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#1 Monday 5th of October 2020 14:32

Adam_James
Member

International connections

Hi all,

My name is Adam and I'm an Occupational Therapy Assistant Practitioner with the UK's National Health Service. I'm currently studying Occupational Therapy at Coventry University in England in addition to my day job. I'm really interested in making connections with the wider international community of Occupational Therapy/ Ergotherapy practitioners to discuss differences and similarities in OT practice and how our different cultures and outlooks change the way we provide services.

Any contact would be greatly appreciated and I will be happy to answer any questions you may have about my role and how things are done here in England. I am also available on Twitter @ajbasford1

Many thanks!
Adam.

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#2 Thursday 8th of October 2020 00:00

Adam_James
Member

Re: International connections

No responses yet? Come on, you're out there!

It would really help with my understanding of cultural and environmental challenges which differ from the UK :')

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#3 Friday 9th of October 2020 21:30

Meg
Member

Re: International connections

Well, hello there!

I actually haven't been active on this forum since my student days (graduated in 2017), but I was curious as to what's been going on. This topic seems very interesting, and I honestly have been wondering about the differences in OT treatment in different countries. Anyway! My name is Megan, and I am a travel occupational therapist. I have been up and down the East Coast of the US and have mostly worked in rural hospitals and in-patient rehabs.  I can say that there are so many differences depending on the US state (productivity, services provided post-discharge, for example). I'll also be happy to answer questions about my area and experiences.

The trend I'm seeing in my area is that there's a lot of need for OTs in the school setting. How is it looking where you are? And what area/field of OT are you working in?

Hopefully more people post on this topic. It can be very interesting!
Meg.

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#4 Sunday 11th of October 2020 20:01

Adam_James
Member

Re: International connections

Hi Meg!

Thank you very much for responding, I really appreciate it. It would be fantastic to hear a little more about your practice and in particular the responsibilities, values, skills, and cultural perspectives you need to do your work effectively. Any links to interesting articles and/or code of ethics etc. would be absolutely fantastic!

I personally work within social care in the North Staffordshire area of England, and we provide social care services to residents on behalf of the County Council. Our work requires a lot of multidisciplinary working and I regularly engage with District Nurses, Physiotherapists, Social Workers, and Doctors in order to ensure we provide a fully holistic service for our patients.

There are several challenges that we face here in the UK which may be a little alien to other countries. As a public sector organisation we rely on funding from the Government and do not take any payment from patients - our service and all equipment, aids, and adaptations are free. However, we do struggle with under-staffing and under-funding - issues which many other health and social care services in the UK echo.  Another issue, which I have found with older patients, is very much a feeling of stoicism and reluctance to accept help - even when it is desperately needed. I find that the spirit of World War 2 still lives on in the minds and hearts of some elderly patients, even if they were only children at the time of the war - and this regularly manifests as a "need" for self-sufficiency and the classic British "stiff upper lip" mentality. I wonder if this is something you encounter in the States?

If you're interested, this link will take you to our code of ethics, which is provided by our governing body; The Royal College of Occupational Therapy:  https://www.rcot.co.uk/file/2044/downlo … n=cl0H9Ubf

Many thanks again for your time,
Adam.

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#5 Monday 12th of October 2020 06:40

Meg
Member

Re: International connections

Hi, Adam!

It was really fascinating to read your perspective and experience in the UK. I'm also going to have to sit down and read the Code of Ethics link you sent me.  The Code of Ethics we have in the US is the same one that is taught throughout the medical professions. Here is the link for the American Occupational Therapy Association (AOTA)'s Code of Ethics pdf: https://ajot.aota.org/article.aspx?articleid=2442685. After briefly looking at it, the Code of Ethics you have seems to be similar to a document we call the "Occupational Therapy Practice Framework," where it defines occupational therapy. It also categorizes occupation and things that affect occupation (eg context, religious beliefs, motor skills, cognition). AOTA recently updated it to the 4th edition, but I don't think I can link the pdf of the 3rd edition on here since you'd have to pay for it, unfortunately.

I'm interested in hearing more about your work in social care. Do you go to the residents' home and perform evaluations/treatments? If so, over in the US we call it "home health care." Social care sounds like a combination of home health care and a community wellness program, but I'm not so sure what social care is. I don't really hear much about OTs in community wellness programs in the US since there's not much funding for it. But I do know that there are opportunities for students to see and experience how OT can be beneficial to people in the community.

It does sound like a struggle to get the best care for your clients. And it seems like it always comes down to the financials. In the US, a lot of patients rely on insurance whether it's private or government issued, and many times, patients would have to pay out of pocket in case insurance doesn't cover the entire amount. Insurance is complicated, and we usually have to fight to get more therapy or services for our patients. I've taken to compiling information for patients to save them money in case insurance doesn't pay for certain items. I've often told patients where to get adaptive equipment as a bundle or at a reduced price since the ones provided at the facility through a vendor is typically more expensive. Also, if I may ask, in what way are you under-staffed? Are there not many OTs practicing in the social care area or is there not enough staff overall?

