Positioning occupational therapy for the future

Prevention and early intervention

Occupational therapists can support people to prioritise their health and wellbeing and balance work and life roles to live healthier for longer. To meet population need, a focus on prevention and early intervention will help people living with multiple health conditions to manage their symptoms and reduce the need for hospital and specialist services. We will help people to live well in their communities despite having a long-term condition(s).  

Positioning occupational therapy in community and primary care services will make sure: 

• families and schools have access to occupational therapy to prevent physical, learning and mental health difficulties from escalating, giving young people the best chance to realise their potential 
• education environments are more inclusive, supporting more children and young people to attend school with their peers 
• people can access occupational therapy assessment, advice and rehabilitation through their GP, including advice on returning or remaining in work and driving ​ 
• there is fair and equitable access to needs based, therapy-led rehabilitation, whether that is tackling mental health, physical health, social or vocational needs 
• new builds or repurposed housing stock, prison and care home environments are designed to be inclusive and adapted to work for all age groups, particularly older people.

Acute and emergency care  

Hospital at home/virtual wards will reduce how often older people and people living with ongoing health conditions need to be admitted into hospital.

There will, however, always be a need for hospital services when people experience injury, mental health crisis or need medical interventions such as surgery.

Occupational therapists based within hospital and emergency care will be confident and capable to: 

• work with complexity of need in critical and emergency medical environments  
• assess immediate and potential ongoing rehabilitation needs  
• assess and manage risk 
• refer on to community services and specialist pathways.

To do this they need to be in therapy teams preventing admission at the front door, in critical/intensive care to make sure rehabilitation starts earlier, in therapy-led rehabilitation units and on specialist rehabilitation pathways. 

AI and tech enabled care 

Occupational therapists will use digital health and care technology to enable people to safely carry out their daily occupations to live well. Building on existing technology such as sensors, wearables and apps, we see AI and technology augmenting the role of occupational therapy.

Practitioners will work with people, families and care givers to inform and create a tailored system based on those people’s needs and goals. This would include rehabilitation, compensatory strategies, managing risk, symptoms, medication and lifestyle management to prevent further deterioration in health and quality of life.   

Occupational therapists will also be co-designers of: 

• AI systems that assist services to effectively manage referrals, waiting lists and caseloads  
• VR (Virtual Reality) programmes to support learning in occupational therapy pre-registration education and post education learning and development 
• Bespoke VR rehabilitation programmes to learn or relearn skills to enable participation in occupations 
• Upgrades to existing everyday technology to improve accessibility. 

Universal, targeted and specialist delivery 

To make the best use of occupational therapy expertise, services will be designed based on a universal, targeted and specialist tiered delivery.  

Expanding our reach beyond individual referrals to working at a population level – a universal offer will support people and their support networks, including the wider workforce such as support workers, social prescribers, work coaches, care staff and housing officers, to access our expertise. This will help to create a culture that gives people and families greater autonomy with timely information and advice.  

Targeted delivery will allow occupational therapists to work with local communities and the support workforce to design and tailor services to ensure they are open and inclusive to everyone in need and offering timely support, minimising the need for crisis or specialist intervention. A tailored, specialist approach will then be more readily available for people with complex needs.

The occupational therapy workforce will be confident and capable of adopting a culture of research engagement and innovation at every level of their career. This will make sure that services are evidence based and quality improvement and impact is at the heart of our work, improving the health and wellbeing of the people we work with.  

Workforce planning and retention 

Occupational therapy practitioners will expect to have several careers during their working life and will seek a working culture that embraces inclusion and offers flexibility, including portfolio working.

Planning of workforce numbers will need to reflect these expectations, to allow for higher numbers of occupational therapists working outside the statutory sector. When and where the NHS cannot meet demand, independent providers of occupational therapy will offer services to people who can self-fund. This market will mostly grow in England, where fewer people are eligible for state funded care.   

To realise this future and to transform and expand the occupational therapy workforce we have a three-year action plan.