Connections Summer 2023 by Occupational Therapy Australia

Supporting all people to engage in activities they find meaningful

SUMMER 2023 | VOL 20 ISSUE 4

Print Post Approved PP340742/00147 ISSN 1832-7605

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Reflection and Progression OT Week 2023 wrap-up Neurodiversity affirming practice Enacting occupation-based practice Looking ahead to OTX2024

DISCOVER STORIES FROM YOUR PEERS

CONTENTS

ABOUT CONNECTIONS

Connections is a publication of Occupational Therapy Australia (OTA), the peak body representing occupational therapy in Australia. CONTACT US

Occupational Therapy Australia ARBN 007 510 287 ABN 27 025 075 008 5/340 Gore St, Fitzroy, VIC 3065 T: 1300 682 878 E: info@otaus.com.au W: www.otaus.com.au CONTRIBUTIONS

Connections welcomes article submissions, email communications@otaus.com.au Attention: Connections Editor DEADLINES FOR SUBMISSIONS

Autumn 2024: 29 January 2024 ADVERTISING

NEWS

FEATURES

CEO’s Report

President’s Report

Quarterly update – Member news

WFOT Update

AOTJ Update

OT Week 2023 wrap-up

Please contact advertising@otaus.com.au for advertising enquiries

A call to action, to be critically reflective of ourselves and our practice

OTA’s Leadership Program

Student Career Webinar Series

OT Week 2023 wrap-up

Building a workplace culture of occupation-based practice in a tertiary health service

Save the date – OT Mental Health Forum 2024

Looking ahead to the OT Exchange 2024

Conversations That Matter: Assistive technology and occupational therapy

Understanding Personal Accident insurance

Vale notices

Three HR hotspots when managing employee leave in your OT practice

DESIGN

Perry Watson Design COVER

gettyimages/Viktoria Kurpas DISCLAIMER

This newsletter is published as an information service and without assuming a duty of care. It contains general information only and, as such, it is recommended that detailed advice be sought before acting in any particular matter. The materials included in this newsletter by third parties are not attributable to Occupational Therapy Australia, and are not an expression of Occupational Therapy Australia’s views. Occupational Therapy Australia is not responsible for any printed expressions or views in any third parties’ inclusions. Any enquiries regarding inserts, advertisements or articles placed by these third parties should be directed to them. Occupational Therapy Australia respectfully acknowledge the Traditional Custodians of the country on which we live, learn and work.

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CEO’S REPORT

CEO’s Report Samantha Hunter | OTA CEO

s we welcome in another summer, the team at Occupational Therapy Australia took the opportunity to come together to celebrate another year of growth and change, and a little less challenge than the previously chaotic COVID years. Whilst less chaotic, it has been incredibly productive and fruitful as our growing team continued to build on our previous successes and initiate new ideas. This year, we built on the work of the previously commissioned white paper – Thinking Ahead, the Future of Occupational Therapy and Mental Health in Australia and adopted recommendations for developing a career pathway. This started by commissioning two foundational modules creating the beginning of a pathway to develop the necessary skills required for mental health endorsement. We also launched our inaugural Leadership Program aimed to stretch our cohort from expert clinicians to reflective and reflexive leaders, and it was such a joy to bring members together and give them the time and space for new ideas, frameworks and learnings about leadership as well as connect them with some really impressive members of the profession. We are excited to add this to our programs again in 2024. We celebrated connecting again – in real life – in Cairns! I am always in awe of the impressive sight of over 1,000 OTs converging in one place to learn, laugh and dance together. Despite the longer distances and rising cost of living and doing business, our industry partners turned out in droves to support OTA. I can’t wait for our third OT Exchange in Perth next year, and for the inaugural OTA Oration, a new initiative to

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celebrate our profession and hear from a clinician at the vanguard of their practice. As both a member association and a peak body, our advocacy work remains a major focus as we continually seek to build influence and impact across multiple policy and funding scheme fronts. The NDIS Review, Royal Commission into Veteran Suicide and a multitude of Aged Care Reforms have seen our Government & Stakeholder Relations (GSR) team working incredibly hard alongside our dedicated volunteer members who sit on our National Reference Groups and provide feedback and case studies, quantitative and qualitative data and evidence-based research we reply upon to advocate strongly for the profession. This year we have substantially grown our GSR team and rightly so, given the vast array of issues and the volume of submissions we are being called to respond to. At the time of writing, we await the release of the NDIS Review and the government relations and media advisors are ready to address and respond to what will possibly be a very challenging report and recommendations. We very proudly wrapped up our Reflect Reconciliation Action Plan (RAP) and commenced working toward the next stage, Innovate. Our Journey toward Understanding continued with the Association supporting the Yes campaign. Despite this not bearing fruit, we are deeply committed to being the best ally we can be, and actively moving forward in supporting our First Nations voice and reiterating our commitment to the Uluru Statement from the Heart. After a hiatus in being able to connect as a group, our Board and Divisional Chairs convened at National Forum to discuss

the state of the nation, our commonalities, as well as the specific opportunities and challenges some jurisdictions face. We are very grateful for the work of the Divisional Councils, having their fingers on the pulse of local and state/ territory opportunities and issues. The Board continued throughout the year to work on deeply listening to members and a wide array of stakeholders as they formed a new strategy. This new strategy will be accompanied by a framework that continually assesses our operating environment, ensuring we don’t set and forget. It aims to deliver true strategy in action and is another opportunity to demonstrate our ability to flex and adapt, as both an association and a profession. The deep reflection, broad conversations and future forecasting has also led us to reflect on our history as an association and a profession. We have looked at the values that underpin not only who we are as an association but also who we want to be as we grow and each year shine more brightly, boldly and confidently in the allied health landscape. So, we are excited that next year our members will start to see the that emerging – a bright, bold and confident association with a clear direction. Once again, it has been a great privilege to serve the members of OTA and lead the team that delivers the benefits of belonging and a wealth of support, advice and advocacy to our members. We growing as an association, and through careful financial management we have kept a stable rein on membership pricing with only a 2% increase in over six years. OTs now enjoy the lowest association membership cost of all the registered allied health professions, and I am grateful to each

PRESIDENT’S REPORT

President’s Report Professor Carol McKinstry | OTA President

of you who invest in providing a voice for the profession. As my team often hear me say “if we don’t speak for OTs, who will?” I am once again indebted to the Board of Directors for their intelligence, enquiry and insights, and the ongoing collaborative commitment to our common goal. And finally, on behalf of the association and our staff, an enormous debt of gratitude and heartfelt thanks to outgoing President and Chair Professor Carol McKinstry. Carol has spent the maximum time available as Chair of the Board of OTA. Fortunately, we have retained her wisdom and wit on the board for a further term as a general board member. I am incredibly grateful to Carol for her leadership, her wisdom and her sage advice. Carol has demonstrated the ability to keep us all on track and to cut through to the critical and important issues, to see the nuances and the greys in what might sometimes seem very black and white. She has always held the very best interests and intentions of the association and our members and is a fierce advocate as well as a cheerleader for us all. Wishing all of you a safe and happy festive season.

his is my last Connections article as OTA President and I have mixed emotions but mostly pride in the ongoing development of OTA, and heaps of optimism for the future. My four years as president have flown and it is time for renewal. My first year as president was in 2020, which was a year of much uncertainty as the global pandemic started. There were many phone calls with our CEO Samantha Hunter about what we should be doing and speculation about what might happen. Firstly, we needed to support our members and try to give them as much information as possible in an environment that was changing by the minute. I reached out to the presidents of occupational therapy associations in other like countries and WFOT to see if we could share resources, and this group met regularly and has become particularly important for both peer support and sharing of resources. I would like to congratulate the successful nominees elected for OTA Board positions and thank the outgoing board directors for their significant contribution. The work of the OTA Board may not be fully recognised; however, the responsibility to ensure we are delivering the services members need and making strategically sound decisions is not a responsibility taken lightly. We are fortunate to have high calibre members who want to volunteer their time, not only for board director positions but also for divisional councils, special interest groups and other OTA volunteer work. Please take the time to read the Annual Report and note the very pleasing achievements of the past financial year, particularly our financial position. Recently we celebrated OT Week and World OT Day with the theme of Unity Through Community. Reading the social media posts from WFOT, OTA and members of the profession celebrating in various ways highlighted what a broad church we are. Not only are our areas of

practice expanding, but recognition of our worth and value has also increased. We are our own most effective marketers. It’s what we do every day, to make a difference for not just the individuals and families we work with but also the impact we have on communities. Focusing on wellbeing and health promotion, working as a community to advocate for opportunities for everyone, but particularly those experiencing occupational injustice and deprivation, is presently even more important. A shout out to the Bendigo occupational therapists who year on year for OT Week put together a feature in the local newspaper highlighting local occupational therapy services and the profession. Another recent celebration was an awards ceremony at Government House in Adelaide where Marilyn Pattison AO was conferred as an Officer of the Order of Australia by the Governor General of South Australia. This is second highest award in Australia and recognised the long-standing voluntary work by Marilyn to her local occupational therapy community as well as OTA and WFOT. Congratulations Marilyn and also to the other Australian award recipients. The increasing number of students and graduates joining OTA and renewing their memberships gives us a solid foundation to build an even stronger association and profession for the future. The leadership from experienced occupational therapists to guide not only the association but also our early career therapists is also essential. As we look forward, work on the finalising the next strategic plan for OTA is nearing completion and part of one of the current strategic projects is the rebranding of OTA. Moving into 2024, there is much look forward to, and many exciting developments that will give OTA more impetus for further advocacy and marketing, building a strong occupational therapy profession that has contemporary relevance and sound values. CONNECTIONS SUMMER 2023 5

F E AT U R E

Quarterly update – Member news

What we’ve been doing for members The last three months have seen the close of the NDIS Review, the launch of the Scope of Practice Review, and ongoing advocacy to further the interests of OTs working in mental health, aged care and workers compensation schemes.