It's interesting how patients' mindsets can be similar yet different. I've run into a lot of people who are in denial about their situation. It could be from the self-sufficient mentality as you've stated, but many times, they think that their situation would get "magically" better or they just rely on the staff for help even though they could physically perform the task. Still, I try to see where they're coming from and how I can help, but it is challenging and frustrating to see.

Gosh. I could go on and on about this, but I should leave things here for now before I write a book. Haha. Looking forward to reading your response!

Sincerely,
Meg

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#6 Tuesday 13th of October 2020 20:23

Adam_James
Member

Re: International connections

Hi, Meg,

Likewise, it's really interesting to hear what you've got going on in the States. My little brother actually lives in NY, but asking him anything about the state of occupational therapy in the US would be like asking a brick what the time is. As you say, the Code of Ethics from both sides of the pond seem to overlap, we also have the HCPC standards of conduct which again seems to overlap with your own documentation, but might be worth a look if you're interested - https://www.hcpc-uk.org/standards/stand … nd-ethics/. I Will get round to having a good read of the American perspective when I have 10 minutes to myself (full-time job, part-time uni, single parent - getting a bit tricky to catch those elusive moments to think). A shame the practice framework is locked down behind a paywall, but can't have everything I suppose!

To answer your questions about my work in social care, I do indeed conduct home visits. I'm largely an autonomous worker and conduct assessments in individuals' properties but have the full support of a qualified therapist whenever and wherever I need it. Social Care in England is a bit difficult to describe, as it covers many different demographics  (Child protection, Vulnerable adults, etc.). Personally, I work in Occupational Therapy within the "Adult Social Care" umbrella, which involves supporting over 18's with chronic physical and mental conditions and learning disabilities to live independently via the employment of equipment, advice, aids, and adaptations to their properties. This work is mostly funded by the state, but there are some complexities when seeking larger adaptations. It's rewarding to work in this role and very humbling, but also tends to be laced with a little sadness that most of your patients will never be well again. The King's Fund website has some fantastic bitesize videos regarding social care in general if you'd like to dig any deeper into the subject https://www.kingsfund.org.uk/projects/w … ocial-care.

I can somewhat understand and sympathise with the struggle to obtain funding, but on a lesser scale. Our services are mostly free for the individual, as we're paid by the state. However, if we identify someone with very specific needs (for example, needs a custom-made shower chair or bed etc.) we have to seek funding from the Local Council. Sometimes this is incredibly difficult - but at least in the meantime we can provide the patient with at least some level of support, even if it's not the most optimal solution. When it comes to staffing it's generally a big issue in the UK as a whole. The NHS and Social Care are chronically underfunded and often we just go without staff in favour of just picking up more work (at the moment we have vacancies of 1 OT and 1 OTA in my team alone - and there's only 2 of us who are actually full time in the area). I also think the popularity of OT in social care is not great, especially in the area I work due to recent dramatic changes in the services we're funded to supply.

I can certainly relate to your last paragraph. It's heartwarming to see some people's tenacity in the face of adversity, but often it is sad to know that without help they will either deteriorate or simply continue to struggle.

I wonder if I could ask you a few questions for my project Meg? If that's ok?

1) What does OT mean to you?

2) Why did you choose this profession?

3) Where did you study and how long did it take to become an OT?

4) How do you reflect in your work as an OT? Any particular models you like to use?

Your response as always is greatly appreciated! smile

Many thanks,
Adam

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#7 Friday 16th of October 2020 03:36

Meg
Member

Re: International connections

Hi, Adam,

Honestly, my family is the same way whenever I talk about OT. The only ones who understand are my aunt and uncle who are a PT and OT, respectively. It’s always fun to discuss things with them whenever our family gets together, and the lost looks on my other family members’ faces are amusing.

So your work is most definitely like home health care here, but I feel as if your work is more cohesive and structured than ones in the US. Then again, I can’t speak for that area since I’m not too familiar with it. I can definitely relate to some of that sadness for patients/clients. I think about them every now and then and wonder how they’re doing. I’ll definitely have to check out those videos you mentioned. I’m always down to learn new things.

I feel like it’s always difficult when getting funding for specific needs, as you’ve written. We usually have to write a letter to insurance companies when that happens. It’s really unfortunate to hear that you’re understaffed. It also seems that you’re also overworked? What areas are more popular in the UK? Or what areas are OTs drifting to? In the US, pediatrics seems to be on the rise, especially with school-based settings and outpatient sensory gyms. This is my opinion based on my area though. I'm not sure what it's like in other parts of the US.

Sure. I don’t mind answering questions, but I’ll message my answers to you separately. Some of my responses are a little personal.

Hope you’re doing well.

Sincerely,
Meg

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