Therapies

There are many opportunities for occupational therapists in the Trust, working in in-patient and community teams within our adult, older people’s, CAMHS and specialist services. Occupational Therapists also work in training and practice development roles, and in team and service management posts at all levels in the Trust.

All OTs are supported by a strong leadership structure that delivers professional supervision, enables service development & facilitates continuing professional development. Quality, improvement and innovation are a priority and support is given to OTs wishing to develop new ways of doing things to improve quality. The OT service is involved in a variety of research projects and pilots of innovative mental health interventions including Graduated Living outside the ward (GLOW), Increasing participation in everyday life (IPEL) and Valuing active life in dementia (VALID).

The Trust has adopted the Model of Human Occupation as its main model of practice to ensure that staff deliver high quality evidence based assessments and interventions.

We also draw on a range of frames of reference including cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT), psychodynamic psychotherapy and provide the role of disability champions to our services.

Occupational Therapists may be involved in the following interventions:

• Functional assessment: assessment of a person’s ability to manage the practicalities of everyday life
• Activities of daily living: skills training; aids & environmental adaptations
• Lifestyle planning: exploring occupation-related options; setting goals; activity scheduling
• Leisure enablement: working collaboratively with a person to resume or take up a valued leisure activity as part of their mental health recovery
• Vocational & educational interventions: as above but with work or education as the focus of the intervention
• Activity as Therapy: using activity media (often as groups) for therapeutic benefit, including using activity to optimise a person’s sensory environment

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Occupational Therapists work on in-patient units split over three hospital sites:

• Tolworth Hospital
• Springfield Hospital (Tooting)
• Queen Mary’s Hospital (Roehampton)

The purpose of hospital admission is to provide care and treatment where it is not safe or appropriate to provide this in the home or other residential setting. Occupational Therapy takes an instrumental role in the assessment, treatment and discharge planning process to ensure safe and effective transitions for patients and their families.

Occupational Therapists have the following roles and responsibilities:

• Individual assessment & interventions re independent living skills
• Coordinating the activity / therapy provision & ensuring patient involvement / feedback
• Acting as Disability Champion for the ward

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Occupational Therapists work in many of the community teams including

• Recovery support teams (RSTs)
• Early Intervention services (EIS)
• Primary care services (Sutton Uplift)
• Recovery college( as trainers)
• Specialist- Attention deficit hyperactivity disorder (ADHD) / Autistic Spectrum Disorder (ASD) service
• Community Mental Health Learning Disability team
• Home treatment teams
• Assessment teams

Occupational Therapists are integral to the multidisciplinary team. They offer time- limited recovery focused interventions, supporting individuals to maintain their roles and to develop strategies for managing their symptoms. They often work in care coordinating roles and have protected time to offer specific Occupational Therapy assessment and deliver evidenced based interventions. They use outcome measures to demonstrate the value of Occupational Therapy.

Occupational Therapy in this service helps older people with dementia, depression, and other serious mental health conditions to overcome the barriers they are experiencing in doing the things they need or want to be able to do. We also work with carers supporting them to develop coping strategies.

Occupational therapists have an important role in helping older people with mental health needs cope with the impact of their illness/disability and to equip them with the skills and confidence to prepare for safe discharge. We carry out functional assessments and advise on the need for community support, aids/adaptations or possible placement. We also provide interventions designed to improve quality of life and social inclusion.

Occupational Therapists are based in a range of in-patient and community services

We work on the in-patient units at:

• Tolworth Hospital (Jasmines Ward)
• Springfield (Crocus Ward)
• St Helier Hospital (Liaison Psychiatry team)

Occupational Therapists also work in older peoples’ community services including:

• Memory Services - providing assessment and short term input around the diagnosis and treatment of mild to moderate dementia.
• Recovery & Support Teams – providing longer term support to older people with severe and enduring mental health conditions.
• Care Home Liaison Services - providing support to care homes to meet the psychological and physical needs of residents with dementia or mental health difficulties, using the Newcastle Model

The Forensic, national and specialist (FNS) services are a unique group of services providing highly specialist mental health care to adults.

