stroke care in scotland 29 - strokeaudit.scot.nhs.uk · stroke care in scotland scottish stroke...
TRANSCRIPT
Getting back to work
Stroke Care in Scotland
Scottish Stroke Care Audit meeting
29th August 2017
Thérèse Lebedis
Consultant Occupational Therapist in Stroke
NHS Grampian
What are the
issues?
• In 2016 of the 9331 people who had a final diagnosis of stroke in Scotland, 2321 (25%) were of working age i.e. aged 16-64.
• Decisions re return to work often made as soon as they have a stroke
• People attempt to return to work too quickly
• People are not always fully realistic about skills required for RTW
Return to work can ....
• Promote recovery and aid rehabilitation
• Improve physical & mental health and wellbeing
• Reduce social exclusion and poverty
• Waddell G & Burton AK: Is work good for your
health and wellbeing? 2009
Vocational rehabilitation
• Helping someone with a health condition to remain in or return to work
• Finding a match between a persons abilities and limitations following a stroke, the demands of the job and work environment
Scottish Stroke Improvement
programme
8.3. Living with stroke
• Vocational rehabilitation – Stroke services
should ensure that people of working age who
wish to return to paid or unpaid work or
voluntary work are signposted to vocational
rehabilitation services.
• People who wish to return to work are assessed
with regards to their capacity to do so; and
• Vocational rehabilitation services are available if
further advice and support is required.
Vocational
rehabilitation
services are
available to
people who
wish to
return to
paid, unpaid
or voluntary
work.
BLACK No vocational rehabilitation services available
for people who have had a stroke or plan to
establish them
RED Plan to develop referral process & pathway for
vocational rehabilitation services for people who
have had a stroke
AMBER
Vocational rehabilitation services exist for
people who have had a stroke, however
availability and referral is ad hoc across the
MCN area
GREEN
There is a documented referral process and
vocational rehabilitation pathway available, with
provision of specialist services in some MCN
areas
COMPLETE
All those across the MCN area with identified
vocational rehabilitation needs after a stroke
have access to specialised assessment and
intervention services as required.
S.I.P– priority 8.3 Living with stroke
Priority Action (3)
vocational rehabilitation
Ayrshire and GREEN
Borders AMBER
Dumfries & Galloway BLUE
Fife BLUE
Forth AMBER
Grampian AMBER
Greater Glasgow and
Clyde AMBER
Highland AMBER
Lanarkshire BLUE
Lothian GREEN
Orkney BLUE
Shetland GREEN
Tayside AMBER
Western Isles AMBER
healthWorks
• Presenting on behalf of the ‘healthWorks’ project
team. NHS Grampian
– Juliet McBean – Occupational Therapy Project worker
Steering group
– Susan Carr – AHP Associate director
– Thérèse Lebedis – Consultant OT - Stroke
– Dr Linda Leighton-Beck – Head of social inclusion
– Shona Strachan –AHP sector lead, Aberdeenshire
H&SC Partnership
healthWorks
• Public Health funded project since 2012
1. healthWorks training in understanding the link
between health and working/volunteering to all
health, social care and 3rd sector staff.
2. AHP Advisory Fitness for Work Report training
3. Three staff focus groups
4. Interview x3 people who have received a Fit
for Work report
Results
Stage 1 - healthWorks
• Number trained n=604
• Wide uptake from health, social care and 3rd sector
• Confidence increased
• Knowledge increased
• Awareness of services increased
• Good uptake of resources
Stage 2 – Fitness for Work
• Number trained 206
• OT (40%) PT (34%) Podiatry (26%)
• Pre-training n=191 : 97% had not completed a report
• 2 months post training – four people had completed a FfW report. (3x1&1x3)
• 6 months post training – six people had completed a FfW report
(1x11; 1x2; 1x3 & 3x1)
• 12 months post training - four people had completed a FfW report (1x29; 1x4 & 2x2)
Stage 3
Focus Groups
• Should we give advice?
Yes…importance of work to living
• Who should give advice?
everyone – at different stages when
the person needs it
• When?
As part of assessment process;
person dependent
• How?
In variable formats* - accuracy and
consistency needed
• To whom?
Adults/certain conditions
• What stops us?
17 reasons emerged but lack of time & ↓confidence
• What prevents us changing our practice
• Lack of clear processes; experience; complexity of cases
• What do we need in place…?)
better process/ access/ exposure to this type of work / VR specialist
Stage 4 – Service user interviews (n=3)
• All found the experience positive and helpful.
• All were proactive in seeking support and taking onboard advice
• Themes such as ownership and influence of the effect of the report emerged.
Recommendations
• On line training
• Training offered across organisations & professions
• Competency framework
• Improve communication.
• Specialist in employability and vocational rehabilitation
• Regular resource updates
• Develop pathways
What next......
• Active and Independent Living Programme
• Aims:-
– Development of vocational rehabilitation pathway in each health & social care partnership in Scotland
– National vocational education framework
– AHPs who are delivering vocational rehabilitation will be utilising the AHP Fitness for Work Report