National Disability Insurance Scheme NDIS Review

In August OTA lodged its final written submission to the NDIS Review in response to the Review Panel’s Interim Report. This submission is the last of five OTA has prepared on behalf of its members, which are available on our website – scan the QR code to view them:

• Key issues submission: a comprehensive submission advocating for 24 key improvements (January 2023) • NDIA Quality and Safeguarding Framework (May 2023) • NDIS Safeguarding Proposals (May 2023) • OTA response to NDIS Pricing and Payments Issues Paper (July 2023) • OTA response to the NDIS Review Interim Report (August 2023) These submissions were informed by feedback from our NDIS National Reference Group, as well as our individual members. We’d like to extend 6 otaus.com.au

a warm thank you to all those who contributed their time and wisdom. In August, we followed up our written submission by attending several consultation opportunities organised by the NDIS Review Secretariat for allied health professions and peaks. OTA has also provided more in-depth feedback on the treatment of psychosocial disability both within and outside the NDIS directly to the Review Panel and through our Mental Health Australia membership. OTA attended a face-to-face briefing in Melbourne in late September, during which members of the Review Panel explained the direction of the review and next steps. The NDIS Review Panel has now delivered their final report to the Disability Reform Ministers. It’s now expected the Federal Government will consult with state, territory, and local governments, before outlining their response to the recommendations. Following the publication of the government response to the panel’s recommendations, there is likely to be a lengthy implementation period involving further consultation about the details of implementation. OTA will continue to advocate strongly for our members during this time.

Aged Care In September OTA’s CEO Samantha Hunter, along with members of the Government & Stakeholder Relations team, met with Michael Lye (Deputy Secretary of Department of Health and Aged Care) and Thea Connolly (First Assistant Secretary for Home and Residential Division). During this

meeting, Sam highlighted the value and role of OTs in aged care and our concerns about the levels of OT representation in reforms and residential aged care settings. OTA is coordinating ongoing engagement with Michael and his team.

Ongoing impact of AN-ACC

OTA, along with Allied Health Professionals Australia (AHPA) and other allied health representatives continues to lobby with the Department of Health and Aged Care and key stakeholders to raise concerns about low levels of allied health service provision in residential aged care and the associated impacts on older people and allied health professionals. To inform advocacy efforts, OTA developed and released a survey seeking feedback from allied health professionals on the consequences of aged care reforms on the provision of allied health services and clinical outcomes in residential aged care, one year on from the commencement of the AN-ACC tool. The survey was circulated broadly to all allied health professions via their peak bodies, and builds on a similar survey conducted in October 2022. The latest results show ongoing reduction to the OT workforce and clinical hours across residential aged care. There is also an ongoing reduction to individual treatment sessions with a preference towards group sessions. OTA will work with AHPA and other allied health peaks to use this data to build key messaging and advocacy materials to continue highlighting the impacts of residential aged care reforms on access

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to occupational therapy and other allied health professions, delivery of quality care and clinical outcomes.

through Commonwealth funded schemes, and that the eligibility criteria should support early intervention services.

NACA update

Mental Health

OTA was pleased to attend the August National Aged Care Alliance (NACA) meeting in Canberra. NACA is a representative body of 48 peak national organisations in aged care, comprising consumer groups, providers, unions, and health professionals. The alliance meets quarterly to work together to determine a more positive future for aged care in Australia. The August meeting was an opportunity to connect with a range of key stakeholders in the aged care sector and to hear updates from senior leaders across the federal government. NACA members heard from a range of senior leaders from across the federal government, including Nigel Ray (Deputy Chair of the Aged Care taskforce), Ian Yates (Interim Inspector General for Aged Care), senior staff from the Department of Health and Aged Care who talked about the program of aged care reforms, the Aged Care Quality and Safety Commission regarding aged care standards, and the Department of Home Affairs regarding skilled visas.

Submissions

The Aged Care Taskforce (Taskforce) is currently reviewing funding arrangements for aged care and developing options for an aged care system that is ‘fair and equitable for everyone in Australia’. In August OTA provided a submission on behalf of members in response to the Taskforce’s Draft Aged Care Funding Principles. OTA also attended an in-person consultation with members of the Taskforce in September. The funding principles will underpin the Taskforce’s recommendations, which will be outlined in the final report due to government in December 2023.

Mental Health Foundations by OTA

Deakin University has been developing a comprehensive suite of training developed by expert OTs designed for OTs. The first module was released on 30 June, with a focus on Mental Health Assessment and Planning. The second module, Mental Health Systems, Diagnoses and Co-occurring Factors, has now been released. This module includes training on mental health frameworks, systems, and legislation, common mental health diagnoses and treatments, occupational therapy models of practice and recovery-oriented practice, trauma-informed practice, child and adolescent developmental stages and attachment theory, substance use disorders, gambling, and other addictions, culturally aware practice and LGBTIQA+ aware practice. The mental health capability framework has been used to drive the development of the eLearning modules, which support the pathway for OTs seeking OTA mental health endorsement. Scan the QR code for more information on registering for the modules:

Mental Health Australia Parliamentary Advocacy Day

In September, OTA travelled to Canberra for Mental Health Australia’s (MHA) Parliamentary Advocacy Day. The event coincided with the release of MHA’s 2023 Report to the Nation, which includes an annual independent benchmark survey, and called for the Australian Government to put mental health reform on the agenda. The aims of the advocacy day were to ensure the Government makes assertive changes that increase access to early intervention and digital mental health support; increase funding for psychosocial services outside the NDIS; and increase people’s access to timely care by building the mental health workforce. OTA delegates Alissa Fotiades (General Manager, Government & Stakeholder Relations) and Geoffrey Lau (member volunteer) spent the day at Parliament meeting with Members of Parliament and advocating on behalf of OTs working across the mental health sector.

Scope of Practice Review In August, the Australian Government announced a Scope of Practice Review, titled Unleashing the Potential of our Health Workforce. Continued next page

OTA contributed to AHPA’s submission to the Federal Government’s proposed Aged Care Act. Our points highlighted the need to define quality care, ensure older people receive the same level of funding and access to care that others receive CONNECTIONS SUMMER 2023 7

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This review arose out of recommendations from the Strengthening Medicare Reform Taskforce.

scholarly literature, an online survey of over 2,000 OTs, 20 interviews and ten focus groups. We look forward to sharing the Workforce Development Plan with the profession upon finalisation.

Unleashing the Potential of our Health Workforce is an independent review, led by Professor Mark Cormack. It will look at evidence about health professionals’ (including OTs) ability to deliver on their full scope of practice in primary care.

State/territory news Compensable schemes

As an initial consultation step, the Review has published its Terms of Reference, to which OTA has provided a comprehensive submission. The OTA submission sets out the current scope of OT practice in Australia, the key barriers to utilising OTs to their full scope, and possible enablers to unlock their potential. A copy can be found on the OTA website – scan the QR code:

OTA remains in discussions with Victoria’s Transport Accident Commission (TAC) on several matters including parity issues relating to the TAC’s ‘Above Rate Service Agreement’ and the TAC’s current review of the Statewide Equipment Program (SWEP). OTA conducted a survey to capture member feedback about the SWEP process, which will inform our engagement with the TAC. OTA has also been advocating for changes to the various workers compensation Acts to enable OTs to issue certificates of capacity under these schemes. We will keep members updated on the outcomes of our efforts.

The Review Panel intends to conduct three further phases of stakeholder consultation during 2024, ahead of publishing the final report in December 2024. OTA will continue to engage with the Review throughout this period.

Department of Veterans’ Affairs In August, OTA met with Minister for Veterans Affairs Matt Keogh’s Chief of Staff to follow up on a recent letter we sent to the Minister about the Occupational Therapy Fee Schedule Redesign Project, in which we expressed our dissatisfaction with the current fee schedule review. The Department of Veterans’ Affairs (DVA) has informed OTA that the project is currently on hold. OTA will continue to liaise with DVA on the fee schedule, and on the DVA’s equipment schedule. We are also working to ensure OTs have more support to resolve issues and complaints.

Workforce Workforce Development Project

As outlined in previous editions of Connections, OTA commenced a Workforce Development Project in March 2023 in response to challenges being experienced by OTs across the country. This project will identify actions OTA can take to support the occupational therapy workforce over the next five years. The project is nearing completion and has used an evidence-based approach involving extensive consultation with the profession. This included an examination of occupational therapy workforce data, review of over 300 articles from the international and national 8 otaus.com.au SCA34714_GeneralScooters_119x87mmW_OT-Connections_Outline.indd 1

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WFOT REPORT

WFOT Update Associate Professor Emma George (1st Alternate Delegate)

Occupational Therapy Australia strives to develop networks and collaborations across the globe through our membership of the World Federation of Occupational Therapists (WFOT), and more locally through our neighbouring associations in the Asia Pacific region as a member of the Asia Pacific Occupational Therapy Regional Group. WFOT President Samantha Shann recently spent some time in the region in the lead up to the 8th Asia Pacific Occupational Therapy Congress, and I took the opportunity to ask her about her experiences: What is the most exciting thing about the growth of OT in the Asia Pacific region? Samantha: What I find most exciting is that there is development at all levels across the Asia Pacific region. Countries that have had occupational therapy for many years are expanding scope of practice and getting recognition from health and social providers for the development of new posts. Countries where the profession is less established are working hard and beginning to get more recognition at government level. National occupational therapy associations are growing in number and advocating for the profession. On a recent visit to Vietnam, it was good to witness the official launch of the new Occupational Therapy Network, which will hopefully in time become an official association and member of WFOT. There is also lots of exciting research happening, at undergraduate as well as PhD level, and it’s good to see the evidence being shared with the rest of the world, influencing practice and education globally.