There are opportunities for Occupational therapy staff in the following areas:

• Medium secure inpatient forensic male and female wards
• Low secure male inpatient unit
• Forensic step down/ rehab unit.
• National inpatient OCD/ BDD unit.
• Deaf Adult Inpatient unit
• Deaf Adult Community Team
• Inpatient adult eating disorders
• Adult eating disorders day hospital
• Adult eating disorders outpatient team

The FNS Occupational Therapists have been involved in many innovative projects and partnerships including the development of a forensic recovery college Links are being built with SLAM and Oxleas NHS Trusts as part of the South London Partnership providing exciting opportunities for learning and service development across South London.

The Forensic OT team were recognised as team of the year in the annual Trust quality awards and Occupational Therapy is a highly valued and respected part of the service line.

The CAMHS Occupational Therapy team provide input to the Adolescent mental health inpatient service, the adolescent eating disorders unit and to the National Deaf CAMHS inpatient unit.

Occupational therapists also work in the National Deaf CAMHS community teams based in London and Kent.

The CAMHS OTs have close ties with the national and London and SE east OT CAMHS interest group and regularly attend study days to build links and share learning.

South West London & St George’s Mental Health Trust is the leading provider of mental health services across south west London and a beacon of excellence for many of our national services.

We serve 1.1 million people across the London Boroughs of Kingston, Merton, Richmond, Sutton and Wandsworth and provide care and treatment to over 20,000 people at any one time.

With over 100 clinical teams, you will have the opportunity to work with a range of mental health services as part of a skilled multidisciplinary team.

Occupational therapists use the Model of Human Occupation and the recovery framework to underpin their practice. The Trust has an active research and development strategy and there will be opportunities to engage in a number of practice development initiatives. We offer:

• Preceptorship for newly qualified OTs
• Dynamic OT research and innovation programme.
• Preceptorship plus to support OTs moving from Band 5 to Band 6 roles.
• Innovative new roles such as Home Treatment teams.
• Professional supervision.
• Return to practice.
• Opportunities for observed practice to promote peer reflection.
• Profession-specific as well as mental health CPD opportunities.
• A well-established network of speciality-based OT development forums to share & support best practice facilitated by a practice development lead.
• Opportunities to supervise students from four universities supported by a practice placement coordinator.
• Model of Human Occupation e-learning packages and tools within the electronic record.
• As well as a range of other staff benefits.

Find out more about staff benefits at the Trust

The Occupational Therapy service at SWLSTG has been at the cutting edge of Mental Health Occupational Therapy practice for over a decade. Here are just a few of the practice initiatives that have been embedded locally and shared nationally.

Promoting Professional Growth

• Preceptorship programme and handbook developed in SWLSTG and adopted by RCOT.
• ‘Working Smarter, not Harder’ framework and CPD portfolio to support HCPC CPD requirements.
• Observed practice programme to advance reflective practice for OT and allied health professionals.
• Preceptorship Plus: innovative new programme to support Band 5s to transition into Band 6 roles.

Delivering Practice Development

• All OTs use Model of Human Occupation (MOHO) to promote occupationally focused practice.
• MOHO tools and OT care plan library in the electronic record highlight OT contribution to patient care and facilitate audit of occupationally focused practice.
• Prioritisation protocols to meet occupational need introduced into local OT care pathways and shared across UK.
• Training and resources for OTs taking on the role as disability champions to promote equality
• Piloting of an OT hub with agreed OT pathway and manualised interventions in CMHTs in two boroughs in the locality.

Leading on Research and Innovation

• England wide project to develop OT indicative care packages for use within Mental Health Payment by Results.
• Multisite research study of occupational need across forensic settings with University of Illinois, Chicago.
• Development and piloting a manualised OT intervention ‘Increasing Participation in Everyday Life’ (Birken, Parkinson and Morley)
• Research studies funded by Health Foundation and by UKOTRF to evaluate a manualised OT intervention, ‘Graduating Life Skills Outside the Ward’ with people with mood disorder and personality disorders. (Birken and Morley)
• Opportunities to be involved in OT research and evaluation, to collaborate on publications and presentations.

