The Royal College of Occupational Therapists (RCOT) and the Chartered Society of Physiotherapy (CSP) recognise that preparing for the potential impact of the Omicron variant and other winter pressures requires another rapid response from NHS services. As part of a range of measures announced under the Level 4 National Incident, NHSE/I is seeking to maximise bed capacity across acute and community settings, including the procurement of spare capacity within CQC registered Care Home settings. This is a temporary solution to support surge capacity where it is needed within acute hospitals.
Many of our members will have a role in supporting these measures, including those within the independent sector. Under a range of surge plans announced, Pathway 2 patients with identified short-term rehab needs should be prioritised for acute-hospital discharge to temporary rehab beds, with the expectation from the outset that patients will return home after rehab. RCOT and CSP continue to support ‘Home First’ as a priority and the preferred discharge option when safe and appropriate for patients, yet understand the need to respond to immediate pressures by reviewing discharge planning.
We want to acknowledge everything our members have achieved over the past two years in response to the pandemic and the continued importance of therapists taking a lead in discharge planning. We wish to reassure our members that we recognise the risk-management decisions that they make with every patient and that local services retain the ability to decide how this temporary model will work for their local populations. Where patients are medically stable for discharge from an acute care bed, ongoing rehabilitation needs may be met outside of hospital, in whichever setting the local system chooses to utilise. Members should be clear with patients that they are being provided with ‘short-term rehabilitation outside hospital before going home’ to alleviate any concerns that patients and their families may have around ‘going into a care home’.
We understand that these changes may also cause concern for some occupational therapists and physiotherapists within local systems, particularly around any redeployment of staff that may be necessary to deliver surge capacity. We urge that members who may be affected, engage with their system leaders as soon as possible to ensure any support or training that is needed to facilitate redeployment is provided.