An Evaluation of the Prioritisation of Referrals by Leeds Social Services Senior Occupational Therapists

Abstract

Leeds occupational therapy section formally adopted a priority system for referrals in 1989. Written priority guidelines defined three levels of priority: immediate need (P1), urgent need (P2) and non-urgent (P3). Senior occupational therapists assign priority to referrals which they subsequently allocate to field workers. P1 and P2 referrals are visited by occupational therapists and P3 referrals by occupational therapy assistants. This study attempted to discover if the priority assigned by the senior occupational therapists was accurate. The senior occupational therapists were asked to allocate a number of referrals from each priority level to the occupational therapists without indicating what priority they considered the referral to be. The occupational therapists were asked to visit the client and record the priority of the case on the basis of their home assessment, using the written guidelines. The priorities assigned were compared and agreement was measured by use of the kappa statistic. The senior occupational therapists allocated 264 study referrals. Occupational therapist information was gathered on 216 of these. The occupational therapists and senior occupational therapists agreed on 64.4% of the P1s, 40.3% of the P2s and 47.4% of the P3s. The kappa statistics indicate that the level of agreement was poor to fair. Further information should be gathered on those referrals considered to be either P2 or P3 by the senior occupational therapists to allow more accurate prioritisation.