Occupational Therapy Week 2020: Working with ‘people’ not ‘patients’

Anita Whalley is an Occupational Therapist currently employed as the Team Leader for the Older Persons Assessment and Liaison Service (OPAL) at Salisbury Foundation Trust. She has worked in a variety of therapy settings including community and integrated care. Anita is a clinical leader specialising in Frailty within Emergency and Acute Medicine. She completed a Quality Improvement Fellowship with Health Education England South East in 2018 and is a Q Community Member. Anita is passionate about person centred approaches to service provision within care organisations and is working towards an MBA in Leadership and Management.

This week is Occupational Therapy Week in the UK and, since becoming an OT, I have used this week each year to reflect on why I am an OT and what value OTs add to the wider health system. Admittedly I am highly biased as I think that OTs are fundamental to healthcare; we advocate for patient centred practice, we complete holistic assessments and in the acute Trust we are essential to patient flow. However, during a recent discussion with some fellow AHPs, I was also struck by the amount of professional pride that the OTs in the room displayed when speaking about their patients.

None of the OTs bragged about their impact on length of stay or patient flow, but instead they beamed with pride and told me stories of the difference they had made. I heard about Margaret, who had been an avid gardener until her admission and how the OT had supported Margaret to adapt the way she gardened so that she could enjoy the rest of the summer with her flowers, and the story of a gentleman named John who hated being in hospital, until the OT put the radio on and he would then dance in the middle of the bay with his wheeled zimmer frame.  

This year, instead of advocating for OTs to take over the world, I decided to write about the value of occupational therapy to the people that they treat.

After working in acute hospitals for the past few years I realised how easy it is for older people to become patients as soon as they walk or wheel through the hospital doors. Once ‘the person’ becomes ‘the patient’ it’s much easier to move them through the system. We assign them a bed number, log them onto the consultant list with their hospital number, give them a labelled wrist band with all the important information on it, and when they are medically stabilised and able to leave hospital, we use a check list of the essential tasks they need to be able to perform to “live safely at home”. If the patient can mobilise, wash and dress and access meals then they are supposedly ready to go.

But…… what about the person who initially walked through those doors? Did they care about those three essential tasks? Are those the three things that gave their life meaning?

When an OT walks into a bed space, they see a person sitting in the uncomfortable high back chair (that’s probably too low for them to stand up from), and asks them what they did to fill their days before they came to hospital, and what they want to achieve when they leave.  Sometimes the most important things are on that check list, and sometimes they aren’t, but the OT always asks the person anyway. In saying that, OTs are under the same pressures as the rest of the healthcare system and we can’t always provide the intervention to target those meaningful activities, despite our university training encouraging this intention. However, the value of being seen as a person, of being heard, is what OTs bring to healthcare, and is why I am proud to be an OT.

Hospital systems exist for a reason and everyone involved in the person’s journey has a job to do. But, maybe if more staff asked the person what was meaningful to them, what they wanted their outcomes to be, then maybe we would have fewer patients on the wards and more people. There is a subtle but important difference.