Innovation Hub

• access to our growing real-world change database
• feedback on your ideas via our discussion forums and events
• increased recognition within the OT community as a change-maker
• extending the reach of your work so that other OT services can adopt it and scale
• guidance on building a case for change and evaluating real-world change projects.

To join our innovation community, you need to submit:

• something you have noticed that needs to change
• a change you are planning or currently testing
• an evaluated pilot, project or programme.

You can share this with us by submitting an improvement journey. This is a semi-structured mixed methods questionnaire, based loosely on the model of improvement.

It takes 15–30 minutes to complete depending on the stage of your idea.

We welcome submissions from all members of the occupational therapy workforce including those who support pre-registration education programmes, learners, support workers and those who manage and commission occupational therapy services. 

Once we’ve received your submission, we will be in touch with you to share information on joining the innovation hub community.

If you would like your change idea to be included on the real-world occupational therapy focused change database, we will use your submitted information to create a database entry.

We’re passionate about becoming a data-informed organisation that uses member insight to drive decision making.

In addition to networking and sharing your ideas with the OT workforce, we also use both quantitative and qualitative data analysis methods to study your anonymised submissions.

This helps us better understand:

• the current problems OT change-makers are working to address
• trends in solutions being tested
• barriers change-makers face in practice and the support they require to keep projects progressing. 

We can then use this anonymised insight to make better decisions about the support we can offer occupational therapy change-makers.

An example of this is our new pilot innovation seed fund.

Alicia Ridout, Director and Founder of Involve Me Digital Health Ltd, explains how her project will use the funding:

Occupational therapists are one of the professional groups included in the scope for implementation of the new Skills for Care Delegated healthcare Activities (DHA) Principles guidance released in 2024. A workshop exploring DHA deployment was held with occupational therapists as part of University of Birmingham IMPACT Demonstrator project in Leeds, focused on integrated neighbourhood team service improvements. The insights form occupational therapists highlighted a need for further development of profession specific guidance and implementation planning.

This project aims to support the profession’s work to explore ways to effectively deploy the new principles in adult social care practice contexts, by reviewing existing literature, and undertaking co-design work with occupational therapists and citizens. This will be the basis for testing ideas for the effective deployment of DHAs via a plan do study act service improvement methodology. The action plans arising from this small-scale test and learn work will be shared widely via the RCOT innovation hub. The project seeks to trigger wider conversations about delegation of healthcare activities to support person centred care across pathways and services.

Alison Gillespie, Practice-based Learning Lecturer in Occupational Therapy, shares the details of her project:

OT student-led groups are an innovative approach in the Integrated Master’s programme for Occupational Therapy at Robert Gordon University. Anecdotal evidence from our pilot student-led groups indicates that participants became more socially engaged and focused, with perceived improvements in their physical and mental health and well-being as a consequence of participating in occupation-focused activities.

The Innovation Seed Fund will be used to stock occupation-focused resource boxes, which will serve as the foundation for our group activities. These boxes will include user instructions and linked risk assessments. By providing sustainable items, students can select relevant occupations from the boxes that will align with participants’ goals.

For our students, understanding the resident group both collectively and individually, and considering their needs and objectives within a group context, enhances practical skills. These hands-on experiences will help our new graduates demonstrate creativity and versatility, using sustainable methods and techniques to highlight the importance of occupation for their client group.

Catherine Seals, Mental Health Team Lead, notes how she plans to utilise her funding:

I work within Nottinghamshire West Primary Care Network (PCN) within the GP surgeries as a Mental Health Occupational Therapist (MHOTs). In our local area wait times for most secondary and sometimes third sector services has increased, impacting on the preventative work that is essential for supporting mental health.  As MHOTs, we are a limited resource within primary care and being able to offer group work as a regular intervention would enable us to see multiple patients and intervene in a more occupation focused way, providing the much needed preventative work and in the long term reducing pressure on already overburdened services. 

Our plan is to offer a rolling group programme accessible to all individuals registered within a GP surgery in Nottingham West PCN.  All of the groups to be offered have not fully been decided on and will focus exclusively on the needs of the individuals within the PCN, so will be flexible to change depending on those needs. Some ideas discussed have been, Autism and ADHD – executive functioning, Recovery through activity, community engagement groups. We have already run one pilot group which ran for six weeks – Mental Health Skills Group. It focused on; occupation supporting anxiety and depression management, goal setting, occupational balance, compassion and mindfulness, motivation. With the funding we have now been able to access we are excited to build on this work we have started and develop a sustainable service for our patients across our patch. 

Lucy McNeill, Advanced Practitioner Primary Care Occupational Therapist, describes her Innovation Seed Fund project:

Occupational therapy in primary care has shown the benefits of earlier intervention. Often enabling patients to have the skills and confidence to self-manage symptoms increasing a patient’s functional ability and reducing the need for contact with the GP practice.

