Workforce survey

• Demand is climbing. Most respondents (67%) saw demand for OT services increase over the past year, with complexity of needs the most common driver.
• You’re improving services. Engagement in improvement is high – 84% report they sometimes, often or very often lead or take part in improvement activity.
• Satisfaction and stress sit side by side. 57% are satisfied or very satisfied with their roles, while 41% report high stress (7–10 out of 10).
• Service user feedback drives practice. Most practitioners use feedback from service users (71%) and patient-reported outcomes (54%) to inform practice, though use of published research (47%) and cost-effectiveness data (13%) is lower.
• Over a quarter of OTs live with disability or health conditions. 27% (34% among learners) report living with a disability or health condition. Neurodivergence, physical health and mental health are the most common.
• We see the potential in AI. 57% think AI and digital tech could improve our services, but we need support to build confidence – only 6% feel very confident using these tools now.
• Change is expected. 55% anticipate significant changes in their area of practice over the next three years.

This evidence is already supporting our influencing work and helping us press for the changes you’ve told us will make the biggest difference.

The workforce survey has been a really valuable resource for us, and we’ve used it in several ways.

• Government consultations: It informed our responses to key consultations, including (but not limited to) the 10‑Year Health Plan and the 10‑Year Workforce Plan.
• Ongoing policy and public affairs work: Cited in meetings with ministers and MPs to help us convey some of the challenges in the sector.
• Parliamentary evidence: The survey has been cited by Sally Payne and Karin Orman during oral evidence sessions to the Health and Social Care Committee.

Importantly, all of this work is forming a baseline that we can measure against as we update and monitor progress on the workforce strategy.

Joe Brunwin, Head of Policy and Practice

We’ll continue to use the data to:

• monitor and raise critical shortages with government, NHS and social care bodies
• help members measure and communicate value and impact
• build research and innovation capacity
• share workforce models that improve outcomes for people, teams and systems.
• work with journalists to raise awareness of OT and the challenges our workforce faces – the data was already used to highlight the struggle of accessing disability equipment, particularly in the aftermath of the NRS Healthcare collapse.
  • You can also find examples of our work sharing these results on the Community Care website and Learning Disability Today.

To get the most out of these findings, share the results with leaders and influencers and discuss with other OTs how this data can inform your next improvement projects.

Conversations in RCOT Communities have already started – head to a relevant network to join in or get one started.

Thank you to everyone who took part. The data you gave us is already being put to good use, advocating for our profession at the highest levels. This publication contributes to the global evidence base, but you can use the findings to make your case locally, strengthen your improvement work, or support your research.'

Dr Elizabeth Taylor, Research and Development Manager

• 86% reported an increased demand for OT services within the previous 12 months
• 79% stated that people were presenting more complex needs due to delayed interventions
• 78% said that their team wasn’t large enough to meet the demand
• 63% felt they were too busy to provide the level of care they’d like
• 59% rated their work-related stress as 7 or above on a scale of 1 to 10, with 10 being the highest level of stress.

Being told not to work to gold standard due to capacity issues provides a huge amount of stress.”

• Governments must recognise that investment in the NHS and social care is critical to a healthy population and therefore economic growth.
• Investment in the OT workforce must be matched to service and demographic need, not just in the NHS but in social care as well.
• Capacity should be built within primary and community health and social care services, to ensure people receive advice and help early on, rather than when in acute need or with increased complexity due to delayed intervention.

Increased demand for occupational therapy

86% of respondents stated that demand for OT services had increased during the previous 12 months. The reasons given for this increase were varied, but; 

• 79% attributed it to lack of capacity elsewhere in the health and care system
• 79% felt that the complexity of people’s needs had increased due to delayed intervention, resulting in an increased need for OT input.

The following factors also increased demand on OT services: 

• deterioration of occupational performance due to delayed intervention (66%)
• increase in mental health needs (54%)
• lack of availability of carers (52%)
• a broader range of referrals being received (42%).

