Living, not Existing: Putting prevention at the heart of care for older people

Michelle Moore Content Writer OTNews Magazine Royal College of Occupational Therapists

Building on the Royal College of Occupational Therapists’ (RCOT) previous report Reducing the pressure on hospitals, this report focuses on the contribution that occupational therapists can and do make in order to give older people back their dignity and help NHS and social care services to work better together and be more efficient.

RCOT’s new publication Living, not existing: Putting prevention at the heart of care for older people, was launched on 12 July 2017, at London’s iconic Shard, as part of the Royal College’s Occupational Therapy: Improving Lives, Saving Money campaign.

This report concentrates on the important contribution that occupational therapists can make to support further integration of health and social care.

The message is clear: too many older people talk of simply existing, and improving older people’s health in the community is the essential component to relieving pressure on NHS services, keeping older people independent and ensuring efficiencies are achieved for the public purse.

Call for action

As part of sustainability and transformation planning, RCOT is calling for the commissioning of occupational therapy services to develop community centred approaches to addressing local population need.

As occupational therapists span across housing, health and social care sectors they are ideally placed to create the right environment and support to allow older people to maintain autonomy and control in their day to day living.

This will help people to maintain their independence, and to remain active members of their community for longer; reducing and delaying their need for expensive home or residential care services.

This report shows how delivering responsive interventions that truly meet users’ underlying desires and needs actually works out cheaper for local authorities.

RCOT seeks to show how doing the right thing for individuals can actually reduce their need for expensive care long-term. It calls for an end to the inequality in access to occupational therapy which is a barrier to people in need receiving high quality, person-centred care that enables people to stay as active, independent and safe as possible.

The older person retains their right to self-determination, independence and self-esteem whilst the tax payer gets a saving in the long-term.

Region specific actions for change

A specific version of the report has been produced for each of the four nations of the UK reflecting the health and care landscapes and the varying progress made in each nation towards everyone receiving high quality care. RCOT is calling for region specific actions of change.

Box out:


  • In England, RCOT is calling for occupational therapy to be incorporated within all 44 sustainability and transformation plans at the next point of review.
  • In Wales, the call is for all regional partnership boards to identity a named person to action and report on outcomes.
  • In Scotland, RCOT is calling for all integration joint boards to appoint an Allied health professions director to action and be responsible for reporting on outcomes.
  • In Northern Ireland, the call is for local commissioning groups within the health and social care board (or within new models following review) to identify a named person to action and report on outcomes.


The report makes three recommendations:

Box out:


  • Prevention or delaying the need for care and support: In Scotland, Northern Ireland and Wales the recommendation is that more occupational therapists are based within primary care to prevent or delay the need for care and support. In England, the recommendation is that occupational therapists are incorporated into multidisciplinary teams within new models of care, as outlined in the GP Forward View.
  • Helping older people to remain in their communities: Across the nations, the recommendation is that occupational therapists are deployed to develop person and community-centred approaches to ensure older people live independently for as long as possible in their communities.
  • Equality of access to occupational therapy: In all the nations, the recommendation is that partnership agreements are formally developed across local housing, health and social care trusts to ensure all older people irrespective of social, economic or housing circumstance, have access to occupational therapy.

To download a copy of the reports, visit:



Edel Harris





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