Thinking OT

Thoughts from Harrison Training and the occupational therapy world

Posts Tagged ‘transition

Challenge What I Think

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Changing What We Think

I thought was going to write about the NHS Confedration’s consultation paper, and looking in particular at the consortia that service purchasers, previously known as GPs, will be obliged to join.  I might get onto that later.

Instead I got distracted by a curious search that has come up on the blog stats.  It read;

“Challenge what I think”

Someone had searched for “Challenge what I think” and Google, in its infinite algorithmic wisdom sent them here.

That set in motion a chain of thought.  How readily do we open ourselves to being challenged in what we think?

The two topics are not entirely disconnected.  The angle I was contemplating on NHS reform was that it is easy to get stuck in resistance, anger and opposition.  We might rail against the system on the basis that it is

  • Wasteful
  • A broken promise
  • Unnecessary
  • Politically motivated
  • Unworkable
  • Meddling
  • Unwelcome change

or we can recognise that the march of this reform is inevitable.  Once we do that then the challenge is not to change the system or the political tide, but to look to ourselves and change how we are going to respond to it and engage with that change.

Note the word “Respond” as opposed to “React”

For those who are employed within the NHS, then we need to consider our roles within our teams.  How can we bring greater value, not just in pounds and pence, but in contribution?  What skills can we tap into to make our contributions more meaningful?

This has motivated the previous posts about self-effectiveness, or self leadership.  How can we position ourselves as being central to a team’s effectiveness, but not in a destructive way that undermines others, but constructively, helping to support and improve the whole.

For independent practitioners, how are you going to position yourselves in order to market your services to a larger number of smaller purchasers?  What do you need to do to demonstrate utility, effectiveness and ensure (to use the current buzzword) improved outcomes.

The current uncertainty needs us to remain adaptable.  It might mean getting to grips with social media – and the momentum that is now seen within social media and occupational therapy is very exciting.

It might mean, depending on how the consultation goes, that we need to be much more commercial in selling ourselves.

For some, let’s be realistic, it might mean looking for new roles altogether.

All of this needs us to be open to be challenged about the way we think.

We need to break the well worn patterns of X leads to Y and therefore Z applies. Experience shapes our responses so that if we find ourselves facing a situation we anticipate the outcome will the same as last time.  That can often drive how we respond.

And yet the outcome, to some extent, is shaped by our intervening response.  What if we choose, therefore, a different response?

What options have we got to select from?

What responses have we not tried previously and how might they serve us, and our service users and clients, better?

What new responses can we create for ourselves?

For more on this consider the issue of heuristics – there is a good summary on Wikipedia, right here.

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Reablement and Personal Care at Home

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There is an important role for occupational therapists in providing more reablement and rehabilitative services to local authorities, to ensure that clients do not find themselves marooned in hospital wards and longer term residential care.

Gordon Brown stumbled into a political storm last week when he spoke about his Personal Care at Home Bill.  The explanatory notes can be found here.

A key part of this was to provide extend reablement or rehabilitative support …

“…to help with the transition back home after a hospital stay, a residential care stay, or simply a fall or accident…” Source

The immediate political storm revolved around funding and the view held by many that this was cynical political grandstanding.  Regardless of the politics, reablement at home will be appropriate in many situations. 

It has to be unattractive that an admission to hospital for a minor issue results in a client not being discharged just because of a lack of rehabilitative care.  To appease the political wing, this is also likely to be uneconomical.

Some of the immediate criticism of the Personal Care at Home Bill was wide of the mark.  This letter in The Times, for example, states that

“Two, three, or even four hours of care a day does not help someone living with a neurodegenerative disease, who is immobile and has other serious health needs. Only 24/7 care can provide this.”  Source

That is, I believe, an extreme position and therefore a false argument to set up.  It does not disprove a role for reabling work.  It simply states the obvious that it would not be adequate for that particular client.

The feverish political baying that surrounds any health care announcement in the run up to an election should not drown out the substantive debate. 

How can the occupational therapy sector facilitate reablement, for example after a hospital visit, using the skills they already have in rehabilitation, adaptive technology, seating, gait and the like?

Neil Denny

Written by harrisontraining

February 18, 2010 at 11:06 am