We believe that all staff should have access to continuing professional development (CPD) activities and career development opportunities. We demonstrate this commitment through:

• Regular professional supervision and appraisal
• An annual CPD conference
• Encouragement to share best practice through publications and conference presentations
• Practice forums
• Preceptorship
• Preceptorship Plus
• Clinical and management secondments at all levels

The future development of:

• Apprenticeships across all levels
• New roles e.g. advanced clinician, perinatal & psychiatric liaison roles
• A recognised career pathway

Occupational Therapist Band 5: In-patient Role

The Band 5 Occupational Therapist is part of a multi-disciplinary team providing care and recovery focused assessment and interventions to individuals facing a broad range of mental health conditions who require the short term intensive support of an in-patient unit. The role is responsible for:

• Identifying and prioritising individuals requiring occupational therapy assessment following the OT pathway.
• Designing and delivering profession specific individual or group interventions to those identified as meeting the prioritisation criteria to ensure discharge is safe and timely.
• Planning and co-ordinating the group programme, working alongside activity coordinators and other staff to ensure this meets the needs of the individuals on the unit and is of the highest standard.
• Engaging in regular professional supervision (individual and peer based) and development opportunities to increase your skills. The senior occupational therapy team will train and support you through the band 5 Preceptorship programme if appropriate.

Occupational Therapist Band 6: In-patient Role

Band 6 Occupational Therapist roles can be found on in-patient units within the local boroughs and in regional/ national services for a particular specialism. The services cover all age groups and include acute admissions, forensic and rehabilitation. The role is responsible for:

• Working as a core member of the multidisciplinary team and contributing to service development and profession specific service innovation.
• The delivery of care and treatment to service users with various complex mental health conditions.
• Providing a seamless, recovery focused occupational therapy pathway via professional assessment of need and where identified delivering a range of evidence based interventions.
• Overseeing the group programme.
• Providing leadership to junior staff supervising and developing band 5 OTs, activity workers and volunteers.

Occupational Therapist Band 6 Community Roles

Recovery Support Team: There are a range of band 6 OT roles across the boroughs working in multidisciplinary Recovery Support Teams. These teams undertake a range of assessment and treatment interventions in line with the Care Programme Approach and Social Inclusion strategy. The roles include:

• The responsibilities of a care coordinator, holding a caseload for a defined number of service users and their carers. The emphasis is on enabling individuals to receive the highest level of co-ordinated health and social care plans to meet their individual needs.
• Developing clinical skills such as psychosocial interventions and family work agenda.
• Delivering evidence based occupational therapy assessments and time limited treatment interventions and recording clinical outcomes to show effectiveness.

Home Treatment Team: These innovative band 6 Occupational Therapy roles have been established across most of the boroughs. The Crisis and Home treatment Team practitioner has a focus on providing safe and effective treatment to service users in their own home and providing an alternative to in-patient admission and/or facilitating early discharge for hospital. The role involves:

• Working generically as part of the team to undertake initial assessments and be involved in the gate keeping process, linking in with bed management services. You will build on advanced assessment and liaison skill to work in a recovery focused way to support individuals in crisis and self-management.
• Working as an occupational therapist within protected time to complete occupational therapy assessments and evidenced based OT interventions, signposting to key services.
• Enhancing skills such as psychosocial interventions and risk assessments.

Occupational Therapist Band 7: Lead Role: Band 7 Lead roles are found in inpatient and community settings across the 5 boroughs and specialist services posts. Most have a split role component between professional managerial responsibilities and a clinical specialism dependent on the area of work. The roles are responsible for:

• Professional leadership and governance to the occupational therapy staff under their remit.
• The development of the occupational therapy team via individual supervision
• Contributing to the development of the profession within the Trust by shaping new services and / or improving systems and services with innovative thinking.
• Actively taking part in the senior leadership team and representing the occupational therapist team at internal and external forums.

Occupational Therapist Band 7: Team Manager Role: There are opportunities across the trust for occupational therapists to work as team managers. The role involves managing and leading a multidisciplinary community team to ensure that holistic care is provided. The roles are responsible for:

• Ensuring that performance and quality standards of the team are met and the team provide safe & effective services.
• Coordinating the team and working with them to put into action the values of the Trust’s Recovery and Social Inclusion Strategy.
• Overall clinical and managerial responsibility for the team caseload.
• The leadership and development of the team.

You can find out more about student placements here.