotuk

Evidence your CPD. If you joined in this chat you can download the below transcript as evidence for your CPD, but remember the HCPC are interested in what you have learnt.  So why not complete one of our reflection logs to evidence your learning?

HCPC Standards for CPD.

  • Maintain a continuous, up-to-date and accurate record of their CPD activities.
  • Demonstrate that their CPD activities are a mixture of learning activities relevant to current or future practice.
  • Seek to ensure that their CPD has contributed to the quality of their practice and service delivery.
  • Seek to ensure that their CPD benefits the service user.
  • Upon request, present a written profile (which must be their own work and supported by evidence) explaining how they have met the Standards for CPD.

The Stats

OTalk

#OTalk Tuesday 14th September 2021 – Following Boris Johnsons announcement on more funding for social care. What is the OT’s community thoughts?

This week our very own @OT_rach will try her best to guild you thorough the British Prime minister announcement from Tuesday 7th September, that has been described as  ‘A once in a generation’ shake-up of adult social care and how it is to be funded.

The cabinets have agreed upon a new plan to modernise the social care system, ensuring it is better integrated with healthcare, that will be financed through tax rises. 

Photo credit Sky News – Social Care Graphic

The Guardian reported 

In the short term, much of the money being raised will finance the NHS to catch up with elective surgery and other appointments delayed due to Covid. While the financing plan is UK-wide, the actual implementation of health and social care is run by each UK nation. 

‘Next year, national insurance contributions for employees, employers and the self-employed will rise by 1.25%, then in April 2023, while the rises will stay the same, the tax rise will be rebranded as a health and social care levy, which will appear separately on people’s tax records.’

The Observer goes on to reports that Downing Street says the tax increase will raise an additional £12bn a year.  A total of £36bn over three years of which the following has been allocated:

  • £16bn Direct NHS funding in England
  • £8.9bn for ‘health-based Covid response’ in Englan
  • £5.4bn for social care in England, of which £500,000 is for training £5.7bn for devolved nations, to support health and social care.
  • £5.7bn for devolved nations, to support health and social care.

Source: HM Government

Changes are also being made to the contributions people will pay towards social care, if and when they may need these services.

Currently in England if you have 

  • Assets less than £23,250 – Care is completely funded by state.
  • Assists over 23,250 – care is self-funded with no cap.
  • Those above the state pension age who still work do not normally pay national insurance.

The changes from October 2023 will mean if you have

  • Assets less than £20,000 – Care is completely funded by state.
  • Assets £20,000 to £100,000 – Care is self-funded with a cap of total contributions at £86,000 or until you reach less than 20,000
  • As of 2023, those above state pension age will begin to pay the new rebranded ‘health and social care levy’.

This is where it gets a bit more complicated well for me at least.  National insurance is a UK-wide system, it is reported that income from theses changes will be distributed across the four UK nations, and that by 2024-25.

  • Scotland, will benefit from an extra £1.1bn
  • Wales an extra £700m
  • Northern Ireland an extra £400m 

Although those living in Northern Ireland, Scotland and Wales contributions towards their social care need may differ form those in explained above for England. 

Lastly other than the prospect of a white paper to develop longer-term plans. The overhaul of social care and promise to bring health and social care systems together, has very little further detail. 

“We’re pleased that the government is starting to look at the future for social care, but today’s announcement is thin on detail other than on the levy. There is also little on how the government proposes to break down the historic divisions between health and social care, beyond a short reference to the development of a future integration plan and vague mention of reform. 

“Social care should be provided to all who need it and free at the point of use, to help address the inequalities COVID-19 has shone a light on in the sector. Whilst today’s announcement will provide relief to some, the announcement of £5.4bn over three years with no guarantees of sustainable funding beyond this is a big concern for the long-term future of care. 

“Nor does it say the government will address the real issues in the social care workforce which are leading to chronic shortages all over the country. Occupational therapists as well as other allied health professions will have listened in vain to hear about how the government intends to tackle the issues they face on a daily basis. 

“Whilst it is positive that in principle the government has committed at least £500m of funding for the development of the social care workforce, it is not nearly enough to fund this, mental health support, and also reform key aspects of the workforce. For social care staff it is offset by the extra levy that they and their employers will pay, which will take more resources out of the system.

“It is now the time to improve access, quality, and levels of social care and rehabilitation support, so that those who need it receive the care they need, when they need it. Those working in social care must have parity of esteem with the NHS workforce and be given proper development opportunities. We cannot wait until 2023 to start tackling these issues, we need to start now.”

So taking all this in to account and your own experiences of working in health and social care fields the chat will ask the following questions.

The Questions

  1. What were your initial thoughts following this announcement?
  2. Why should our profession concern itself with the details of this ‘once in a generation’ shake-up of adult social care?
  3. Who do you think will befit most and least from the Prime Ministers announcement on social care?
  4. How might these changes impact Occupational Therapy practice? 
  5. Are you happy with The RCOT response to this announcement?

Ref

https://www.rcot.co.uk/news/rcot-response-government’s-announcement-social-care-funding-reform

https://www.theguardian.com/society/2021/sep/07/what-has-boris-johnson-announced-social-care-plan

POST CHAT

Host:  Rachel Booth @OT_rach

Support on OTalk Account: OT_rach

Evidence your CPD. If you joined in this chat you can download the below transcript as evidence for your CPD, but remember the HCPC are interested in what you have learnt.  So why not complete one of our reflection logs to evidence your learning?

HCPC Standards for CPD.

  • Maintain a continuous, up-to-date and accurate record of their CPD activities.
  • Demonstrate that their CPD activities are a mixture of learning activities relevant to current or future practice.
  • Seek to ensure that their CPD has contributed to the quality of their practice and service delivery.
  • Seek to ensure that their CPD benefits the service user.
  • Upon request, present a written profile (which must be their own work and supported by evidence) explaining how they have met the Standards for CPD.