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Occupational therapy Workforce Strategy action plan – Northern Ireland

2025–2027 

This is a reduced version of the Workforce Strategy action plan – Northern Ireland. 

Developing our action plan has been a team effort. We’d like to thank the member volunteers in our Workforce Strategy Northern Ireland Advisory Group who’ve helped to shape it.

If you want to know more about our Workforce Strategy action plan, or our policy and campaigning work in Northern Ireland, please contact Cliona McCarney, Policy and Public Affairs Lead for Northern Ireland at cliona.mccarney@rcot.co.uk.

Read the full Workforce Strategy action plan – Northern Ireland

Unpick the data and find the case studies that fuel our plan.
Download the PDF

The challenges facing the occupational therapy workforce in Northern Ireland 

  • Demand outstripping capacity: There is a growing need for occupational therapy services in Northern Ireland, due to an ageing population and the prevalence of long-term health conditions. 
  • Workforce shortages: The current workforce is under pressure, with staff shortages and retention issues impacting the profession’s capacity to provide essential services. 
  • Budgetary constraints: The Department of Health in Northern Ireland and the five health and social care Trusts are facing huge financial challenges – affecting the availability and quality of services in Northern Ireland. 
  • Upskilling the workforce: There is a need to make sure the occupational therapy workforce in Northern Ireland has the necessary qualifications, ongoing professional development opportunities and support to fulfil their roles. There’s also a need for visible career pathways that show longevity in the profession. Occupational therapy support workers need to be given the tools, training and skills to continue to play an invaluable role in the delivery of care. 
  • Expanding the profession: The only route to registration as an occupational therapist in Northern Ireland is via a three-year bachelor’s level university degree. This doesn’t reflect the needs of the emerging population and inhibits diversity. 

The state of the occupational therapy workforce in Northern Ireland

Staffing shortages, high demand for services and low morale and job satisfaction

According to the Occupational Therapy Workforce Review 2019–2029 published in 2022 by the Department of Health, there is a need for strategic planning to address these issues and to ensure a sustainable workforce. 

The review highlights that the ageing population and increasing prevalence of chronic conditions are driving the demand for occupational therapy services. 

The impact of the COVID-19 pandemic has worsened these challenges. 

 

Health inequalities are of significant and growing concern in Northern Ireland

This has been identified by Health Minister, Mike Nesbitt, as one of his key priorities. 

The Department of Health estimates that health inequalities cost the public purse up to £1.7 billion every year. 

This is due to a range of factors including: 

  • welfare costs 
  • lost productivity 
  • health service costs. 

In Northern Ireland, the top ten areas of deprivation are situated within two health and social care Trust areas, Belfast and Western. 

Efforts being made to address workforce issues

The Department of Health has been working on improving recruitment and retention strategies.  

There is also a focus on enhancing the role of occupational therapists within multidisciplinary teams to improve service delivery and outcomes. 

 

Engaging in research and innovation

We must create a culture that values evidence-based practice and continuous quality improvement. 

Occupational therapists should receive robust support to engage in research and innovation, as outlined in the AHP Research and Innovation Strategy Northern Ireland. This includes: 

  • access to dedicated funding 
  • mentorship programmes 
  • collaborative opportunities with academic institutions. 

The forthcoming RCOT Research and Innovation Strategy will set out how we will enable the occupational therapy workforce to generate and integrate research and real-world evidence into practice. 

Waiting lists for occupational therapy services in Northern Ireland

  • 1,235 days – the longest wait to see an occupational therapist in the Northern Trust 
  • 1,447 people – inpatient and day case waiting lists for patients under 18 in the Western Trust  
  • 887 young people – waiting for occupational therapy input in the Western Trust. 

 

Services in Northern Ireland are facing particularly acute challenges

Data from the Northern Health and Social Care Trust tells us that the longest wait for children’s occupational therapy is more than three years. In the South Eastern Trust, the longest wait was 973 days. 

This is due to a myriad of factors, including a demand capacity mismatch and staffing challenges. 

As of 31 August 2024 – there were more than 19,000 people waiting to access occupational services in Northern Ireland. More than 57% of those are waiting more than 13 weeks. 