What is the biggest challenge for growth of OT in the Asia Pacific region? Samantha: I think the challenge of growth is much the same around the world. As occupational therapists, we need to advocate and promote the profession at every level. Finances are often stated as a reason for limited growth, so we need to provide evidence of our value. WFOT tools such as QUEST and the Economic Evaluations can assist with this. We also have to recognise that the majority of national associations are run entirely by volunteers and therefore members of associations need to contribute and be willing to volunteer too. The more people we can divide the work between, the more we can hopefully achieve by working together. Right now, with the adoption of the World Health Assembly resolution on ‘Strengthening Rehabilitation in Health Services’, I believe we have a great opportunity to promote the occupational therapy profession and to demonstrate our value as essential members of rehabilitation teams. What do you think Occupational Therapy Australia can do to support and promote OT in our region? Samantha: I believe sharing of resources and listening to each other is the best way to support growth. Being able to understand the local context is important and developing culturally relevant and sensitive practices – for example, looking at how useful standardised assessments may or may not be in certain contexts and how these may be revalidated and adapted. As a profession we need to look at how we support and develop early researchers, guiding them so they can keep an occupational therapy and/ or occupational science focus and assisting

with publication opportunities. For many years now my biggest feeling about support and development is the involvement of the local national associations. I strongly believe if we can support national associations to develop and plan strategically, we build stronger foundations for the profession in the country. The Asia Pacific Occupational Therapy Regional Group plays an important role here in bringing countries and associations together. Any final message to OTA members from WFOT? Samantha: Thank you for the courageous and innovative ways OTA members have responded to recent natural disasters that have affected communities across Australia. Also, thanks for the continued support of WFOT and the profession on a global level. I see and hear about some excellent collaborations especially between occupational therapy education programmes. I look forward to seeing many OTA members at the WFOT 2026 Congress in Bangkok, and also in Sapporo next year for the APOTRG Congress.

8th Asia Pacific Occupational Therapy Congress

The 8th Asia Pacific Occupational Therapy Congress (APOTC) will be held 6-9 November 2024 at the Sapporo Convention Center in Sapporo, Japan Early bird registration for international participants is open now. Visit https://www.c-linkage.co.jp/ apotc2024/ for more information.

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WFOT REPORT

WFOT Update

QUEST

Launch of the Vietnam Occupational Therapy Network at the 1st Occupational Therapy Conference.

WFOT President Samantha Shann recognised the work of many individuals to date and offered guidance for future steps. (WFOT 1 August 2023)

WHO – Strengthening Rehabilitation in Health Services

Scan the QR code to read more.

Customised Assistive Technology Wheelchair Modifications Mobility Aid Adaptations Accessibility Solutions Sports & Recreation Adaptations Personal Care & Daily Living Aids Customised & Modified Bikes, Trikes & Electric Assist

QUEST provides a comprehensive strategy to use data to demonstrate the value of occupational therapy. QUEST describes a set of seven occupational therapy quality indicators applicable to all practice settings. Scan the QR code for QUEST resources.

A O TJ U P D A T E

Rehabilitation 2030: Health policy and systems research and occupational therapy Louise Gustafsson

n a first for the Australian Occupational Therapy Journal, the final issue of the year includes an editorial that has been co-published together with approximately 30 (and increasing) journals. The editorial (Frontera et al., 2023) was developed by the Health Policy and Systems Research for Rehabilitation Group of the World Rehabilitation Alliance, World Health Organization. The World Rehabilitation Alliance is a global network whose mission is to advocate for the Rehabilitation 2030 initiative from the World Health Organization (https://www.who.int/ initiatives/rehabilitation-2030). Rehabilitation 2030 recognises that there is an urgent need for changes within the global landscape to improve equity of access to rehabilitation. Indeed, there is a growing global need for rehabilitation to be recognised as critical for health and wellbeing and thus included within universal health coverage in many countries, but particularly low to middle income countries. This is essential if we are to achieve the United Nations Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages (United Nations, n.d). The World Rehabilitation Alliance (https://www.who.int/initiatives/worldrehabilitation-alliance) includes five workstreams: Workforce, Primary Care, Emergencies, Research, and External Relations. Each workstream has developed specific activities in their area of focus united by the continuing failure to meet the

Rehabilitation 2030 recognises that there is an urgent need for changes within the global landscape to improve equity of access to rehabilitation. global population needs for rehabilitation. The research workstream (https://www. who.int/initiatives/world-rehabilitationalliance/research) has a specific focus on the field of health policy and systems research – and the editorial represents one of the advocacy activities of this group.

What is health policy and systems research?

This is transdisciplinary research, which has a focus on addressing real world issues and situations to support the implementation of health policies and strengthen health systems. The four central elements are health systems, health system development or strengthening, health policy, and health policy analysis (Gilson, 2012). The fundamental concept is to bring together the two fields and understand how health systems and health policy interact to shape, or be shaped by, each other and how the society is organised around these in the delivery of healthcare. There is an urgent need for collaborative health policy and systems research, particularly in low to middle income countries, to support the inclusion of rehabilitation as universal health care and improve equity of access of rehabilitation.

The Australian Occupational Therapy Journal has committed to the advocacy activities of the health policy and systems research group of the World Rehabilitation Alliance. Consistent with this activity, a recent editorial (Aplin & Gustafsson, 2023) discussed equitable and appropriate access to assistive technology on a global and local level. The editorial and the work of others highlights how the health policy and system interaction can and does impact health services and outcomes. As one example, the editorial placed a spotlight on the current conflict between client choice, evidence-based solutions and what is considered reasonable and necessary within the organisations who manage the assistive technology provision. At the core of this issue is the operationalisation of a policy within a system with an increasing focus on economic efficiency (Steel, 2019). Although our experiences do not mirror the experiences of countries where rehabilitation is not included within universal healthcare, there is an increasing need for the profession to recognise, promote, and be involved in health policy and systems research. References can be viewed by scanning the QR code

CONNECTIONS SUMMER 2023 11

F E AT U R E

A call to action, to be critically reflective of ourselves and our practice Micah Perez

n today’s ever-evolving climate, the abuse and/or neglect of human rights of various populations is becoming increasingly evident, thanks in part to brave voices and advocates of social justice bringing this to our awareness. There is, therefore, a real need for us, as OTs, to critically reflect on ourselves and our practice, and the impact of our practice on the rights and needs of our clients. An important part of critical reflection, in my opinion, is to first consider our bias and positionality. Nixon (2019) proposes a coin model of privilege, whereby coins are used to conceptualise systems of inequality that give individuals advantages and disadvantages, depending on what side of the coin they are on. After we have reflected on our bias and positionality, we can then reflect on the impact of these on the way we practice occupational therapy, and the way in which we establish and maintain a therapeutic relationship with our clients. I believe this form of critical reflection is especially important when we work with clients with disability who are neurodivergent (confirmed and suspected) and have culturally and linguistically diverse backgrounds. For example: • Am I biased towards neurotypicality, ableism and Western culture? If so, how does this bias impact my expectations, communication, and interactions with neurodivergent (confirmed and/or suspected) clients with disability, who have culturally and linguistically diverse backgrounds? • Do I come from a position of unearned power and privilege? If so, how

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does my position impact and/or inform my therapeutic relationship and expectations of my clients?

A reflection on the neurodiversity movement

Momentum appears to be gathering for OTs to join the neurodiversity movement. I’m excited about this, because I am very much on a journey of resonating with the neurodiversity movement and moving towards neurodiversity affirming occupational therapy practice. My journey began with a process of critical reflection, like I have outlined in the section above. According to Dallman et al. (2022), neurodiversity affirming OTs must critically question the following: Are your goals targeting reducing or changing diverse behaviours central to your client’s personhood and important for their wellbeing? When I reflected on this question when working with my paediatric clients, it prompted me to think about whether I was being client-centred in relation to the child or the child’s parents, and this has since informed the way I approach goal setting and intervention planning. When I reflected on it when working with adult clients, it prompted me to think about the expectations I had and the basis of those expectations, and to question what wellbeing means for each client. I have since come to appreciate how diverse the definition of wellbeing is for my clients. Proponents of the neurodiversity movement argue current therapeutic and medical

practices often attempt to normalise behaviours and ways of participation that originate from these differences in neurology and contribute to an individual’s sense of identity. Dallman et al. (2022) argue that an ethical and morally just occupational therapy practice should affirm neurodivergent ways of being, and OTs must be agents of change by listening to and collaborating with their neurodivergent clients. A neurodiversity affirming perspective, according to Dallman et al. (2022), requires: 1. Respect for your clients as having a unique style of neurological processing that leads to differences in sensing and operating in their environments; 2. Listening and consulting with neurodivergent individuals to determine the meaning of their behaviours and occupations; 3. Framing neurodivergent behaviours as natural and valid responses to a specific situation, given the skills, abilities, and preferences of each individual; 4. Having goals that prioritise emotional wellbeing and positive engagement, rather than therapy compliance; 5. Respecting the right of neurodivergent individuals to physically engage with a task or move their bodies during therapy; 6. Guaranteeing social agency and the right to socially engage in ways that are comfortable to them; whereby you, as a therapist, must seek to understand neurodivergent social rules, norms and communication styles that can best support your clients; 7. Validating, encouraging, and honouring all forms of communication (e.g., verbal AND non-verbal); and

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8. Being reflexive and acknowledging how your own understanding of behavioural norms aligns or differs from your clients’ ways of being. As a neurodivergent individual, I really resonate with the above list, and strongly encourage all OTs to consider all these points when working with neurodivergent people.

Neurodiversity affirming occupational therapy

The evidence supporting neurodiversity affirming occupational therapy for neurodivergent individuals is compelling, yet still emerging. Available evidence comprises research studies, clinical trials, and systematic reviews. What I can glean from the evidence (e.g., from the American Occupational Therapy Association, WFOT, and the Journal of Autism and Developmental Disorders) is that neurodiversity affirming occupational therapy can result in improved functional outcomes across various life domains, enhanced self-regulation, and a positive impact on executive function. It involves: 1. Individualised assessments – To gain a holistic understanding of strengths and difficulties, through evaluations that seek to understand the unique needs, preferences, and goals of each individual; 2. Sensory techniques – To support individuals to regulate their sensory experiences and develop adaptive responses within their environments, and to promote self-regulation; 3. Skill development strategies – To enhance an individual’s functional abilities in self-care, productivity, leisure, and social participation, and to empower an individual to lead a fulfilling life (based on what they identify is important to their personhood and wellbeing); and 4. Environmental modifications – To create supportive and inclusive environments that accommodate the unique needs of individuals.

