Occupational therapy Workforce Strategy action plan – England

Complicated referral processes and a lack of understanding about what occupational therapy is makes it difficult for people to access the support they need. 

In July 2024, 8,957 adults and 19,070 children and young people were waiting to see an occupational therapist in the community (outside of hospitals). 

While community health services play a critical role in helping people live independently, they account for just 13% of daily NHS activity. 

The average annual leaver rate is 8%, higher than the 6.9% among other allied health professionals. 

This rate differs depending on specialism, employer type and location. 

This happens when systems use occupational therapists to fill gaps in services, rather than make use of their skills. This leads to dissatisfaction and eroding of professional identity and confidence. 

83% of occupational therapists employed by NHS England are white and 90% identify as a woman. The 12-month rolling turnover for international occupational therapists in June 2024 was 19.8% compared with 12.8% for domestic. These figures are consistent with those working in social care. 

The 2024 Labour Government has committed ‘to build an NHS fit for the future’. They’ve set out three strategic shifts to achieve this: 

• Shifting care closer to people’s homes, to improve access to treatment and help delay or prevent severe health issues later in life 
• Moving to a system which emphasises preventing illnesses before they occur  
• Adopting new technologies to improve diagnostics, treatment delivery, and communication across health and social care services. 

To facilitate these shifts, the UK Government has committed to: 

• Use the independent sector to help get waiting lists down 
• Direct a greater proportion of NHS funding towards out-of-hospital care to speed up hospital discharge 
• Reform the NHS to give mental health the same attention and focus as physical health 
• Deliver the NHS England 15-year Long Term Workforce Plan, proposing an estimated 3.4% growth in occupational therapists by 2036/37, with 25-50% of these positions being filled through the degree apprenticeship route by 2031/32
• Boost economic growth by supporting people back to work

In Spring 2025, the UK Government will publish a 10 Year Plan for Health and Care, setting out how this will be delivered. In the longer term, they will undertake a programme of reform to create a National Care Service.  

Our action plan will advocate for the crucial role that occupational therapists can play in achieving these goals. By prioritising prevention and early intervention, occupational therapists help people manage their health and the need for crisis interventions and care services. 

Drive innovation (2024 to 2026) 

• We will use the Innovation Hub to build our knowledge and confidence to drive innovation and demonstrate the impact of OT.   
• We will theme requests for innovation and good practice examples to illustrate diversity of practice. 
• We will create opportunities for funding, mentorship and networking to help innovators turn their ideas into reality. 

Retain upskilled workforce (2024) 

• We will highlight the value and impact of practitioners working at enhanced, advanced and consultant level of practice. 
• We will promote retention of an upskilled workforce, facilitating study at enhanced, advanced and consultant levels.  

Case studies (2024 to 2026) 

• We will collect a range of service and service user case studies. 
• We will promote improvement journeys and the application of impact examples. 

Net zero NHS (2025 to 2026) 

• We will encourage submissions to the Greener Allied Health Professional hub to help deliver a net zero NHS and make our practice more environmentally sustainable.    

Raise the profile of OT (2024 to 2026) 

• We will create resources to help members measure and communicate the value and impact of their practice economically, socially and experientially. 
• We will run a campaign to support members to raise the profile of OT. 
• We will hold a series of profile raising cafés for members to develop their skills in promoting the profession. 

Digital health and care (2024 to 2026) 

• We will map how the OT workforce is working within AI and digital health and care, ensuring OTs are at the forefront of using AI and digital tools to improve their practice. 
• We will monitor growth, regional distribution and demographics of the OT workforce working in AI and digital/informatics roles.
• We will support practitioners to co-design AI and digital health and care tools, sharing examples and best practice with external stakeholders. 
• We will provide resources and deliver workshops to make the workforce more confident using AI. 
• We will bring together leaders across research, business, education and health and social care to expand our understanding of the potential role of OT in AI and digital health.  We will publish a consensus statement. 

Portfolio careers (2025 to 2026) 

• We will hold a workshop to understand the support OT practitioners need to prepare for portfolio careers. 
• We will develop a toolkit for OT practitioners to help them progress their portfolio careers. 
• We will work with our commercial partners and employers to create opportunities for OT practitioners to develop and sustain careers across economic sectors. 

Helping systems position their OT workforce (2024 to 2026) 

• We will create resources to help systems decide how to position their OT workforce – including a data sources repository for building business cases and evidencing impact. 
• We will share guidance to support successful OT business cases and cases for change. We’ll use these examples at a national and regional level to argue for best value positioning of OT services in systems. 

Workforce reform workshops (2024 to 2026) 

• We will co-deliver workforce reform workshops to support and accelerate workforce transformation. These include workshops for independent practice and our role in public health. 

