PRESS RELEASE: AOTI PDS Survey Report Published
Occupational Therapists report “unsustainable” caseload demands and “unsafe” staffing allocations in disability services
19th October 2023
90% of Occupational Therapists (OTs), working in Progressing Disability Services (PDS), have reported that staffing and caseload numbers are having a negative impact on their practice. That’s according to a report, published today by the Association of Occupational Therapists Ireland, outlining the findings of a survey assessing the impact PDS is having on the delivery of Occupational Therapy services in Ireland.
9 out of 10 Occupational Therapists (OTs) reported that there are insufficient OTs to meet with current demands, with respondents adding that they were trying to “keep [their] head above water”, part of an “extremely stressful work environment”, and “fire-fighting”. The report also highlights unsafe caseload numbers being carried by individual OTs. One respondent stated there were only 3 OTs responsible for providing Occupational Therapy to 750 children in their service.
PDS is a programme that aims to achieve a national unified approach to delivering disability health services, so that there is a clear pathway to the services for all children regardless of where they live, what school they attend or the nature of their disability or delay. As part of the programme rollout, clinical staff – including Occupational Therapists – working with children in disability services were reconfigured to work on Children’s Disability Network Teams (CDNTs) or in primary care services.
The report features responses from a total of 233 Occupational Therapists working in PDS – both on CDNTs and in Primary Care Settings.
Commenting on the report findings, Odhrán Allen, CEO of AOTI, said: “This survey yielded an impassioned response from experienced paediatric Occupational Therapists, working in PDS, and its findings – although not surprising – are of concern. As a result of the significant change in service delivery over the past two years, it’s clear that a vast majority of OTs working in these settings are feeling disheartened, frustrated and ultimately at the end of their tether with their working conditions and the detrimental effect this is having on children and families.
“We conducted this survey as we wanted to develop a better understanding of the true impact the rollout of PDS is having on the delivery of OT services. The many challenges it has presented, for both clinicians, and indeed for families seeking to access services are undeniable.”
Loss of expertise
79% of respondents working in CDNTs reported that since the rollout of PDS, they were working in new or less familiar clinical areas, such as postural management, seating and working children with very diverse complex needs. Allen added: “The report also found that there was evidence that many highly skilled OTs working in PDS do not have the time and resources to provide more individualised interventions as a result of caseload pressures and the lack of staff to meet the demand. We have highly experienced and skilled OTs in this country, who are committed to their work, and it is not right that the children and families of Ireland cannot benefit from this expert knowledge, as a result of our OTs being over-burdened with their caseload . The demand for OT services within the system is relentless, and it needs to be addressed immediately, before we lose even more experience and talented OTs.”
Leaving the job
Over half of survey respondents (59%) said they intend to stop working for PDS, or they are unsure if they will continue working within the services impacted by PDS in the future. 65% reported “dissatisfaction” in their current role.
One respondent noted that despite having worked in disability services for over 10 years, they are now planning to leave: “It has been incredibly stressful. I have worked in disability services since 2010 but I am planning to leave. It’s an impossible job. I feel that I and many other skilled professionals are being pushed out of disability services with the way things are.”
Recommendations
AOTI’s recommendations emerging from the analysis of the survey findings, include the following:
- The HSE and relevant government departments should engage in ongoing consultation with AOTI and other Health and Social Care Profession professional bodies on the design, development and delivery of children’s disability services.
- Resourcing and staffing of children’s disability services needs to be a priority for Government in order to address the inadequate staffing levels and to address the current recruitment and retention challenges in CDNTs.
- The discrepancy in salary and terms and conditions of staff in voluntary bodies compared with HSE staff needs to be addressed by Government as a matter of urgency.
- There needs to be a clearly articulated plan for how PDS is going to meet current and future demands for children’s disability services.
- The Disability Act needs to be reviewed as it has unintentionally led to the separation of assessment and intervention. The Act provided for a statutory right to an assessment of need but not for intervention.
Allen concluded: “The reconfiguration of children’s disability services has had far-reaching effects on both clinicians and families within the system, but also on other stakeholders outside of PDS – it has been felt within Acute Hospital settings, and in the wider community in various health and education settings.
“Urgent action is needed by the Government and HSE to address this situation. As a result of the issues with caseload numbers and recruitment, many of the most vulnerable young people and children in Ireland are suffering and are not receiving the essential services they both require and deserve. AOTI is committed to working closely with Government and the HSE to resolve these persisting issues, but they cannot – and must not – be overlooked or left unaddressed.”
ENDS
Contact: Maisie Lynch / Sara Byrne, Alice Public Relations. Phone: 086-8966298 / 086-3956396 / 01-5582151. Email: [email protected]
Notes to editors:
Spokespeople
- Occupational Therapist, Adrianne Carolan is available for media interview.
- Odhrán Allen, CEO of AOTI, is available for media interview on request.
About AOTI
The Association of Occupational Therapists of Ireland (AOTI) is the professional body serving, promoting and representing Occupational Therapists in the Republic of Ireland. It is the voice for the Occupational Therapy profession. AOTI provides national leadership to its members and works on their behalf with the best interest of the profession and service users in mind. AOTI promotes the value of Occupational Therapy as a critical means of improving the occupational performance, health and wellbeing of the people of Ireland. AOTI considers current practice in Ireland and abroad, working at both a strategic and operational level to advance the profession in Ireland, to ensure appropriate governance and to optimise communication with the public and its members.
Progressing Disability Services (PDS)
PDS is a programme, run by the HSE, with the aim of having a single national approach to delivering disability health services. Prior to PDS, children’s services were provided by the HSE or voluntary organisations. Service delivery was based on individual diagnoses and dependent on locality. Inconsistent service delivery models and varying waiting lists resulted in inequities across the country in the accessibility of services for children and their families. PDS was proposed as a solution to address the imbalance in service provision. Further information here.