My experiences as a neurodivergent OT providing neurodiversity affirming therapy to neurodivergent families

I have seen firsthand how neurodiversity affirming occupational therapy has helped my clients achieve goals related to: • Functional outcomes including self-care, learning, play, leisure, and social participation; • Improvements in self-regulation and co-regulation between caregivers and children; • Improvements in executive function (i.e., cognitive, behavioural and/ or emotional regulation); • Deeper understanding, appreciation, and validation of the uniqueness of their personhood and wellbeing; and • Validation and willingness to self-advocate for their desires and needs, according to their personhood and wellbeing. However, I have also experienced challenges, including (but not limited to): • Undertaking robust assessment when available standardised assessments are not suitable for neurodivergent and culturally and linguistically diverse clients; • Undertaking consistent progress reviews with available standardised assessments not suitable for neurodivergent and culturally and linguistically diverse clients; • Navigating a therapeutic relationship when the expectations of the parents are different to my own (e.g., the amount of parent involvement in sessions and follow-up at home, openness to receiving parent coaching, deciding whether other family member involvement is beneficial in sessions); and • Providing evidence based and/ or appropriate culturally safe and responsive practice to culturally and linguistically diverse clients.

Proctor from Learn Play Thrive (https:// learnplaythrive.com/instructors/megproctor-ms-otr-l/). This includes her Two Sides of the Spectrum podcast (https:// learnplaythrive.com/podcast/). In Australia, there is an OTA Neurodivergent Affirming OT Practice Special Interest Group convened by Janine Langley (https://otaus. com.au/member-resources/interest-groups/ neurodivergent-affirming-ot-practice). Doing a search on LinkedIn and Google yields results for services claiming to use neurodiversity affirming practices within and outside of Australia. Furthermore, there was a panel discussion session included in OTA’s 2023 National Conference & Exhibition in Cairns. This discussion provided what I felt was a small jumping off point to hear about examples of neurodiversity affirming practice with adult autistic clients. I hope this article will inspire you to undertake critical reflection of your own biases and positionality and the impact of these on your practice, and to consider taking a step (small, medium, or large) towards neurodiversity affirming occupational therapy practice.

About the author

I am a neurodivergent female (she/ her) Filipino-Australian, who has lived in Queensland since I was three years old. I am a chronic migraine warrior with Attention Deficit Hyperactivity Disorder, Anxiety and Depression. I have over ten years of experience as an occupational therapist, working in the private and public sectors, with a varied caseload extending from toddlers to older adults. I also provide clinical education support to occupational therapy students at Griffith University.

Where to from here?

Within the occupational therapy profession, I have seen examples of neurodiversity affirming occupational therapy practice in our American colleagues, such as Meg

References can be viewed by scanning the QR code

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OTA’s Leadership Program I n 2023, OTA launched our inaugural Leadership Program, which ran from May to August 2023. Facilitated by Professor Stephen Duns, the 15-week program was delivered virtually, together with in person retreats in Victoria’s beautiful Yarra Valley marking the beginning and end of the program.

The program featured valuable networking opportunities and presentations from highly regarded leaders of the profession.

We’re pleased to share the rave reviews from participants who took part in the 2023 program and excited to announce the Leadership Program will be back in 2024! The Leadership Program is designed to transform expert OTs into leaders, with participants learning about modern leadership principles and their application to occupational therapy.

With the program capped at 30 participants, the small group allowed for increased participation, learning opportunities and meaningful networking.

Following the success of the inaugural program, the second Leadership Program will commence in May 2024, with the in-person components delivered in regional Victoria.

Here’s what participants of the 2023 Leadership Program thought: 90% of participants rated the program’s value for money as excellent

“The venues were so beautiful and meant I could relax into the program as it helped me get on the balcony and observe. The networking was amazing and to share the journey with others who were on both similar and different paths was so helpful. I would recommend this program to anyone who wants to grow as a leader, no matter what level you are at.” – Vivienne Williams, QLD

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“The information provided in this course has been so helpful in creating a solid foundation for effective team management and leadership that has helped me to actualise the personal and professional values and standards that underpin my business. The face-to-face retreats allowed for deep connections with peers and a safe space to be vulnerable while transitioning from a worker to a leader. I would recommend this course to any early business owner!” – Lauren Mills, NSW

“Not only has the program changed me as a leader, but it has also changed me as a person.” – Christine Siddle, VIC

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2024 Leadership Program The 2024 program will again be facilitated by Professor Stephen Duns, who is an experienced executive, coach and consulting adviser. Upon completion of the Leadership Program, you will have gained enhanced self-awareness, confidence and resilience. You’ll also be able to:

The two-day opening retreat will take place at Hotel Bellinzona in Hepburn Springs, the heart of Victoria’s spa country. The two-day closing retreat will be hosted at Balgownie Estate in Victoria’s picturesque Yarra Valley. The program includes luxury accommodation and premium food and beverage packages at both locations. Registration includes transfers to and from the venues from Melbourne’s CBD.

• Lead high performing teams • Effectively coach and motivate others • Master the art of courageous conversations • Identify and work with strengths • Confidently work with complexity • Diagnose problems and influence systems

The Leadership Program is designed for emerging or aspiring leaders, newly appointed leaders, and established leaders. Ready to take the next step in your career? Visit otaus.com.au/ leadership for more information and to enrol in the 2024 program.

Student Career Webinar Series In 2023, OTA hosted a Student Career Webinar Series to support final year students commencing their OT careers. Held across April to September, the four-part webinar series provided essential advice for a smooth transition to practice, with over 700 students registering for the series. The topics covered included: • Getting the most out of your final year: Skills to kickstart a career as a final year student and information on the current employment landscape, both opportunities and challenges. • CVs, cover letters and interviews: Practical advice on writing a CV and cover letter that stand out, as well as insights into preparing for interviews and what to expect. • Choosing the right workplace for you: Valuable information from a panel of OTs on choosing where to work and what practice area to choose. • Preparing to enter the OT workforce: Experiences of transitioning from student to OT from a panel of OTs, including valuable tips and practical strategies for early career practice.

We were privileged to be joined by guest speakers Clare Jones (MediRecruit); Karina Lewis (Karina Lewis, Health Careers Consulting); OTs from a range of practice areas including Sarah Briggs, Adrian Leet, Tess Donaghy-Adsett, Jacqui Keys, Raquel Skaf, and Renee Khamis; and early careers OTs including Liana Hart, Phoebe Maguire, Vivianne To’mah, Matthew Harrison, and Callum Sinclair. As part of the series, we ran a giveaway offering a free OTA new grad membership, career coaching

sessions and OTA merchandise packs. Congratulations to the winners! We’re excited to announce OTA will be hosting the Student Career Webinar Series again in 2024. If you’re heading into your final year of study, make sure you keep your OTA student membership active (it’s free!) to be the first to know how you can register and what topics we’ll be covering. If you work with OT students at a university or supervising placements, keep an eye out for when registrations open so you can let your student network know.

Thank you to our Student Career Webinar Series Sponsors and Supporters for 2023! Sponsors

Supporters

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OT Week 2023 wrap-up OT Week 2023 ran from 23-29 October, coinciding with World Occupational Therapy Day on 27 October. OT Week is an annual celebration of all things occupational therapy, shining a light on the important work of OTs. This year’s OT Week theme was Unity Through Community, recognising the vital and dynamic role OTs play in helping people engage with and participate in their community – in whichever way is meaningful to them. During OT Week, OTA hosted two webinars with special guest speakers. ABC News Breakfast journalist Charles shared his inspirational story about how occupational therapy impacted his life, helped him build his community and is allowing him to change the perception of people living with a disability following a life-changing motorcycle accident in 2010. OT Georgie Gott’s work is influenced by her experience of living with a disability. Georgie experienced an illness as a young child resulting in lower limb paralysis with ongoing mobility issues. Georgie’s experience with OTs inspired her to choose a career in OT and she shared her story with us. OT teams across Australia celebrated by hosting events, displaying our OT Week social tiles and poster, and sharing what Unity Through Community means to them. These are photos from just some of the many events that took place across the country.

Georgie Gott 16 otaus.com.au

Charles Brice

OT Week Student Conference at Ch

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OT Week Quiz Night in Perth hosted by Occupational Therapy Australia and OT Services Group

harles Sturt University, NSW OT Week celebration at Sydney University

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OT Week 2023 wrap-up OT Week celebration at Latrobe University, Victoria

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OT Week celebration at Flinders University, South Australia

Playsense Occupational Therapy’s OT Week photo wall

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Building a workplace culture of occupation-based practice in a tertiary health service Jennifer Wort, Matthew Thorpe, Zoe Ellis, Danielle Hitch, Karen Kessner and Sue Giles

ccupation is the foundation of our profession’s unique expertise and contribution to care. Despite the challenges of the past three years, the profession has continued to support “the right of all people to engage in the occupations they need to survive … and that contribute positively to their own wellbeing and the wellbeing of the communities”1. The key to our ability to uphold these rights for our consumers is our commitment to occupation-based practice.

However, it can be difficult in practice to enact our fundamental values and principles, and long acknowledged barriers to occupation-based practice cause both frustration for therapists and suboptimal outcomes for our consumers2. The importance of occupation-based practice is especially urgent in tertiary care settings, as occupational therapy is the only health profession focused on occupation in relation to the person and their environment. However, the fast-paced and medicaloriented nature often leaves therapists providing reductionist or abbreviated services. This disconnect between our ambitions and realities potentially distresses staff, impacting recruitment and retention. For more than a decade, the Occupational Therapy department of Western Health in Melbourne has worked to sustain a culture of occupation-based practice by developing strategies that ensure occupation remains at the centre of everything we do. This commitment to occupation-based practice has informed the culture of the 20 otaus.com.au

department, and data from internal focus groups suggests it has contributed to the engagement and retention of staff. By sharing our strategy, we hope to provide colleagues around Australia with examples to draw upon in their own practice.

