Item 11 - OT Paediatrics Update
North Lanarkshire Council · 19 April 2023
Back to IJB Performance, Finance and Audit Committee — 19 April 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 11 SUBJECT: Children & Young People’s (CYP) Occupational Therapy Waiting Times Performance TO: North HSCP Integration Joint Board Performance Lead Officer for Report: Maggs Thomson, Head of Health, North HSCP Author(s) of Report Janice McClymont, Head of Occupational Therapy Profession, NHS Lanarkshire DATE: 19 April 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☒ Endorsed By: ☐ Prepared by: Janice McClymont, Head of Occupational Therapy Profession, NHSL
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2 Reviewed by: Claire Rae, Head of Health & Social Care, South Health & Social Care Partnership 3. RECOMMENDATIONS It is recommended that the IJB PFA Committee: (1) recognise the current demands on NHSL Children & Young People’s Occupational Therapy Services (2) approve the enclosed mitigating actions to manage service demand and work towards the achievement of the agreed waiting times performance target 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES Current performance against local AHP Waiting Times performance: at 28th February 2023: Total Number waiting: 664 Number of people waiting beyond target: 517 Longest patient wait: 39 weeks Performance within 12week target: 32.2% Performance Commentary The CYP OT Team have seen a 24% increase in demand post pandemic Throughout the pandemic the team developed a wide variety of universal and targeted video resources and information packs to support children and families to access early therapy information and advice. This supported the service to absorb the increased demand and remain within the 12week target until April 2022. National developments within CAMHS and Neurodevelopmental Services in 2022 resulted in a migration of experienced CYP OT staff to these new services. A total of 9 staff at B6 – B8a moved on from the service (7.0 wte to the NHSL Neurodevelopmental Assessment & Diagnostic Service; and 1.2 wte to NHSL CAMHS) There is currently a 28% vacancy factor within the CYP OT Team at Feb 2023. Yes ☒ No ☐ N/A ☐
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3 This picture is replicated across many Board areas, and there is currently a national challenge in the recruitment of experienced CYP OT. Locally, recruitment to Band 5 CYP OTs has been successful, but the staff require support to build their skills in this specialist area as OT practice based learning placement have been reduced across children’s services. All open cases have been transferred to the remaining CYP OT staff, reducing the ability to address new patient assessments, and impacting negatively on waiting times performance. Performance Recovery Plan The following actions are being undertaken to address the current waiting list position: Monthly caseload review of all open caseloads to maximise potential for discharge Continued signposting to universal and targeted resources where applicable. Additional funding agreed to support excess hours/overtime. Monthly Waiting List Validation Exercise in line with CYP OT Priority Framework. Review of CYP OT Workshops and Group Programmes completed Dec 2022 Re-introduction of AHP Baby Group for babies with complex neuro rehab needs in April 2023. An additional number of group programmes scheduled for April & May 2023 to increase capacity. Launch of CYP Advice Line – 7th February 2023. Teams measuring impact of new workshops and advice line via QI Projects. Generic email address introduced to support any professional making a request for assistance. Introduction of Activity Profiles for every child in ASN Schools. On target to have this exercise complete by 31st March 23. This will reduce the time spent on clinical report writing and increase capacity and communication in ASN schools. A seating surveillance system will be commenced when additional staffing secured to increase the efficiency and co-ordination for children with postural management and seating needs. Early developments have commenced with Neurodevelopmental and CAMHS services to redesign pathways for CYP, and avoid duplication across teams. 6. CONCLUSIONS It is predicted that the NHSL CYP OT Service will breach the locally agreed waiting times performance target over the next 6 months due to the national recruitment challenges of specialist and experienced CYP occupational therapy staff. However, the application of the performance recovery plan
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4 noted above, and progression of recruitment opportunities will be progressed to optimise performance and progress towards the 12 week waiting times target. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) Monthly reporting of performance via the Lanarkshire Primary Care & Waiting Times Performance Group. Monthly re- assessment of risk via the CYP OT Waiting Times Performance on South HSCP Risk Register 7.3 FINANCIAL This paper has been reviewed by Finance: Yes ☐ No ☐ N/A ☒
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5 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 PEOPLE The CYP OT Team are being supported by the CYP OT Care Group Lead, and the Head of Occupational Therapy Profession. The Spiritual Care Team are supporting staff health and wellbeing. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS None. 9. APPENDICES None. Please include a glossary of terms if not already included. Yes ☐ No ☐ N/A ☒ Yes ☐ No ☐ N/A ☒
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6 CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Janice McClymont, Janice.Mcclymont@lanarkshire.scot.nhs.uk