"It’s a Lifestyle choice for me which enables me to go travelling"

A Day in the Life of a Locum Occupational Therapist – Sarah Piercey

Published on 21st April 2017

Sarah Piercey is a Locum Occupational Therapist (OT) currently on a contract with a local authority social services department in North London. Sarah is from Perth in Western Australia and found that locuming enabled her to travel around the UK since moving here three years ago.

Locuming keeps your fresh

I studied to be an OT in Western Australia on a four year course. I’d always wanted to work within the health profession and had an interest in psychology and human biology. Towards the end of my time at high school, I came across a family friend who was an OT and the breadth that the role covered and the philosophy of improving the overall quality of life intrigued me and I found out more information and went on to study it. I’ve since been an OT for nine years and a locum for four of those.

Seven years ago I came to the UK for a year and did some locum work in Scotland, in Aberdeen and Ayrshire and then I went back to Australia for three years. I then came back to the UK three years ago as I wanted to travel around the UK and Europe with my partner (we both have dual citizenship) so we’ve lived in Brighton, Northamptonshire and now London and I’ve taken contracts accordingly. It’s great, it enables me to see how the different services operate in different parts of the UK and enables me the flexibility to travel too.

Due to the different demographic and population, working as an OT in the UK is different to Australia. Both countries have their challenges, whether it is demand on service or geographical distance, and you have to be creative with solutions.

I thoroughly enjoy locuming though – I think it keeps you fresh and as you change contracts, it provides you with expertise in a variety of areas. So far, I’ve worked in hand therapy, medical wards/discharge planning, community rehab, ward-based rehab and community social services – it keeps you stimulated.

I have 25 cases at the moment, most of which are active

I provide support and intervention to adults with long-term conditions and disabilities to improve their daily life and what’s important to them. I go out to see someone in their home and carry out an assessment to see how they carry out everyday activities such as washing and dressing, making a cup of tea, accessing the toilet etc. I look at the house and identify risk factors and how to improve safety. I can provide education about how to do a task differently, or can issue assistive equipment such as a toilet frame, bath board, or rails and then review this to ensure the equipment enables the individual to carry out the activity. We provide quite a bit of manual handling equipment such as stand aids, slings and hoists; and specialist seating. If equipment doesn’t help, we may then look at major adaptations to the home such as a level access shower, stair lift or ceiling track hoist. I provide education to carers and link service users to community organisations. I currently have a service user who I am linking into a charity grant for a car hoist which will enable him to get his wheelchair on to his car to enable him to get out and about, so the work is very varied.

My core duties are completing home visits, functional assessments and lots of working with other professionals, mainly social workers or equipment specialists. I also complete assessment forms and case notes, review that a person’s care package is appropriate for their needs, order equipment/minor adaptations and organise major adaptations following joint visits with a surveyor, for the individual to enable them to live independently. There are a lot of onward referrals such as to Physiotherapy, or the Wheelchair service. I have about 25 cases at the moment, most of which are active, we usually aim for 20 but it varies according to need. If the needs of the person are less complex, or basic equipment only is required then the cases can be closed relatively quickly. If the person has more complex needs and major adaptations are needed, this can be a time consuming process especially depending on who owns the property and if a grant is required. If you are going through the grant process, there are usually a number of forms and joint visits, and the case could take months to close. Some service users we work with have Parkinsons or MS, and their needs might change whilst we are working with them so we may need to try a few different solutions and the case could be open for a longer period of time.

Every day is different

The authority I work for is very flexible. We have new offices which are eco-friendly and it’s in central London. There are 11 floors and a lot of people work there. There is a huge emphasis on flexible working and maximising time efficiency and there is the option to work from home with manager approval. When we are in the office, we hot desk and we all have our own laptops and lockers and then link up to a free monitor. I work a seven hour day and arrive at work by tube usually around 9.30am. I work in the Assessment, Care and Management Team, which is a multi-disciplinary team. There is an Access and Response Team and the bulk of OTs work there. Then there are three locality teams. I’m based in the North Team which is comprised of three Operational Managers, 15 social workers, three OTs and three outreach officers.