Why occupation-based practice?

In the Australian context, Di Tomasso et al characterised occupation-based practice as having “occupation as the foundation within the assessment, intervention and evaluation phases of the occupational therapy process”3. A key characteristic of occupation-based practice is its deep integration or embedding within daily practice, which is combined with accountability or governance processes that allow us to remain ‘true’ to its espoused values. Consistent evidence of its presence should be explicit within professional documentation, and in the language used by OTs with their colleagues and consumers. Explicitly enacting occupation-based practice can enable opportunities for consumers to engage in authentic occupations, which enhance their engagement in therapeutic processes4. It can also help to identify instances of ‘gap filling’, where OTs take on generic tasks and roles that don’t make the best of their unique skills and abilities. Greater clarity around what is and isn’t within the scope of OTs can prevent the dilution of their contribution to tertiary healthcare, enable clinicians to work more effectively at the top of their scope5 and have a positive influence on recruitment, retention and workplace wellbeing.

Our occupation-based strategy

Western Health is committed to empowering and supporting our clinicians to be occupation-based practitioners. To act on this commitment, the following multidimensional strategy was developed from Wilcock’s dimensions of ‘doing, being, becoming, and belonging’6, supported by our Senior Leadership Team and the Culture Committee. The strategy was also founded on the Sustainability Wheel7, which is an evidence-based assessment tool for embedding sustainability into process. The strategy aims to clearly communicate the unique contribution of occupational therapy to care, and counter frequently heard claims that it was “just like physio” or “just common sense”. Doing occupation-based practice The Sustainability Wheel7 provided a framework for developing occupationbased practice activities within Western Health. There are four elements to the wheel – fostering commitment, clarifying expectations, building momentum for change and instilling capacity for change. Existing activities were mapped to each element, along with gaps in the current approach that required further development. Using this tool, it became apparent to the team that doing occupation-based practice involves operating within four interdependent domains: Education, Communication, Demonstration and Evaluation. As shown above in Figure 1, Western Health now has specific strategies and tools to enable doing across all areas of our service.

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EDUCATION Purpose: To establish occupational identity with occupational therapists, colleagues and community. • Story telling via case studies • Promotion of self as occupational beings • Regular review of practice methods • Consulting with experts for professional development • Seeking opportunities for public communication to promote occupation-based practice outside of Western Health (i.e., conference presentations, articles) • Journal club • Internal Occupational Therapy newsletter

COMMUNICATION Purpose: To record and provide tangible evidence of occupation-based practice. • Timely and clear records of all occupational therapy activities • Formalised policies and procedures (e.g., prompt in supervision tool, documentation) • Biennial documentation audits of occupational language • Occupation-based practice embedded within business plan directives • Departmental branding with a logo

DEMONSTRATION Purpose: To provide tangible examples of the occupation-based practice strategy. • Explicit presence in competencies, supervision, recruitment and leadership initiatives • Active participation in Allied Health research, quality and innovation opportunities • Communicating occupational therapy roles appropriately to various audiences • Monitoring perception of occupational therapy within team meetings and multidisciplinary contexts • Culture committee developments • Living and breathing vision statements

EVALUATION Purpose: To instil the Reflection, Action and Evaluation spiral within the occupation-based practice strategy. • Use of occupation-based outcome measures over time to measure change • Benchmarking against other tertiary health services • Multiple supports for reflective practice • Action plans based on past initiatives and learning • Staff and student satisfaction surveys • Implementation of observed practice

Figure 1: Doing Occupation-Based Practice at Western Health

These strategies and associated tools enable the review and refinement of practice using formal and informal channels. They also promote innovation that aligns with occupation-based practice and culture. For example, ‘scripts’ were developed to consistently guide the documentation of occupation-based clinical reasoning and expertise. Western Health also uses observed practice for peer evaluation and support, providing opportunities for demonstration of the application of occupational therapy values to daily practice. Being an occupation-based practitioner Being an occupation-based practitioner means staying true to our values as OTs and adhering to the following non-negotiable principles (see Figure 2 on next page). These values were identified through much work, discussion, and reflection within all cohort areas, across the care continuum. Constant reflection on these nonnegotiables occurs through multiple avenues including orientation, culture committee

activities, celebratory events, professional development, and supervision. An example of these iterative opportunities includes explicit prompts for the discussion of values and culture within initiatives such as buddy programs and professional development. Becoming an occupation-based service For occupation-based practice to become ‘just how we do things around here’, the implementation of this strategy has helped to develop a sustainable, embedded culture. A key aspect of becoming an occupationbased service has been supporting OTs throughout the organisation to stand their ground around our non-negotiables. This is particularly important to reduce the tendency for OTs to be seen as ‘jacks of all trade’ and be asked to fill gaps in service provision with support that could be offered by multidisciplinary colleagues. Our OTs can now recognise and clearly articulate their expertise and value and feel less pressure to do generic tasks just to be helpful.

Four critical factors have guided our implementation of this strategy: vision, leadership, ownership and structures, procedures, and tools. This strategy has been enacted in a number of ways, many of which address multiple factors. One example was the establishment of a culture committee comprised of staff from all clinical areas to explicitly champion occupation-based practice. Amongst other achievements, the committee has implemented processes and expectations related to the sharing of patient stories. These stories challenge and illuminate practice norms, both to spark inspiration and enable peer learning. This approach has been embedded into procedures through the presence of clinical storytelling as a standing item in meeting agendas. The committee has also facilitated regular occupation-based practice forums, led initiatives to explicitly recognise best occupation-based practice through acknowledgements and awards, and identified opportunities to publish and share our organisational strategy more broadly (including this article). CONNECTIONS SUMMER 2023 21

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Building a workplace culture of occupationbased practice in a tertiary health service An investment in professional identity. The occupation-based practice strategy continues to evolve in response to the ever-changing demands of the health, community, and socio-political context in which we practice. What has not changed; however, is our commitment to embed occupation-based practice aligned with our core professional values and nonnegotiables into everything we do. Developing and maintaining this approach has enabled positive changes for both our patients and staff. The development of the strategy and its associated tools and resources has been a massive undertaking for the entire workforce, but there is no doubt that our investment in occupationbased practice is paying off. Our colleagues now have a better understanding of the value of occupational therapy, and our clinicians report greater confidence, satisfaction and clarity around explaining their role to others. All of which leads to a happier workforce, more effective service, and better outcomes for our patients.

About the Authors

Jennifer Wort: Formerly a Grade 3 Occupational Therapist for Acute Care Matthew Thorpe: Current manager of Western Health Occupational Therapy service Zoe Ellis: Grade 3 Occupational Therapist for Inpatient Aged Care Danielle Hitch: Senior Research Fellow with Deakin University and Western Health Karen Kessner: Formerly a Grade 3 Occupational Therapist for Inpatient Aged Care Sue Giles: Former manager of Western Health Occupational Therapy service

References can be viewed by scanning the QR code

Belonging as an occupation-based service The occupation-based strategy at Western Health shows it is possible within a fast-paced tertiary health service to ensure occupationbased practice is embedded in service delivery and service planning and delivers improved outcomes to patients and staff alike. Our service belongs to a community with one of the fastest growing populations in the country, with associated high demand for access and flow, and the multiple challenges of low socioeconomic status and significant resource constraints. Maintaining an occupation-based focus helps us to belong to our community, as we offer personalised and culturally appropriate assessments and interventions that make a real difference in daily life. 22 otaus.com.au

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Figure 2: Occupational Therapy Non-Negotiables at Western Health

SAVE THE DATE OT MENTAL HEALTH FORUM

EMPOWERING MINDS TRANSFORMING LIVES 28-29 NOVEMBER 2024

MELBOURNE CONVENTION AND EXHIBITION CENTRE We’re excited to announce the OT Mental Health Forum will be held 28-29 November 2024 at the Melbourne Convention and Exhibition Centre. The Mental Health Forum is an opportunity for OTs to come together and exchange ideas, share practices and challenges, network and learn from an exciting array of current OT mental health practice and research activity, all while earning CPD hours. The two-day program will offer an extensive selection of plenary sessions, concurrent sessions, workshops, occupation stations, as well as opportunities to meet with exhibitors and view the latest products and services available. Registrations Registrations will open in mid-2024 with early bird prices available. OTA members will have access to discounted pricing, as well as a limited-time member special price. Interested in presenting at the Mental Health Forum? The call for presentations will open in February 2024 – stay tuned for more information coming soon.

www.otausevents.com.au/mentalhealthforum2024

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Looking ahead to the OT Exchange 2024

head of the OT Exchange 2024 being held in Perth from 13-14 June, we spoke to co-convenors Kathleen Langford and Lisa Cooper about what you can look forward to at the event and how to make the most of your time in WA. Registrations for OTX2024 will open on 1 February 2024. Discounted prices will be available to OTA members, as well as special early bird rates. Discounted Perth accommodation and tour bookings are available now. Visit https://www.otausevents.com.au/ otexchange2024/ for more information.

Kathleen Langford

Lisa Cooper

What differentiates the OT Exchange from other conference events?

Kings Park and Botanic Garden

Kathleen: This is not an academic conference, but a conference for clinicians who work hard and strive to continually improve their skills and clinical outcomes for their consumers. There will be an array of hands-on workshops, occupation stations and ‘Pitch It’ presentations, which will provide loads of practical and real-world approaches to feast upon.

differently for greater client outcomes, and to ensure we are staying fresh and relevant in our skills – while earning CPD hours too. Visiting Western Australia is also a perfect opportunity to plan a holiday to recharge – and get a selfie with a quokka!

Lisa: OTX2024 is also a unique opportunity to bring together all fields of OT – from clinicians to academics, students to experts – to create a collaborative and creative space ensuring OT continues to be responsive and relevant now and in the future.

What kind of OTs will benefit from OTX2024?

What are you most looking forward to about OTX2024?

Why should OTs attend the OT Exchange 2024?

