Practice-based occupational therapists could save NHS £200m and cut GP workload

Integrating occupational therapists into primary care services could save NHS mental health trusts £200m per year, a report suggests - and GP experts say the move would reduce practice workload.

At least half of England's occupational therapy workforce should be moved into general practice, according to the report by the Royal College of Occupational Therapists (RCOT).

Although 85% of people first disclose mental health problems to their GP, less than 5% of mental health professionals such as occupational therapists work in primary care. This can mean that patients reach crisis point before receiving the help they need, the report warns.

It highlights a Sussex 'pathfinder clinical service' that offers patients with mental ill health easy access to relevant services and provides support for people transitioning out of secondary care, which was able to discharge 46 people from secondary services within its first three months - and suggests that rolling out a similar model across the country could save £196.9m a year.

GP workload

Leicestershire GP and occupational physician Dr Rob Hampton - a former fit for work programme director - told GPonline there was 'clear evidence' that the model could improve outcomes and ease GP workload.

A spokesperson for the college said: ‘The college is recommending that at least 50% of the occupational therapy workforce should be working in primary care.' This would allow people ‘currently unable to access mental health advice and support to get the help they need at the right time and closer to home’.

‘If 2,500 occupational therapists were commissioned to lead models similar to the pathfinder clinical service, with the expectation that each discharged 100 people from secondary services per year, this would lead to the saving of £196.9m.’

The report, 'Getting my life back: Occupational therapy promoting mental health and wellbeing in England', also implies that the introduction of such services could reduce pressure on primary care services by ensuring timely interventions that would prevent people’s mental health problems from escalating.

Dr Hampton said he ‘would definitely welcome the introduction of more occupational therapists into primary care’.

‘As a GP with an interest in the health of the working age population, I’ve often wondered why most GPs' interaction with occupational therapists is through "arms-length" referrals for issues relating to old age and frailty. In secondary care, occupational therapist services are far more heterogenous and their work is frequently aimed at helping people with long-term physical and mental health conditions to maintain independence through meaningful daily activity and employment.’

Improving health outcomes

Dr Hampton said the 'evidence is clear' that integrating occupational and mental health services with general practice 'improves health outcomes and leads to fewer GP appointments'

He said: 'Occupational therapists are ideally placed to be at the forefront of these changes. The introduction of more occupational therapists into mainstream primary care will certainly improve the chances of such patient-centred approaches becoming systemic in all GP practices.’

RCOT chief executive Julia Scott said: ‘What we propose is a refocusing of the way mental health services are delivered, focusing on prevention and early intervention, rather than waiting for people to reach crisis point.’

In 2016, the DHSC estimated that the cost of mental ill health to the economy, the NHS and society as a whole was £105bn a year.

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