Research and Innovation Strategy (2024 to 2026) 

• We will develop and publish a new Research and Innovation Strategy, enhancing the capacity and capability of the workforce to embrace research and innovation. 

Data improvements (2024 to 2026) 

• We will seek data sharing agreements with the Health and Care Professions Council (HCPC), Skills for Care and NHS England to help us understand the size, distribution, career levels and skills mix of the OT workforce.
• We will collect data through our workforce survey, membership database and workforce maps. 
• We will monitor and raise critical shortages and associated risks in OT with the relevant government, NHS, and social care bodies. 

Workforce reform workshops (2024 to 2026) 

• We will convene a planning group to co-design and co-deliver a series of national (UK-wide) workforce reform workshops to agree effective measurements for the profession. 

Celebration and debate (2024 to 2026) 

• We will share learning, celebrate successes and stimulate debate around workforce opportunities and challenges. 

Prescribing rights (2025 to 2026) 

• With other membership bodies representing AHPs, we will engage with UK Government to advance the case for prescribing rights for the OT workforce. 
• We will develop evidence to support the case to allow occupational therapists in England independent prescribing rights. 

Morale and satisfaction (2024 to 2026) 

• We will work with employers to understand and improve morale, job satisfaction and pride in the workforce. 
• We will support research to understand the factors that affect the workforce’s sense of morale, satisfaction and pride for their practice. 

Pre-registration education (2024 to 2026) 

• We will review our learning and development standards for pre-registration education, expanding them to include early careers. This will help ensure new graduates have the skills and capabilities to excel in an evolving OT practice. 
• We will embed the AHP principles of practice-based learning to ensure the capacity, breadth and quality of placement provision are improved.  
• We will host education summits to gather insights on graduates’ and employers' perceptions of them. This will help us align expectations and improve graduates' transition into the workforce.  

Work-based mentors (2025 to 2026) 

• We will work with employers to spread the adoption of work-based mentors to support the progression of OT practitioners through their career. 

Our academic educator workforce (2024 to 2026) 

• We will work with education providers to understand the current position and needs of our academic educator workforce. We’ll explore the education needs of those registered for longer than five years and identify any gaps. 
• We’ll support education providers to provide high quality education to those on pre and post education programmes. 

The Career Development Framework (2024 to 2026) 

• We will revise the Career Development Framework (CDF) and support members and employers to use the framework to nurture practice at all levels.
• We will develop a strategy to support the learning, development and career growth of our members. 
• We will develop resources to promote the framework. 

Supervision (2024 to 2026) 

• We will update our guidance on supervision and publish resources to support its implementation. 

Workforce survey (2024) 

• We will undertake an inclusive survey of the UK’s OT workforce every three years to give us a deeper understanding of the challenges surrounding retention and career development. 

UNISON (2025 to 2026) 

• We will empower and encourage members to use their UNISON member benefit to make sure they get fairness and equity within the workplace.
• We will share intelligence and raise issues with UNISON on pay, working terms and conditions for the workforce. 

Equity, Diversity and Belonging (2025 to 2026) 

• We will implement our Equity, Diversity and Belonging (EDB) Strategy action plan. 
• We will create peer support opportunities for practitioners recruited internationally on RCOT Communities. 
• We will improve and promote our international recruitment hub for managers and practitioners recruited internationally. 
• We’ll share best practice for integrating practitioners who trained abroad through the Innovation hub. 
• We will research to understand the different approaches to embedding cultural competence across different UK practices. We will share our recommendations across health and social care bodies. 
• We will develop an EDB Strategy from the year 2027 to build on the progress of our current strategy and action plan. 

Workforce planning tools (2024 to 2026) 

• We will publish workforce planning tools for England to give members and systems comprehensive resources to help them make decisions on workforce planning. 

Resources and data (2024 to 2026) 

• We will signpost our members and partners to resources that support access, use and application of workforce data. Our data sources include HCPC, Skills for Care and NHS England. 
• We will use this data to inform policy development and influence plans with the UK Government. 

Co-produced plans (2024 to 2026) 

• We will publish co-produced plans for each of our priority areas for workforce growth including: primary care, children, young people and families and community rehabilitation after a stay in hospital. 

Workforce models (2024 to 2026) 

• We will gather and share examples of workforce models and skills configurations that have improved outcomes for people, teams and systems. Examples will include how to make our practice more environmentally sustainable and equitable. 

Data sharing agreements (2024 to 2026) 

• We will establish data sharing agreements with our workforce and education data owners. 
• We will work with NHS England to standardise how the occupational therapy workforce and their areas of practice are coded on workforce data dashboards.  
• Where there are gaps, we’ll fund work to create an accurate and complete data set of the OT workforce in England. 
• We will work with our members and their employers to undertake an inclusive survey of the UK’s OT workforce every three years.