‘Trusts are delivering in excess of expected volumes, but demand is currently exceeding capacity.’ 

Mike Nesbitt – Northern Ireland Health Minister 

Where occupational therapists are having an impact

Working as mental health practitioners in primary care

Over a three month period, three OTs carried out 6,000 consultations, which resulted in 97% of patients, who responded to a survey, being very satisfied or satisfied. 

The local adult community mental health teams also reported a 43% reduction in referral rates. 

 

Supporting parents’ mental health

100% of parents who attended a ‘Mums and Munchkins’ group for new parents with or at risk of perinatal mental illness felt more confident in their parenting skills after attending an occupational therapy intervention programme. 

Managing health and work

The Condition Management Programme evaluation (2022), showed that out of 500 participants of this OT led programme: 

  • 75% of those who were unemployed reported increases in work readiness 
  • 34% returned to or remained in work 
  • 13% started new employment 
  • 12% started a course or further training. 

Health and social care policy context in Northern Ireland 

Health and Wellbeing: Delivering Together: 2026 recommends developments across four main areas: 

1. Build capacity in communities and prevention: to reduce inequalities and ensure the next generation is healthy and well. 

2. Provide more support in primary care: to enable more preventative and proactive care, earlier detection and treatment of physical and mental health problems. 

3. Reform our community and hospital services: so that they are organised to provide care when and where it is needed. 

4. Organise ourselves to deliver better: by ensuring that the administrative and management structures make it easier. 

A misalignment between current health policy and the reality of service delivery at the coalface

Inconsistent funding

The sporadic and short-term nature of funding, as government departments in Northern Ireland continue to operate with a single year budget, has led to disparities in service provision across Northern Ireland. 

It also doesn’t properly leverage the full potential of the occupational therapy workforce’s skills, knowledge and creativity. 

The lack of multiyear budgets and short-term nature of funding in Northern Ireland is also a barrier to research and innovation for occupational therapy practitioners. 

Leadership opportunities

Occupational therapists are often not allowed to apply for certain leadership and senior management positions. 

The legislative requirement to have a registered nurse on the executive board of Trusts is not reciprocated for Allied Health Professions (AHPs), limiting the capacity for occupational therapists to lead collaboration and systemic change. 

Occupational therapists are also often excluded from applying for some research funding opportunities, which further hampers their ability to lead change. 

Demographic data

Inadequate and inconsistent demographic data prohibits effective workforce planning efforts. 

Lack of recognition for the power and potential of occupational therapy

There’s a lack of understanding and appreciation for the power of occupational therapy and our unique role in addressing broader system challenges and opportunities. 

This lack of understanding of the unique core skills of occupational therapists by operational leadership, outside of the profession, can lead to occupational therapists being given more generic job roles – impacting job satisfaction and retention. 

The key collective actions we’ll take to implement the occupational therapy Workforce Strategy in Northern Ireland 

Through our influencing work and collaborations, we will build a strong case for: 

  • Increasing the number of pre-registration occupational therapy places in Northern Ireland. 
  • Investing in the recruitment and retention of the occupational therapy workforce in Northern Ireland. 
  • Lobbying the Executive to provide equitable access for specialist training. 
  • Increasing and highlighting the value and impact of occupational therapy by supporting and promoting research and innovation. 
  • Optimising occupational therapy in primary and secondary prevention to address health inequalities. 

Read the full Workforce Strategy action plan – Northern Ireland

Expand on these ideas.
Download the PDF

Workforce Strategy action plan – Northern Ireland 

We’ve based our plan on the following principles laid out in our Workforce Strategy. 

This set out our four workforce priorities. These are: 

  • optimising occupational therapy 
  • demonstrating value and impact 
  • retention and career development 
  • effective workforce planning. 

Below is a reduced version of the Workforce Strategy action plan – Northern Ireland. To find definitions or read about how we’ll measure success, please download the full version. 

Optimising occupational therapy

Enhanced and advanced levels of practice (2025 to 2027) 

  • We will highlight the value and impact of occupational therapy practitioners working at enhanced and advanced levels of practice. 
  • We will work with the Northern Ireland Allied Health Professions community to share information and promote different models of practice, challenging practitioners to think and work differently. 
  • We will work with the Allied Health Professions Federation Northern Ireland (AHPFNI) to highlight the value of advanced practice roles to commissioners, elected representatives and decision-makers. 
  • We will support the continued embedding of the Advanced Practice Framework for AHPs in Northern Ireland. 