The Primary Care Occupational Therapy service in Moray is keen to offer Tai Chi and Qigong as part of our falls prevention and long term conditions strategy. This will be offered in both groups and individually and be based in a variety of settings so that it is widely accessible for all patients. Venues will include GP practices, sheltered housing and local exercise and social groups. Moray has a mix of urban, rural and remote communities, which present challenges in terms of travel and suitable venues. To ensure equity of service, a blended, creative approach will be required, including face to face and virtual options.

The Occupational Therapist and the Occupational Therapy Assistant who are completing 'Tai chi and Qigong Training for Therapists' will share this training within the Primary Care Occupational Therapy team and support further development in this area.

Our focus will be on the prevention of functional decline using this holistic and evidence-based activity. Supporting patients to transfer these self-management skills to other areas of their daily routines and increasing the opportunity for meaningful occupation. Finding confidence in learning a new skill with the encouragement of other patients and therapists.The patient can then continue to use these skills independently after being discharged from the Primary Care OT service and if needed signposted to a local community group working.

Philip Wade, Lead Occupational Therapist, tells us about his Innovation Seed Fund project:

Hedley’s College, part of The Percy Hedley Foundation in Newcastle-upon-Tyne, is a specialist education provision for young adults with disabilities. We, the OT team, support students to access the curriculum, gain work experience opportunities and engage in activities that promote independence.

XR Therapeutics (XRT) is an organisation providing an innovative new form of therapy. By applying custom-built virtual reality (VR) technology to conventional therapeutic approaches, XRT enables therapists to deliver interventions using immersive scenes to replicate real-life situations.

When we visited XRT and experienced the technology in their immersive studio we immediately began to think of how it could be used to benefit our students. With XRT’s Chief Scientific Officer we discussed potential ways in which the technology could be adapted to augment our OT service.

Thanks to the RCOT Innovation Seed Fund award we have been able to secure a year’s initial contract with XRT, and we can now make our plans into a (virtual) reality. XRT will install a mini-studio at college and create a bespoke software package for us, with customised VR scenes that will become a key element of our intervention plans.

The virtual reality technology in our immersive mini-studio will offer our students the opportunity to navigate environments and scenarios which may typically be challenging for them. Guided by an OT, who can grade and control variables of the scene, students will be able to work on ways to overcome challenges, in a safe, controlled environment, before transferring these skills into real life situations.

It’s so exciting to see how this technology is evolving and transforming clinical practice, and we are thrilled to be the first OT team to work with XRT to develop a new use for the technology. We are extremely grateful to RCOT for enabling us to collaborate on this exciting project.

Between 31 October 2022 and 31 March 2023, we received 26 occupational therapy service innovation projects.  

To find out what we’ve learnt about these projects, you can read our report about:  

• the problems facing occupational therapy services  
• the change projects occupational therapists are leading 
• the barriers and enablers to occupational therapy innovation. 

Introduction 

Innovation Hub pilot project reflective question 2: What are the current service challenges and how are members trying to improve these? 

Piloting an online improvement journey submission tool, our Innovation Hub collected data from members around problems facing services, projects that are implementing a change to improve service outcomes, any barriers and enablers to their projects and the impact of the change on service outcomes. In this report, we’ve summarised the key themes arising from the thematic analysis of the qualitative questions responses submitted during the pilot phase (28/11/2022 to 31/03/2023). Our analysis includes 26 completed and submitted improvement journeys. 

Methodology 

The Innovation Hub online improvement journey tool is a semi-structured information-gathering questionnaire where the questions are based on change methodology. We piloted this as a new method of collecting service data from members. Five reflective questions were developed in addition to three quantitative data capture ones. The reflective questions can be seen in the table below. Thematic analysis of the responses to these questions was conducted by Julia Roscoe – Research & Innovation Officer using the Braun & Clarke (2022) approach. The resulting themes were also peer-reviewed by Suzy England –Service Innovation Manager. 

Results

The results of our analysis identified seven key themes which can be seen in the table on page 2. Some overlap was seen between the themes, and each is described more fully in this results section. 

Analysis of question 2, where members gave a short description of their improvement idea/project,  found that most improvement journeys submitted were around making improvements to care and improving service delivery for an identified group of people. These focused on improving access to care, efficiency of services and improving patient flow through services by looking to reduce waiting times, improving the effectiveness of treatment, and improving the quality of care or service received. Some improvement ideas were strategically driven, for example by an OT’s organisation and/or manager, and others were new ideas for projects or ideas for change. Several submitted improvement journeys were around supporting occupational therapy students and newly qualified OTs with additional learning and aspects of their role. There was much overlap in responses to question 2 describing your improvement idea/project and question 6 regarding the benefits to people who access services. The small number of responses to question 10, added further links to project reports, information, or posters and two requests for advice.

1. Improving the quality and cost effectiveness of care with equitable and timely access to services.   

Building on the descriptive information from question 2, most improvement journeys submitted were focused on improving care and quality of life for people who access services and were around promoting earlier intervention, reducing risks, providing timely access to services and/or treatment, improving cost effectiveness in the service offered and reducing length of hospital stay. For improvement journeys that focused on improving health and wellbeing for people who access services, this was by providing access to information about available services and treatment, improvements in promoting and supporting self-management for people who accessed services and improving communication with families and carers to build understanding of their relative's care and available services.    