Kathleen: The conference represents a fantastic opportunity to “down tools” and reconnect with our profession. It’s an opportunity to see and hear about the work others are doing in our field, and to feel inspired by these innovative ideas. Attending this conference provides opportunities to network with other members and make connections within your practice areas that will support you into the future. And it must be said that Western Australia is a fabulous place to visit – the sun, sea and surf are at our doorstep! Lisa: OTX2024 is a wonderful opportunity for OTs to pause, reflect and share with others all the amazing work that is being done every day, across the diverse profession! In the rapidly changing healthcare landscape of technology and AI, be inspired by handson workshops, stories of lived experience and conversations with experts and peers. The conference shines the light on how OTs are embracing change and innovation – inspiring us to think, create and do things

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is also designed to spark collaboration between practitioners, students, managers, creators, suppliers, educators and academics in the pursuit of innovative practice and OT advancement. The five key practice areas – Knowledge Translation, Paediatrics, Older Persons, Disability and Emerging & Innovative Practices – are broad to ensure relevance for all OTs!

Kathleen: OTs at any stage in their career will find benefit in this conference – the clinical practice areas are diverse and within each a stimulating array of topics will be presented. Given the innovation lens of this conference, OTs with new ideas, products or an entrepreneurial spirit will find it highly beneficial. Lisa: All OTs should attend – from students to experts in the profession. The program is hands-on and clinically focused, but

Kathleen: I’m looking forward to connecting with colleagues past and present, as well as making new friends in the OT world. I love the feeling of sitting back and being emersed in the world of OT, which for me is more than just a job. We are ensuring all our clinicians are able to attend this conference, so they can feel the benefits of it being held in Perth this year. I’m also excited to tell others more about the niche work we do at Inside Out OT Group in Perth.

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The conference shines the light on how OTs are embracing change and innovation – inspiring us to think, create and do things differently for greater client outcomes, and to ensure we are staying fresh and relevant in our skills. Lisa: I’m also really looking forward to stopping and connecting with the wider OT community – reconnecting with old colleagues and creating new connections. I’m really excited by the creative and inspiring energy this conference promises. Listening to stories, hearing ideas, trying out new products and being inspired to continually adapt and evolve our services at Inside Out to ensure best practice both now and for the future.

What is unique about OT in WA compared to other parts of Australia?

Kathleen: We practice within a highly isolated part of the world; however, we don’t let that stop us connecting with the rest of the world and implementing fantastic and cutting-edge programs. We have to be “noisy” at times to be remembered and prioritised by international speakers to ensure training is also held in our state. Historically, we only had one university providing occupational therapy training for our state with a small intake. As such, we are a small but proud bunch, and have seen dramatic changes through the expansion of tertiary pathways for OT and graduates. Lisa: WA’s size and location make it a unique area to practise in – not only in Australia but the world. Digital strategies and innovative care are highly prioritised to ensure connectivity and accessibility for people and communities across our vast state.

Rottnest Island

Where else should delegates visit while they’re in WA for the conference?

Kathleen: Those visiting from interstate and overseas should book an early ferry ride to Rottnest Island, hire a bike and enjoy a cold beverage at the Rottnest Pub. A stroll through Fremantle is always beautiful, as well as catching a boat from the Barrack St Jetty to Fremantle to see Perth by the river. Additionally, a trip to the Swan Valley (east of Perth) is lovely for some winery time. It’s also great to visit Cottesloe beach and have fish and chips while watching the sun set. Lisa: Perth Convention & Exhibition Centre (PCEC) is in the heart of our beautiful city. It’s walking distance to lots of fabulous small bars and restaurants and the CBD shopping precinct. For outdoor and nature lovers, PCEC is located on our beautiful Swan River. The ‘bridges walk’ is a must for the fitness enthusiast and PCEC is only a ten-minute walk to the biggest innercity park in the world, Kings Park and Botanical Gardens. June is dry season up north and the perfect month to visit the majestic landscapes, waters, gorges and canyons of Kalbarri, Monkey Mia, the Ningaloo (Coral Bay, Exmouth) and of course the majestic Kimberley and Broome. If time is limited, use the weekend to explore Perth or hire a car and head to the Margaret River region – beautiful beaches, vineyards and a spot of whale watching!

What’s your favourite benefit of belonging to OTA and why?

Kathleen: I really value the professional support. As a business owner, I find the support for practice ownership matters, including insurance, legal advice and advocacy is essential. I also value the mental health endorsement program and the associated lobbying OTA do to ensure our role and needs as a profession are heard by governments and policy makers. Lisa: I really value the advocacy role of OTA – ensuring that OTs have a voice across the wider health landscape, and we are at the table when important decisions are being made. The power of OTA’s advocacy and lobbying ultimately means more clients can access much needed evidence-based OT services across private, non for profit and government sectors. I also highly value the mental health endorsement program. When we started Inside Out OT ten years ago, limited OT positions existed within the child and adolescent mental health space in WA. The program allowed for us to be creative and innovative in our clinical model so that children, adolescents and their families were able to access much needed mental health OT support in a responsive and holistic way.

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Conversations That Matter: Assistive technology and occupational therapy

Sharing suggestions from OTA’s National Conference, Cairns 2023 Australian Rehabilitation and Assistive Technology Association (ARATA)

ccupational therapy encompasses the most extensive scope of practice among professions working with assistive products, with OTs focusing on the foundational concepts for utilising assistive technology (AT) as a means to enhance participation (Layton et al., 2023). This article shares findings from the ‘Conversations That Matter’ session hosted by the Australian Rehabilitation and Assistive Technology Association (ARATA)1 at the Occupational Therapy Australia 30th National Conference & Exhibition in Cairns in June 2023. This ‘conversation’ was structured to draw on two important AT reports released in 2022: 1) The Global Alliance of Assistive Technology Organizations’ (GAATO) Assistive Technology Outcomes and Impact: A Global Grand Challenge Report (GAATO, 2022), and 2) The inaugural World Health Organisation (WHO)/United Nations Children’s Fund (UNICEF) Global Report on Assistive Technology (WHO & UNICEF, 2022). An online resource was also developed for the session, which provided ready access to these two open-access reports as well as links to various AT models of practice and outcome measurement tools. This resource is available at https://bit.ly/3oVhdQO. 1

Australia Rehabilitation and Assistive Technology Association (ARATA) - https://www.arata.org.au/

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Figure 1. GAATO Outcomes and Impacts Model (GAATO, 2022)

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The Grand Challenges in AT Outcomes

GAATO, 2022 suggest that AT stakeholders, including OTs, ought to measure need; document all inputs in an AT provision process; and measure valued outcomes, including those of consumers. Further, it is essential to measure broad impacts, for example, downstream influences on family and community. To enhance access to AT for users everywhere, sharing data and informing policy are also vital steps to consider. See Figure 1.

The WHO/UNICEF Global Report on AT

These challenges are highlighted in the WHO/UNICEF Global Report on AT, which presents a path for global AT action by outlining ten recommendations. This report underscores the importance of adopting ‘people-centred, collaborative and multisectoral actions to make access to assistive technology a reality for all those in need’ (WHO & UNICEF, 2022, p. vii).

Figure 2. Photo of ARATA Board Members presenting to session attendees

Recommendation 2: Ensure that assistive products are safe, effective and affordable. Recommendation 4: Actively involve users of assistive technology and their families. Recommendation 5: Increase public awareness and combat stigma. Recommendation 8: Develop and invest in enabling environments. Recommendation 3: Enlarge, diversify and improve workforce capacity. Recommendation 1: Improve access to assistive technology within all key development sectors. Recommendation 6: Invest in data and evidence-based policy. Recommendation 7: Invest in research, innovation and an enabling ecosystem. Recommendation 10: Provide technical and economic assistance through international cooperation to support national efforts. Recommendation 9: Include assistive technology in humanitarian responses.

Figure 3. Ranking by Conversation participants of the WHO/UNICEF Global Report on AT recommendations, in order of the perceived relevance to occupational therapy CONNECTIONS SUMMER 2023 27

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Conversations That Matter: Assistive technology and occupational therapy Hosting the ‘Conversations That Matter’ session

Against this backdrop, an interactive ‘Conversations That Matter’ session hosted by ARATA Board Members (see Figure 2), using participant polling via Mentimeter illustrated with examples asked: I. Which recommendations from the WHO/UNICEF Global Report on AT are most relevant to occupational therapy practice in Australia? II. Among these recommendations, what specific suggestions can be provided to individual OTs and the profession as a whole to drive meaningful change? Of the participants who attended this Conversation, 62 registered to respond in Mentimeter, and 58 (94% of registered respondents) ranked the recommendations in order of the perceived relevance to occupational therapy. See Figure 3 for the polling results.