 

Innovation (2025 to 2027) 

  • We will work with our members to use the Innovation hub as a digital platform to build knowledge and confidence, to drive innovation and demonstrate the impact of occupational therapy. 
  • We will support the continued embedding of the AHP Research and Innovation Framework in Northern Ireland. 

 

Case studies (2025 to 2027) 

  • We will work with our members in Northern Ireland to collect case studies and impact examples across primary care, children, young people and families and community rehabilitation, demonstrating our role in addressing prevention and health inequalities. 
  • We will use these case studies to show external stakeholders the value of improved access to occupational therapy for local populations and to wider health and social care delivery. 

 

Measuring and communicating impact (2025 to 2027) 

  • We will work with RCOT colleagues to develop resources that help members measure and communicate the value and impact of their practice in one of three ways: 

1. Economically (for example, using return-on-investment models). 

2. Socially (for example, using realist evaluation methodology). 

3. Experientially (for example, using people’s stories). 

 

Digital health and care (2026 to 2027) 

  • We will work with the occupational therapy workforce in Northern Ireland to identify and explore opportunities for artificial intelligence (AI) and digital technologies in the delivery of rehabilitation, primary care, and children, young people and families services. 
  • We will add the Northern Ireland perspective to the RCOT national roundtable on digital technology. 

 

Regional strength (2025 to 2027) 

  • We will build up the Northern Ireland RCOT region as an important vehicle to strengthen the occupational therapy profession regionally, raise our profile and optimise our impact. 

Demonstrating value and impact

Sharing, positioning and publicising our work (2025 to 2027) 

  • We will support the occupational therapy workforce in Northern Ireland to modernise its practice in line with local policy priorities and engagement with key stakeholders. 
  • We will work with our members and stakeholders to develop UK-wide resources to help systems make the best value decisions about the positioning of the occupational therapy workforce. 
  • We will empower and upskill the occupational therapy workforce in Northern Ireland to support them to develop arguments for investment in their services, without adding to their clinical burden. 
  • We will use case studies and service improvement journeys at national and local level to argue for the most impactful positioning of occupational therapy services in systems. 
  • We will work with our members and third sector colleagues to ensure the voice of patients, service users and their families are reflected, to help demonstrate the power and value of occupational therapy. 
  • We will work with our regional heads of occupational therapy empower staff to share data and publicise good practice. 

 

Working with collaboratively (2025 to 2027) 

  • We will work with leaders to reposition, invest in and grow an occupational therapy workforce in Iine with population health needs. 
  • We will co-host national workforce reform workshops to support and accelerate workforce transformation. 
  • We will host a virtual workforce reform roundtable with key leaders in Northern Ireland. 
  • We will work collaboratively with and learn from colleagues in other AHP professional bodies. 
  • We will work in partnership with our coalitions and networks, including the AHP Federation in Northern Ireland, to speak with one voice about the support needed for our members and the communities they serve. 

 

Research and innovation (2025 to 2027) 

  • We will publish a new Research and Innovation Strategy to build the capacity and capability of our current and future workforce, to embrace and actively engage with research and innovation. 
  • We will widely publicise the Research and Innovation Strategy to members and practitioners in Northern Ireland. 
  • We will work with our members, partners and stakeholders to have a baseline understanding of our members’ capacity and capability for research that we will use to measure changes over time. 

 

Data driven (2025 to 2027) 

  • We will collect and draw on data through our Workforce Survey, membership database and workforce maps to understand the size, distribution, career levels and skills mix of the OT workforce. 
  • This will allow us to monitor and report on trends to inform our influencing activity and decisions about where we should be positioned within our healthcare systems. 
  • We will collect data to make the case for expanding routes into the profession in Northern Ireland, including the development of an apprenticeship programme and a pre-registration MSc programme. 
  • We can also use the data to assess any changes in demographics of occupational therapy students following the relocation of the Ulster University Health Sciences programmes. 

