Occupational therapy-led supporting independence, improving quality of life and saving money, ABLE2, Southend

Traditionally, new, or increased packages of care are often determined to be the solution to supporting independence for people who have recently spent time in hospital. For many this becomes long term care and a permanent solution. This presented a challenge: the number of people needing care was increasing; there were insufficient care hours available to people to support people at home. Decision making about support was also a crisis response.

ABLE2 was developed to explore an alternative, answering the question ‘can an occupational therapy-led approach support independence, increase quality of life AND save money?’ People who are receiving a permanent care package over 20 hours per week and people recently discharged from hospital or from reablement with a new or increased long-term package of care are the target groups.

A dedicated occupational therapy and social work team offer a service to people in their own homes; people are contacted six weeks after a recovery or medical intervention for a timely and measured conversation, when they are looking forward to how they want to live their lives and focussed on their own strength and effort. Occupational therapists observe the delivery of care and hold conversations focussed on what is important to the person, their strengths and goals, aims for excellence in care and living their life as independently as possible. 

On this basis, changes are identified and agreed with the individual and their carers/support network, for example care may be replaced with new equipment or methods, new approaches to personal care may be used, or there may be a change in the timing/duration/regularity of care calls. These changes are introduced for a trial period to identify any issues and increase confidence, with social worker visits if necessary. There are no changes to commissioned care during this period. Additionally, through teamwork, health, care and social needs are understood together, with support to navigate and connect people to services and their community, motivating the individual to participate in living life.

Focussing on what is important to the person, their strengths and goals has enabled individuals to have more control and choice, and able to access an alternative expert opinion alongside their own as to what would make the difference to them. 

Client feedback: 

“I don’t know how but you seem to have really got things moving”

“I never thought I would get upstairs again”

“I didn’t like so many people coming in and out all day at any time”

“We felt abandoned after hospital and didn’t know these things”

“You’ve given me hope”

Changes to enable independence through this approach have typically resulted in a reduction in the hours of care needed by an individual. In the three-year period 2021-2024, 163 people required less care (72,254 hours in total) that would have cost £1,451,977. This care can then be available to others, or savings used for other reasons. It is estimated that the investment of £60,000 in an occupational therapist post generates savings of £150,000 per annum.