The Occupational Therapy Service reclaims budget and capacity for local authorities 

Through effective proportionate care reviews, The Occupational Therapy Service (TOTS) is delivering high-impact strategies to release social care savings and frontline capacity for several councils across the UK.

TOTS is a respected independent occupational therapy service offering a portfolio of clinical and commercial services. A vital part of its remit is supporting local authorities and health organisations in ensuring that domiciliary care provided is proportionate to the person’s needs. All public sector bodies are facing unprecedented financial challenges in adult social care with escalating costs and rising demand for domiciliary and Continuing Healthcare  packages.

A recent survey* found 9 in 10 directors of adult social care in England have been forced to overspend to meet their Care Act statutory duties, with home care packages being a primary driver of this pressure.  Financial strain is being compounded by significant healthcare system-wide challenges.  An ageing population is driving demand for more complex care, while historic care packages often remain unchanged, locking vital care capacity into inefficient provision. This creates a cascade of issues including longer waiting lists and severe delays in hospital discharges. Nationally, around 14,000 hospital beds per day are occupied by patients who are medically fit to leave but are awaiting social care. The reassignment of community care to these individuals is critical in resolving the current model which is unsustainable.

By delivering Occupational Therapy-led proportionate care reviews, TOTS is ensuring thousands of frontline care hours are appropriately assigned, hospital discharges are expediated, financial savings are implemented and ultimately, local authority resources are more effectively channelled within already stretched budgets. Proven results from The Occupational Therapy Service have delivered significant improvements to local authority services. TOTS recently completed a project with Derby City Council, reviewing 240 care packages, which produced the following results:

£1.46m net savings on domiciliary care

61,000 care hours put back into the system

325% Return on investment 

Adam Ferry, Director and OT for TOTS comments: “Aside from the financial savings we deliver, our approach is first and foremost person-centred. It promotes a strengths-based,  High Impact Change model that maximises dignity and independence.  By ensuring care is proportionate to need, often through the introduction of the right equipment and handling techniques, we ensure residents can live successfully with lower safety risk. This not only delivers significant system efficiencies but also increases the quality of care delivered, and often the length of each care call, helping the person and their carer to build strong, trusting relationships.”

Adam continues: “By expertly reviewing existing care packages, we consistently deliver significant savings that can be reinvested into other priority areas. This approach has a track record of success across the UK. For example, in one project, 60% of relevant cases were safely converted from double-handed to single-handed care, dramatically increasing capacity. In another confidential council partnership, a single complex package review we designed and implemented has created 50 extra care hours per week within the system. 

In conclusion Adam says: ” The Occupational Therapy Service will continue to unlock a sustainable future for adult health and social care through a targeted focus on proportionate care. Our work always aligns with core principles of the Care Act, ensuring resources deliver more wellbeing, choice and interdependence for vulnerable individuals – an outcome we are proud to facilitate.”