Exploring skill-mix to enhance community service delivery

Introduction: The number of older people in the UK is increasing and requires local authorities to consider new and innovative ways of working to meet needs. Evidence suggests that prevention and early intervention helps support individuals to maintain independent lifestyles. Methods: This service evaluation outlines two case study examples of a new service delivery model in a local authority in England, combining the expertise of occupational therapists and assistant practitioners. New referrals requesting a package of care, where there were no existing services, were jointly assessed by two pairs of occupational therapists and assistant practitioners. The aim was to utilise the occupational therapy functional assessment, creative use of resources, a strengths based approach and knowledge of local voluntary, third sector and community resources to prevent, reduce or delay the need for funded care. Findings/ Discussion: Most cases were referred for social work intervention, but benefited from equipment, adaptations and focused advice around managing conditions and daily routines. This approach is predicted to reduce the number of internal referrals to occupational therapy, preventing the need for a second assessment. It also led to significant predicted savings and maintenance of independence and wellbeing for service users. Conclusion: Utilising their specialist skills and approaches, occupational therapists and assistant practitioners can work collaboratively to prevent, reduce and delay the need for funded care, and promote wellbeing for individuals. Anecdotal feedback suggests this is an empowering approach for service users which motivates practitioners and expands their knowledge. Recommendations: Availability of this service has been increased with plans to implement this approach across other localities