RCOT in plea to remember OTs in NHS Long Term Workforce Plan
Occupational therapy spurn concern around the 15-year NHS workforce plan.
Leaders at the Royal College of Occupational Therapists (RCOT) have been left bewildered and disappointed by the recently revealed NHS Long-Term Workforce Plan - but why?
We examined RCOT’s key findings relating to occupational therapy provision within the £2.4 billion plan for NHS staffing in England over the next 15 years.
And our Clinical Director, Jo Throp, who is also a member of RCOT’s Leadership Advisory Group, highlights the crucial care occupational therapists (OTs) provide “when the doctors and nurses are done.”
Forget-us-not
Occupational therapists do life. When the doctors and nurses are done, what’s left? Life is left. Occupational therapists unpick the hard stuff, the stuff that matters to people. 
Jo Throp
RCOT’s response after the Government released its long-awaited NHS Long-Term Workforce Plan this summer was swift, sombre, and sobering.
“There is so much focus on doctors and nurses that it’s as if the Government has forgotten NHS England needs occupational therapists [1] and other allied healthcare professionals to function,” commented Karin Orman, RCOT’s Director of Practice and Innovation.
“Reducing waiting lists is vital but without follow-up and support to manage daily life, many patients will return to NHS frontline and emergency services.”
Representing over 36,000 of the UK’s 43,000-plus OTs, RCOT waded through the 150-page NHS England plan to discover “what's in it” for its members.
Not enough, according to our Clinical Director, Jo Throp who pointed out, “Social connections, contribution and functional competency underpin the state of wellness; the feeling that your life is unfolding as it should.
“Occupational therapists do life. When the doctors and nurses are done, what’s left? Life is left. Occupational therapists unpick the hard stuff, the stuff that matters to people but seemingly not to governments.”
Jo stressed, “But it should. Without occupational therapists to hold the hands of people through ill health and disability, the roles and connections to community and family weaken. The contribution to society is less, hope feels lost, and the barriers are, for some, too big to overcome alone.
“The proposed workforce plan has big implications, not just for individuals but also for the connections we have with each other. Choose life – choose to support RCOT in lobbying for occupational therapy.”
RCOT’s response
Here are some of RCOT’s key findings from the plan - along with their concerns...
The Plan is...not to make any plan to increase the number of occupational therapists in primary care.
RCOT replies...The number of OTs in primary care “needs to increase by at least 2000 by 2036.”
Rehabilitation and reablement are fundamental to tackling waiting lists and improving patient care. [...] Where is the investment in rehabilitation experts?
RCOT
The Plan is...for an estimated growth in occupational therapists of 3.4% to 3.7% by 2036/37.
RCOT replies...As more people will be living with long-term health conditions, a 3.4% to 3.7% growth will not provide enough occupational therapists to meet their ongoing health and care needs.
Indeed, a 2023 RCOT workforce survey reveals occupational therapists are under “immense pressure”, prompting almost a quarter of them to plan to leave in the next five years.
Occupational therapy vacancies in both health and social care are high, with some experiencing up to 40% vacancy rates. The profession has been on the UK Shortage Occupation list since 2019.
The Plan is...to increase education and training but decrease international recruitment across the NHS from, currently, one in four staff joining every year to one in 10 by 2036/37.
RCOT replies...AHP international recruitment levels are not quantified in this report.
There has been recent significant investment from NHS England to establish pipelines of international AHPs to be recruited – will this work now be wasted?
The Plan is... by 2031/32, for 25% to 50% of entrants to the occupational therapy workforce to join via an apprenticeship route.
RCOT replies...The size and speed of the increase in delivery of apprenticeships for each profession depend on the student conversion rate for courses [...]; whether apprenticeship standards already exist [...]; the availability of ‘feeder’ support professional groups [...]
The Plan is...to create 10,000 virtual ward beds by winter 2023 and, longer-term, 40–50 virtual ward beds per 100,000 population, covering a broad range of health conditions.
RCOT replies...Virtual ward workforce models benefit from a range of professionals, drawing on talent across sectors.
Again, there is no mention of occupational therapists or AHPs, although they will be required to meet rehabilitation needs.
The Plan is...to extend prescribing rights to various groups - but NOT occupational therapists.
RCOT replies...We welcome the commitment to advanced practitioners.
We would want this to include occupational therapist advanced practitioners [...] so occupational therapists don’t get left out because of their limited prescribing responsibilities. This could lead to a fundamental gap in expertise in rehabilitation and primary care.
Only six months ago, RCOT, as part of a coalition of organisations, signed a joint letter to the Secretary of State for Health and Social Care, Steve Barclay MP.
The letter, part of the #PrescribeNow campaign, called for the extension of prescribing responsibilities to five allied health professions (AHPs), including occupational therapists.
RCOT’s Director of Practice and Innovation, Karin Orman explained at the time that updating the Medicines and Medical Devices Act (2021) to extend independent prescribing responsibilities to OTs would:
- Improve support and timely care of patients
- Improve patient safety
- Reduce pressure on other professionals and the health and social care system
- Reduce healthcare costs by avoiding unnecessary referrals
- Reduce patient time spent in the healthcare system
- Streamline the care process
Following the publication of the NHS Long-Term Workforce Plan, however, Karin’s disappointment was clear.
“We had high hopes for this workforce plan and, frankly, occupational therapists have been let down, which means patients are also being let down,” she said.
It’s time for the UK government to recognise and value everything that occupational therapists and other allied health professionals do - and invest in occupational therapy to improve people’s health and overall wellbeing, helping people live well for longer.
RCOT is currently analysing the 150-page plan in greater depth to respond more fully to its impact on the profession.
Its leaders are also continuing talks with NHS England and the Department for Health and Social Care “to ensure the interests of our profession are heard” as the plan progresses.
Further reading
It will take time to resolve this situation, which is why the delay in acting to address the workforce crisis is so damaging.
RCOT and 39 other organisations made a health workforce plea to the Prime Minister in June 2023.
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