2. The value of good communication skills and effective communication. 

The value of good communication skills and effective communication was a strong theme found in the learning shared in the improvement journey submissions. While communication was not specified as verbal or non-verbal this theme included learning shared on the importance of effective communication with key stakeholders and team members involved in the projects, working together as a team to problem solve, and the importance of tailoring information messages about the project to different audiences to encourage ‘buy in’. Also communicating with patients, carers, and service users about the change. Concurrent with this was the sub theme that communicating change to others can be hard and identifying and managing key stakeholders through good communication throughout a project is key to ‘bringing everybody on board’ and ‘maintaining momentum.’

3. The importance of collaborative and multidisciplinary working. 

From the improvement of journey analysis, collaborative working across and within teams emerged as a strong theme. Most of the improvement journeys where projects were already being implemented or evaluated identified that ‘change is hard by yourself’ and ‘involving people’ in your idea and change is important. Sub themes included the value of ‘networking to learn from others and share ideas, and the importance of staff working together to feel competent and empowered to deliver change. Collaborative and multi-disciplinary working was identified in many improvement journeys as key to ‘getting support and the right people on board,’ building, and motivating a team with a ‘shared vision,’ promoting project ownership, sharing feedback on the project, and identifying key people and leaders to ‘help drive the project forwards.’

4. The benefits of a structured approach to project and problem solving. 

This theme emerged from many of the improvement journeys and overlaps with the communication and collaborative working themes. The benefits of a structured approach were identified by OTs as helping to identify and explore the nature of a problem first, ‘enabled gathering of appropriate information’ and piloting the approach to problem solve and develop ideas further. One OT highlighted how a structured approach helped to ‘maintain momentum and keep people on board for the project duration.’ 

5. Improvement projects require time and new ways of working.  

Reflecting on what they had learnt and advice they’d give to other OTs, the time taken to plan, implement and evaluate a project in practice was a key theme, taking much longer than originally anticipated in each case. This theme was found to overlap with theme 1 & 4. The advice given was to ‘take time properly to plan,’ and that often, competing demands and workload pressures had an impact on a project duration. 

A few improvement journeys were submitted from OTs who were new in a role which had been established to deliver changes in services or develop new services. Some identified that time is a important factor to build into planning when trying to understand the scale of a problem or change required. Advice given when looking at new ways of working in a project included, ‘don’t overburden yourself or your team,’ ‘use technology to help’ ‘be flexible in your approach,’ ‘define roles within the team’ and ‘accept its going to be challenging!.’

6. Implementing change in organisations can be complex

Building on the themes already outlined, the improvement journey analysis highlighted that implementing change in organisations can be complex. The sub themes identified the potential of organisational cultures to have an impact on facilitating or creating barriers to change, with differing priorities across teams, organisational hierarchy and data systems which are not linked being impactful on project progression, delivery and evaluation. Advice given was around identifying and positively influencing key stakeholders, communicating effectively at different levels within an organisation and working collaboratively to overcome any barriers, problem solve and maintain project momentum. A structured approach and allowing more time were highlighted as important advice to help navigate complex change. 

7. The importance of meaningful data collection and evaluation of projects

The thematic analysis highlighted the importance of meaningful data collection and evaluation of projects as key in ‘being able to prove the projects value and outcomes’. A few OTs suggested that management tools were helpful to support planning of a project and demonstrate a staged process of implementation and evaluation.  

Conclusion 

The thematic analysis of the qualitative data from the 26 improvement journeys, found that the current service challenges these members were facing focused around improving the quality and cost effectiveness of care and equitable and timely access to services. The data submitted helps us to understand some of the challenges members have experienced during their improvement journeys and highlights the consistent themes from their learning and advice given for other OTs. For example, the analysis found that there can be complex challenges within organisations when implementing change, engaging stakeholders and ‘sharing your vision’ and need for change.

The themes from the advice you would give to other OTs overlapped with the responses to questions about what was found to be most challenging and what helped to move your project forward. These identified the value of good and effective communication, working collaboratively and building multidisciplinary teams to plan and deliver change, (including identifying key stakeholders to support change), and the benefits of a structured approach to project planning as core themes. From the improvement journeys where OTs were already implementing and/or evaluating improvements to care and/or services, the analysis found that improvement projects require time and new ways of working, and the importance of meaningful data collection and ongoing evaluation of projects supported by data were key themes. 

References 

Braun V & Clarke V (2022) Thematic Analysis – a practical guide. Sage press, London. 

Using the three sample case studies captured during our innovation hub pilot, we have an opportunity to learn what key features of an innovation project need to be drawn out so that others can learn how to implement the changes in their contexts. The case studies include information such as opportunities, any challenges, key learning, and advice for others undertaking similar projects.  

Each case study builds on its respective submitted improvement journey and designed in collaboration with individual OTs has been tailored to the information available and the stage of their project.  

You can share your feedback on whether the case studies have helped you by completing this MS form.

Thank you to Lucy, Helen, and Becky for giving their time and to their organisation for their support.