My first job is setting up my laptop and checking emails. There are usually around 20, half of which are updates such as who is the duty manager and five to 10 about cases. Every day is different. I schedule my own home visits depending on client availability or the reason for referral so for example if I wanted to assess a service user’s personal care needs, I would schedule the visit for when the carers are there in the morning. I may carry out two visits in the morning, then go back and check emails. If there are no visits scheduled, my day will be writing up assessment forms or ordering equipment/adaptations.

The north team meets every fortnight. We discuss waiting lists, organisational updates and day-to-day issues. Every month I attend an OT forum where all the OTs from the teams meet up to discuss specific issues such as new equipment, training requirements, talk through complex cases and brainstorm solutions. There is a lot of paperwork in social services, so whilst I do get direct contact with clients, a lot of time can be spent on forms, referrals, ordering equipment, travelling etc.

You are expected to hit the ground running

I have been fortunate enough to attend training about the Care Act, safeguarding and new developments in equipment, organised through the Council. If it’s all day training, we as locums can attend but we would not be paid for the day, which is fair. My authority is pretty good in terms of accessing CPD. When I was locuming seven years ago it was very strict and locums could not attend training or meetings. My manager is a social worker and I get formal supervision every four to six weeks. If I have an OT specific issue I can always discuss cases with colleagues or an OT Manager.

I can take up to an hour lunch break and every day is different. You have to be flexible around service user availability. If a family member wants to be present at a visit, I might carry out the home visit on my way home after they finish work to enable them to be there. I’m usually at home by 6pm and in the evenings I’ll catch up with friends, cook, watch tv or sew.

There’s definitely more flexibility being a locum. You have more control over your working life and holidays. If an employment opportunity comes up which suits you, you can go for it and be available more quickly than if you were permanent. It opens options up for you. You are expected to hit the ground running and caseloads are high, you are expected to work independently as a locum but there is supervision when you need it. I’d maybe go permanent one day - It might be different if circumstances changed for example if I wanted to buy a house and needed more stability or if government legislation changed the funding for locums and there was less work around. 

Best thing about being an OT

It is a very rewarding profession, helping people to achieve what they want to, reducing difficulties and enabling people to maintain their independence and live safely in their own homes. You also build great relationships with staff and service users. No day is the same, there are so many areas in OT, everything changes and there is always development in the field which keeps it interesting.

Best thing about being a locum

The flexibility. You meet good colleagues in a range of professions and you can be 100% patient focussed and just concentrate on assisting service users. There is also the opportunity to progress. I was a band six in a previous locum position and they offered me a band seven position and could slot me in which they wouldn’t have been able to do as quickly had I been a permanent member of staff. The pay is also good and you feel valued. As a locum, you often get a lot of good comments when you change placements every year or so and the positive affirmation keeps you refreshed.

Worst thing about being a locum

Not getting sick pay. Also job stability – if the climate changes and funding is cut you can find yourself without a job.

Most challenging thing as a locum OT

It can be a challenge to know when to keep quiet and when to speak up, I find that difficult. Working in a variety of settings, you get to know different processes and procedures and can get to a new placement and you have ideas that could help the service, but you have to establish yourself first and hold back before putting these ideas forward.

What advice would you give to someone going locum

I really enjoy it, it’s a lifestyle choice for me and it gives me the flexibility to travel. You need to be able to adapt well to change and have good time and organisational skills. Research your recruitment agency well and find one that understands your needs. I work with Mel from Tripod Partners and she’s fantastic as she knows what I need from a placement and understands OT so she can find me the best fit in an organisation. I would also say it’s good to have two-three years’ experience before going locum to build up the skills to work independently and as you can have a huge caseload, it’s good to have experience behind you. Once you go locum, get involved and volunteer for opportunities to better yourself.

*This article was originally published in November 2015

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