 

Share, celebrate, challenge and debate (2024 to 2027) 

  • We will host a virtual workshop for Northern Ireland members and key stakeholders on the theme of the occupational therapy workforce, to share learning, celebrate success, stimulate challenge and debate around the future of the profession. 

Retention and career development

Learning and learners (2025 to 2027) 

  • We will make the case to NI government to expand and diversify routes into the occupational therapy profession in Northern Ireland, including pre-registration masters and apprenticeship programmes. 
  • We will review and develop learning and development standards for pre-registration education and early careers. These will be for education providers, practice-based educators and employers to use. 
  • We will support members from Northern Ireland to feed into this process and ensure their voices are heard. 
  • We will make the case to NI government to support the retention of Northern Ireland students into practice in Northern Ireland. 

 

Practice learning and practice placement coordinator (2025) 

  • We will make the case to NI government and stakeholders to make funding available for every health and social care Trust to have a permanent full-time occupational therapy practice learning and practice placement coordinator. 

 

Embedding AHP principles (2025 to 2027) 

  • We will work with pre-registration placement educators to support the embedding of the AHP principles of practice-based learning, to enhance their confidence and capability to support learners. 

 

Progression and development (2025 to 2027) 

  • We will work with employers and members to support the progression of occupational therapy practitioners through career pathways by encouraging the development of a work-based mentor programme, to support and guide practitioners as they move forward in their professional journey. 
  • We will make the case to NI government to develop a regional preceptorship programme. 

 

The Career Development Framework (2027) 

  • We will support our members and employers in Northern Ireland to feed their input and perspective into the revised Career Development Framework (CDF) and support members to use the framework to nurture practice at all levels. 
  • We will feed the Northern Ireland perspective into the RCOT UK-wide strategy to support the learning and development of our members. 

 

Workforce survey (2025 to 2031) 

  • Working with our members and employers, we will undertake an extensive survey of the occupational therapy workforce across the UK. We will conduct this survey every three years and track the information. 
  • This will support us to better understand and demonstrate challenges around retention and career development. 

 

Effective workforce planning

Data gathering (2025 to 2027) 

  • We will collaborate with local health and social care Trusts to gather comprehensive data on the occupational therapy workforce, including demographics, skill levels, and service demand. 
  • Use data from the Northern Ireland Statistics and Research Agency (NISRA) to identify trends. 

 

Reporting (2025) 

  • We will track and report on OT workforce data, structure of leadership teams and OT waiting list data each year. 

 

Planning tools and frameworks (2025 to 2027) 

  • We will develop or signpost to workforce planning tools and frameworks. 

 

Learner data dashboard (2025 to 2027) 

  • We will support the development of an RCOT learner data dashboard, ensuring it is applicable in a Northern Ireland context. 

 

Northern Ireland workforce growth plans (2025 to 2027) 

  • We will work with colleagues to co-produce Northern Ireland specific plans for each of our priority areas for workforce growth: primary care, community rehabilitation after a stay in hospital, and in schools. 

 

Sharing workforce models (2025 to 2027) 

  • We will gather and share examples of workforce models that have improved outcomes for local communities. 

 

Demography of the workforce (2025 to 2027) 

  • We will work with our members and their employers in Northern Ireland to carry out an inclusive survey of the UK’s occupational therapy workforce every three years. 
  • We will use the results to monitor and respond to quantitative, qualitative and demographic characteristics of the workforce. 

Monitoring and evaluation 

We’ll monitor progress through a workforce survey every three years. 

 

Conclusion 

Our action plan is designed to strengthen and expand the occupational therapy workforce in Northern Ireland, ensuring that occupational therapy practitioners are equipped and supported to meet the evolving needs of our local population. 

Through targeted actions such as data collection, stakeholder engagement and tailored education programmes, we’re committed to fostering a skilled, adaptable and resilient workforce. By implementing this strategy, we aim to enhance the quality of care, improve population health and care outcomes, and ensure that occupational therapy services are accessible to everyone who needs them across Northern Ireland. 

Together, we can build a future where occupational therapy practitioners are empowered to make a significant impact on the health and wellbeing of our communities in Northern Ireland.