Occupational therapy leadership in public health – enabling a population health approach to prevention, London Borough of Brent

Central to occupational therapy practice and training is a strengths-based approach which means occupational therapists are ideally positioned and skilled to prevent, reduce and delay care needs and promote health and wellbeing. Opportunities to practice are largely concentrated at an individual level, but there is considerable scope to apply occupational therapy expertise at a population level, analysing needs and developing strategies to meet these, whether this be through addressing inequalities experienced by people with a disability, enabling accessible buildings or breaking down barriers in helping people into work. 

As the Head of Intermediate Care, Brent council’s Principal Occupational Therapist (POT) manages the Reablement Team, one of the primary preventative interventions in adult social care. When the council decided to develop a prevention strategy and delivery plan, the POT was felt to be a natural fit. 

To lead this, initially the POT had a part-time secondment to the public health team. This has since evolved to a full-time, time-limited, role to enable the council to meet operational pressures, with the benefit of the substantive post being back filled and providing a career development opportunity to someone else. 

The development of a prevention strategy is considering the contribution of Adult Social Care to this agenda, mapping what’s available against primary, secondary and tertiary levels of prevention, identifying priorities for the first iteration of the strategy, and developing a delivery plan with measurements and outcomes. A key output is to understand whether care outcomes are experienced differently by different demographics across the borough.

The approach taken has identified the challenge of maintaining an up-to-date understanding of what preventative services are available in the community and across systems resource to understand and manage this is needed; post-COVID-19 and considering well-documented challenges on adult social care, practitioners have not been able to focus on prevention, but the process of strategy development is providing a helpful opportunity to refocus and increase understanding across the system. 

The POT role in working with public health on the strategy has already resulted in the development of a Joint Strategic Needs Assessment for Adult Social Care, initially focussing on two of the five priorities of the prevention strategy but with the intention of building on this, if successful. Colleagues in strategic commissioning have become involved in the mapping work, with a view to capitalising on community assets and delivering a gap analysis.