Exploring the report’s recommendations

After this initial ranking by session attendees, the top-ranked recommendations (see Figure 3) were then explored with session participants using Mentimeter and group ‘conversations’. The aim was to gather examples of occupational therapy principles and/or practices that responded to or enabled each recommendation. Participants provided their suggestions on how OTs - either individually or as part of a professional group - could drive change. The original text was then summarised into key messages by the group facilitators. See Table 1 for the resultant key messages for the top two ranked recommendations. The broad-ranging discussion across these and other recommendations drew together some key principles. These included taking a person-centred approach, embedding user involvement in all steps, enabling access, supporting advocacy, and providing education. An understanding of AT policies and legislation 28 otaus.com.au

Table 1. Key messages summarised from participant suggestions Recommendation 2: Ensure that assistive products are safe, effective, and affordable. • Work within scope: prescribe within knowledge/skills. • Follow guidelines: use a structured assessment and prescription process (e.g., 5-step/good practice guidelines). • Use standardised assessments. • Ensure right product is recommended and fit for purpose. • Perform risk assessments. • Listen to users’ wants and needs. • Consider client’s/user’s available funding or budget. • Don’t use funding to make your decision, use clinical reasoning. • Assess environmental fit. • Collaborate with a specialised team. • Involve all key stakeholders in decision-making. • Schedule follow-up visits post-provision. • Measure outcomes in relation to client/user goals. • Encourage client/user reviews to promote optimal products. • Share relevant equipment standards and unbiased reviews. • Insist on trials and demonstrations. • Consider hiring before purchase. • Engage a helpful equipment supplier and utilise supplier knowledge. • Request a safety statement from suppliers. • Establish competitive buying groups for AT. • Prioritise evidence-based practice. • Conduct research and consult with professionals. • Educate users and providers on AT use and issues. • Implement AT recycling initiatives and have plans/funding for maintenance. • Advocate for training, guidelines, and policy inclusion. • Enforce legislation for mainstream technology accessibility. Recommendation 4: Actively involve users of assistive technology and their families. • • • • • • • • • • • • • • • • • •

Use frameworks and models for guidance. Prioritise client-centred practice and co-design processes. Engage, involve, consult, research, and share information. Enhance communication by asking, listening, advising, and avoiding assumptions. Fund user participation and incorporate user input. Foster a vision of possibilities. Insist on client/user involvement and maintain a record of this. Use user-centred and collaborative assessments, considering all ICF domains, observation, and activity analysis. Focus discussions on client-identified needs, provide education and options, ensuring client choice and control. Involve clients/users and their families in planning and design. Include all relevant parties in problem and solution discussions. Educate family members on AT usage and conduct trials in various settings with input from all involved parties. Provide physical spaces for AT users to share expertise and equipment. Provide accessible support and normalise AT use. Encourage non-judgmental responses to other AT users. Actively seek feedback from clients/users and their families. Evaluate user experiences and measure outcomes with users. Allocate sufficient time and funding for OTs to assess and follow up properly with clients/users.

F E AT U R E

Given the profession’s innate expertise in person-centred practice, OTs play a vital role in the effective implementation of these recommendations. was also identified as critically important for the assessment, supply, customisation and/or revisions of AT over time.

Relevance to occupational therapy knowledge and practice

The WHO/UNICEF recommendations (WHO & UNICEF, 2022), designed to improve access to AT, hold significant relevance for the occupational therapy profession. The GAATO Assistive Technology Outcomes and Impact Model (GAATO, 2022) offers an additional focus on approaches to measure outcomes and impacts for AT advisors, including OTs. By engaging in a ‘Conversations That Matter’ session with OTs who practice, research and/or educate in the field of AT – employing group consensus-building techniques – future directions and suggestions have been made by the profession to support the actioning of these global AT recommendations in Australia. Many of the suggestions reflect the commitment of OTs to enable meaningful participation and enhance the lives of individuals and communities. The WHO/UNICEF Global Report on AT highlights that achieving universal access to AT requires collaborative efforts across diverse stakeholders (WHO & UNICEF, 2022). For OTs, this means actively involving users and their families in the decision-making process, promoting awareness, empowering users, and connecting them with good AT advice and provision principles, and supporting outcome measurement and other research to continually improve AT solutions. Moreover, in advocating with AT users, OTs and our national professional bodies can seek to influence policy and coordinate efforts with local and national governments, in alignment with the WHO/UNICEF report’s recommendations. Given the profession’s innate expertise in person-centred practice, OTs play a vital role in the effective implementation of these recommendations. By embracing innovation and collaboration and ensuring that environments are accessible to and enabling for all users, the profession can significantly contribute to nurturing a more inclusive AT ecosystem. Overall, these profession-made suggestions enable a conversation that matters. They do this by offering one contribution to a roadmap for the occupational therapy profession to further our mission of enhancing individuals’ access to and utilisation of assistive technology, ultimately improving occupational performance and quality of life.

About the Authors

The authors are Voluntary Board Members of the Australian Rehabilitation and Assistive Technology Association (ARATA) and a dedicated volunteer who participated in the “Conversations that Matter” session at the OTA Conference. ARATA is a national peak body for assistive technology stakeholders with an overarching mission to build and sustain an inclusive assistive technology community of practice. ARATA collaborates regularly with Occupational Therapy Australia, including within the National Assistive Technology Alliance, which is chaired by ARATA - see https://www.arata.org.au/access-&funding/towards-a-national-assistive-technology-alliance/

References and author details can be viewed by scanning the QR code

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F E AT U R E

Understanding Personal Accident insurance Aon Why might you need Personal Accident insurance?

Have you thought about what would happen if you were unable to work due to an injury or sickness? Although you must face this possibility when working or running a business, the financial stress that can come with an unexpected injury or sickness may be eased with the right type of insurance. Personal Accident insurance is designed to help relieve financial pressure if you were to suffer an injury from an accident, or a serious illness which prevents you from being able to work or run your business. Many Australians have been impacted by the cost of living, but as a business owner, sole trader or independent contractor, you’re especially vulnerable to financial strain if you’re unable to work because your business operations and income may cease. To help protect your business and livelihood against unexpected injury or sickness that prevent you from working, you can consider taking out Individual Personal Accident Insurance. It’s an insurance policy designed to enable you to continue to afford to look after yourself and your family whilst you focus on getting better.

Personal Accident insurance can include the option to:

• Get cover for 24 hours a day/seven days a week or limit your cover to work hours or outside of work hours only. • Include cover for accidental death, sickness or injury. • Add cover for business expenses. • Add sums insured for weekly benefits. • Adjust the time excess period on the policy.1

In the event of an insured accidental injury, including where you become temporarily or permanently disabled to the extent that you cannot engage in your usual occupation or business duties, Personal Accident policies can help provide a lump sum payment or weekly benefit to help give you the financial support you may need. The lump sum payments under a Personal Accident policy usually pay a fixed amount of money for specified injury or sickness.

Key differences between Personal Accident and Income Protection Insurance

Both Personal Accident and Income Protection insurance are intended to help provide financial benefits due to an insured injury or sickness that results in you being unable to work. While it may seem like Personal Accident insurance and Income Protection are very similar policies, there are some differences which are worth understanding.

Differences in cover

Personal Accident insurance may offer the option to include a death component in addition to various other types of insured injuries, while Income Protection on the other hand is intended purely for loss of income because of an insured injury or sickness. Personal Accident cover is usually a generic policy with standard levels of cover available, whereas Income Protection may offer more flexibility and options under the benefits of the policy and may include a broader definition of sickness and benefits payable. A Personal Accident policy will only cover you for accidental bodily injury or a

30 otaus.com.au

sickness up to an agreed benefit period (typically between two to five years), whereas an Income Protection policy may offer more flexibility to tailor the benefit period to your needs. As such, Income Protection typically may be more expensive than a Personal Accident policy.

Differences in benefit payment

There may also be a difference in how the benefits are typically paid. Income Protection generally covers your lost income in instalments, rather than lump sum payments. For example, it may cover up to a percentage of your usual income in the event of an injury or illness in instalments. Personal Accident insurance policies on the other hand typically provide lump sum payments or weekly payments for insured accidental injuries, as well as lump sum options if you pass away due to the covered injury in question.

Difference in how to get insured

Another difference between the Personal Accident and Income Protection is how they’re issued. Personal Accident policies are underwritten by general insurance companies and are mostly available through insurance brokers or direct purchases. Income Protection on the other hand is usually underwritten by life insurance companies.

Difference in cost

Generally, Income Protection policies provide broader coverage and so is expected to be more expensive when compared to a Personal Accident policy with similar sums insured under the weekly benefit or income protection coverage.

F E AT U R E

Do I need both Personal Accident and Income Protection?

Because both policies cover similar events, it is unlikely you would need to take out both. What’s more, if you did happen to suffer an injury or sickness, it is unlikely you would be able to claim on both policies, as many insurance policies may not cover you for an event if you have already claimed under another policy. That’s why it’s important to ensure you take the time to understand the difference between Income Protection and Personal Accident insurance, and make a decision based on your individual circumstances.

How is Personal Accident different from Workers’ Compensation?

While Personal Accident insurance is designed to protect business owners, sole traders and selfemployed professionals, Workers’ Compensation is intended to protect your employees. Typically, Workers’ Compensation only covers claims involving employees’ work-related injuries whereas Personal Accident policies can include the option to extend the policy beyond your working hours. It’s important to understand that Workers’ Compensation may not cover you as a business owner (although there are some exceptions) and is not required if you do not have any employees. Under Australian law, employers must have insurance to cover their workers in case they get sick or injured because of work.² Workers’ Compensation is a type of insurance that can meets these legal requirements. Everyone’s individual needs and personal circumstances are different, and that’s why it’s important to get the right insurance policy to suit your business needs. If you would like to know more about Personal Accident Insurance³, you can contact Aon’s insurance specialist team on 1300 836 028.

Vale Wilma Wheatland From Lin Oke, Dianne Tribe and Ralda Bourne For over 30 years (1960s – 1990s), Wilma Wheatland was the secretary for what was then the Victorian Association of Occupational Therapy (VAOT). She worked 15 hours a week and was a pioneer in working from home, as the third bedroom in her family home in Oakleigh South was the VAOT office. Over this extensive time frame when the executive committee, of what was then the Australian Occupational Therapy Association (AAOT), was based in Melbourne, Wilma took on extra hours and was also the AAOT secretary at the same time. This was the era when the AAOT was managed by three volunteer members nominated by the state association, as every three years it was rotated between NSW and Victoria and other states at a later stage. AAOT was permanently located in Victoria and purchased their own office after the 1990 World OT Congress, which Australia hosted. Wilma was a marvel at shorthand, and it was a delight to sit next to her at meetings and watch her create “hieroglyphs” from the discussions and debates around her and then magically type them up into minutes, which were then of course posted out, as it was a non-internet era. She had a very calm, steady manner about her, and Wilma was able to charm members she telephoned to persuade them on how helpful it would be if they joined a new working party of a specific topic or a committee. Wilma was regarded as the most professional, confidential and unflappable secretary. She was greatly valued and respected by all who worked with her in the association over the decades. For her retirement party, the VAOT president Richard Howard created a song for her: ‘We Still Call Wilma at Home’, based on the Peter Allen song ‘I Still Call Australia Home’, because VAOT’s phone number was our lifeline to Wilma and so we did call Wilma at home or left her a message, if after hours on the answering machine, and she would always phone back the next morning. Farewell Wilma and thank you.

1. Time excess period means the period of time following an Event giving rise to a claim for which no benefits are payable 2. Work Safe Australia, Workers’ Compensation, https://www. safeworkaustralia.gov.au/workers-compensation 3. Subject to the policy terms, conditions and exclusions.

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F E AT U R E

Vale Cecilie Bearup From Professor Angela Berndt and Susan Gilbert-Hunt

Vale Penelope Coombes Adapted from Warwick Coombes

Ms Cecilie Bearup was born on Wattle Day, 1927. Her early life was spent in Melbourne and Sydney and although she was accepted into medicine, she chose to complete a Certificate in Librarianship, finding employment in the library of the Sydney Morning Herald.

Penelope Audrey Coombes, née Alexander, died on 23 September 2022, a few weeks short of her 82nd birthday. She was a force of nature who saw blue sky through every grey cloud.

In 1946, the family moved to London and Cecilie took up an office job that she did not enjoy. This prompted her to investigate studying occupational therapy, something she had heard about from a friend who was one of the first Sydney graduates.

After she gained her Diploma in Occupational Therapy, the highest OT qualification then available in Australia, she worked at the Royal Alexandra and the Royal North Shore hospitals before winning a US Fulbright postgraduate scholarship. In 1967, this took her to the Rancho Los Amigos National Rehabilitation Centre, a Californian teaching hospital for the Harvard Medical School, where the complex needs of Vietnam war-wounded veterans were forging a change of scope and new OT solutions.

Cecile was one of 70 students to commence training at the London School in 1949. She loved being a student and did an exchange with Tufts University, Boston. This cemented her interest in America. Following graduation, she spent ten years working in England and USA. Cecilie returned to Australia with her parents and settled in Adelaide. She was appointed Head OT at Glenside Hospital and founded South Australia’s Aid to the Mentally Ill – a sheltered workshop. There were about seven OTs in Adelaide; they became a close group who successfully lobbied for the establishment of a much-needed School of Occupational Therapy. In 1971, Cecilie was appointed the first Senior Lecturer. She was also instrumental in the establishment of the SA Occupational Therapy Association and State Registration. Her contribution to the profession was recognised in 1982 via the Sylvia Docker Lectureship and in 1985 she was awarded an OAM for services to occupational therapy education and to the community. She was a founding member of the Adelaide Committee of University of the Third Age. Upon retirement Cecilie completed a Research Master of Arts at Flinders University and was an active artist, regularly exhibiting her work at local venues. Cecilie loved people and Scottie dogs and had many of both in her life. Professor Esther May, a graduate of the 1978 cohort of OTs, says that Cecilie Bearup was an incredible innovator with a vision of growing occupational therapy in South Australia. She set about advocating for a School of Occupational Therapy in South Australia, won that battle and headed up the inaugural school in with compassion, leadership and a kind and determined attitude. We, who had the pleasure of having Ms Bearup as our leader and mentor, credit her with helping to build our values, skills and capabilities as OTs. She gave all South Australian occupational graduates the beginnings of what has become a solid and empowering profession that we all love so much. 32 otaus.com.au

Back in Sydney in 1968, Penny became head of the OT Department at the Royal Prince Alfred Hospital, leading to major changes for patients, training and research. In 1974 Penny was appointed the Foundation Head of the School of Occupational Therapy at Cumberland College of Health Sciences (now part of Sydney University) and oversaw the introduction of the first Occupational Therapy degree course in NSW. The new curriculum was imaginative, broadening the scope of OT, giving it relevance across many disciplines. Penny used a WHO Fellowship in 1976 to study medical decision-making at Michigan State University, the WHO invited her to establish OT training in Hong Kong, and in her ‘spare time’ she commenced studying for a Master’s Degree, which she was awarded by the University of NSW in 1981. After Penny and her husband Warwick moved to an apartment in Sydney’s city centre she established a consultancy, The People for Places and Spaces (PPS) in 1983. PPS would advise planners on how to successfully revitalise public spaces through dialogue with those who lived, worked and visited there. Penny’s friends and colleagues remember her effervescent vision and her ability to find the best in people. Penny is survived by Warwick, brothers Peter and Tim and sister, Victoria, and their families, and by a cavalcade of dear colleagues and friends.

F E AT U R E

Three HR hotspots when managing employee leave in your OT practice WorkPlacePLUS Practice owners and their staff each have rules to follow regarding employee leave:

• Practice owners must follow the applicable rules and obligations outlined in the Health Professionals and Support Services (HPSS) Award, the National Employment Standards (NES) and the Fair Work Act. • Employees must follow the applicable rules and obligations outlined in the HPSS Award, the practice’s workplace policies and the employment contract. This article focuses on some key HR hotspots regarding paid annual leave and unpaid parental leave.

Hotspot 1: Closing your practice over Christmas

If you plan to close your practice over the Christmas holidays, this becomes a compulsory shutdown period for your staff. You must provide your staff with at least 1-2 months’ reasonable notice of any compulsory shutdown period, and this should include directions to take a period of paid annual leave during the shutdown. The exception to this rule is when you already have a clause in the employment contract indicating that your practice has a compulsory shutdown period over the Christmas holidays. However, it’s still best practice to provide a written reminder 1-2 months prior. Practice owners are required to provide notice and consultation to affected

employees before implementing compulsory workplace shutdowns. If an employee does not have enough accrued annual leave to cover your compulsory shutdown period, they may agree in writing to take leave without pay (leave in advance can be agreed but it’s not best practice), but you cannot direct them to take leave without pay. If the employee does not agree, they may be entitled to wages during the shutdown period.

Hotspot 2: Excessive annual leave balances

Annual leave is an entitlement for employees that is to be taken regularly to ensure they have appropriate down time and can

relax. Not taking accrued annual leave can be hazardous to the health and safety of employees. Excessive accrued annual leave balances can also represent a significant financial liability for practice owners. General options for managing excessive annual leave balances include: • Compulsory shutdown period: you can require your staff to take annual leave during quiet periods such as over Christmas (see HR Hotspot 1) • Direction to take leave: If an employee has accrued an excessive amount of leave, it is considered “reasonable” to direct them to take annual leave. While the Fair Work Act doesn’t define how much leave is CONNECTIONS SUMMER 2023 33

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“excessive”, greater than four weeks can be used as a general guide. The HPSS Award also allows practice owners to direct their employees to take paid annual leave; however, it’s important to note that there is a process that must be followed. • Cashing out of leave: Employers can cash out some of an employee’s leave balance, but only if the employee agrees to it. The agreement must be in writing and the employee can’t be left with a leave balance of less than four weeks. Staff employed under a registered award or agreement can only cash out a maximum two weeks’ leave every 12 months. Cashing out of leave is not applicable to practices or organisations that do not have an EBA or agreement in place that allows this to occur. • Requiring employees to use leave within a certain period: Some employers ask their staff to use their leave in the same year they accrue it, by stating in their policy that if an employee builds up a certain amount of leave, they must talk with their manager about a mutually convenient time to take it. Such policies may “encourage” staff to take leave, but these can’t be legally enforced unless the requirement is deemed “reasonable”. Accrued leave can’t be lost just because an employee hasn’t used it within the stipulated time. An employee who doesn’t comply with the leave policy is still entitled to accrue leave and have it paid out on termination.

Hotspot 3: Unpaid Parental Leave

Under the Fair Work Act 2009, employees (including regular casual employees) who have worked with their employer for at least 12 months can take unpaid parental leave when they or their partner are to give birth or adopt a child, or if they experience stillbirth premature birth, or the death of a child. Effective 6 June 2023, under the Secure Jobs Better Pay Act 2022, there are changes to how practice owners need to respond to requests for extending unpaid parental leave. Practice owners can: • agree to the request, or • discuss and agree with the employee to a different extension period.

Occupational therapy practices should have an up-to-date workplace policy, which covers all aspects of accessing leave entitlements. Best practice tip: Have a policy and keep a leave planner

It is advisable for practice owners to have systems and processes in place to plan and manage employee leave. Importantly, occupational therapy practices should have an up-to-date workplace policy, which covers all aspects of accessing leave entitlements including compulsory workplace shutdowns, directing an employee to take leave, and requesting an extension to unpaid parental leave. Employees must request in writing to take annual leave before going on leave. The request process and notice period should be set out in your policies. Practice owners should also review the employee leave provisions in their employment contracts and the HPSS Award on a regular basis, to ensure they are meeting their obligations and keeping up to date with any legislative changes. For more information or assistance with managing employee leave, you can contact the Fair Work Ombudsman or seek advice from an HR consultancy that works closely with the allied health sector such as WorkPlacePLUS. As OTA’s HR/IR partner, WorkPlacePLUS provides support to OTA members on employment matters affecting your practice. For more information, contact Anna Pannuzzo on (03) 9492 0958 or visit www.WorkPlacePLUS.com.au.

These responses must be in writing within 21 days of the request. If a practice owner refuses a request to extend unpaid parental leave, they must: • respond to the request in writing within 21 days • only refuse a request if: – they’ve discussed and genuinely tried to reach an agreement – they’ve considered the consequences of refusing the extension – the refusal is on reasonable business grounds Any employee whose requests have been refused can now seek arbitration of a dispute by the Fair Work Commission.

34 otaus.com.au

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Connections Summer 2023

Articles inside

Three HR hotspots when managing employee leave in your OT practice

Understanding Personal Accident insurance

Conversations That Matter: Assistive technology and occupational therapy

Conversations That Matter: Assistive technology and occupational therapy

Looking ahead to the OT Exchange 2024

SAVE THE DATE

Building a workplace culture of occupation-based practice in a tertiary health service

OT Week 2023 wrap-up

Student Career Webinar Series

2024 Leadership Program

Here’s what participants of the 2023 Leadership Program thought:

OTA’s Leadership Program

A call to action, to be critically reflective of ourselves and our practice

Rehabilitation 2030: Health policy and systems research and occupational therapy

WFOT Update

Quarterly update –Member news

President’s Report

CEO’s Report