Difficulty recruiting has increased, [plus] lack of availability of carers. Also due to complexity of clients the pace of caseload has decreased.”

• 78% of respondents felt that their team was not large enough to meet demand
• 55% said that longstanding issues with recruitment had impacted their ability to provide OT support to meet needs
• only 8% felt that they were able to fully provide the necessary level of OT support to meet local needs for some, staff shortages were resulting in long waiting lists, with more than 100 respondents saying that people were waiting over 12 months to access their service.

I am able to meet the basic needs of most patients. Some die before I am able to visit. The majority do not get the opportunity for rehab or prehab due to lack of capacity.”

• 68% of respondents said that they were under too much pressure at work
• 63% stated they were too busy to provide the level of care they would like
• 55% felt that too much of their time was spent on non-OT duties.

Over a third of respondents said they intend to leave their current role within the next two years. The most common reasons related to a lack of satisfaction with their role or setting:

• work related stress (48%)
• feeling undervalued (47%)
• unable to provide the standard of service they would like (46%)
• staffing levels are too low (40%)
• poor work/life balance (37%).

We often work beyond our paid hours and accrue time in Lieu, which we do not get to take.”

A high majority of respondents felt able to discuss their wellbeing, request adjustments to their working arrangements and suggest workplace improvements. However, many people noted that requests and suggestions were often not acted upon in a meaningful way. Some said this was due to the pressure that staff and services were under. Others felt it was due to a lack of appreciation for the OT role, and low numbers of OTs in senior management positions.

I have discussed personal health and disability, support for staff,  and bullying in the workplace. However, I have been met with empty words.”

We asked respondents about incidences of bullying, harassment and discrimination by colleagues and people who use their service. They were asked if they had experienced any of these personally and if they had witnessed them happening to colleagues. 

Almost a quarter of respondents had experienced or witnessed bullying by colleagues, and a similar number had experienced or witnessed bullying by people who used their service. Fewer people had experienced or witnessed harassment by colleagues, but more than a quarter had witnessed colleagues being harassed by people who use their services. A similar percentage had witnessed colleagues experiencing discrimination by people who use their services.

Some people felt supported by their managers and colleagues to address bullying, harassment and discrimination. Some felt unsafe to speak up, while others reported a lack of empathy or action from managers when concerns were raised. For some respondents, a lack of support had resulted in them leaving their jobs.

Huge issues in the  organisation including discrimination, lack of understanding of staff disabilities, bullying and harassment.”

Almost a quarter of respondents said they intend to stop working as an OT practitioner within the next five years. Less than half expected to be working as an OT for over ten years. 

The implications of this are huge, when recruitment and retention are already significant challenges for many OT services.

Retirement was the most common reason given for leaving the profession. For some this was early retirement, influenced by a desire to focus on their personal wellbeing. Other reasons for leaving the profession were most commonly linked to lack of satisfaction with their role:

• work-related stress (38%)
• poor work/life balance (36%)
• lack of fulfilment in the role (32%)
• rates of pay (29%)
• lack of opportunities for progression (24%).

Understaffed due to difficulty recruiting. Insufficient management support. Service Users are unhappy about waiting times and decisions and can be abusive as a result.”

Despite the significant challenges reported by respondents, the overwhelming majority felt positive about the profession.

• 93% said that occupational therapy is a rewarding career
• 86% would recommend it as a career to others
• 79% said that they were enthusiastic about their job most of the time
• 80% believed that the OT profession would offer them a secure job for years to come.

Many OTs said they’re passionate about their profession but frustrated their work settings don’t permit them to practice in a way that best uses their OT skills and expertise. Some linked this to a lack of understanding of the OT role by colleagues from other professions. 

Others blamed a lack of OTs in leadership roles within their organisations. Issues with increased demand, staff shortages across multiple professions and long waiting lists also meant some OTs were expected to ‘dilute’ their roles to cover others’ responsibilities, or to reduce their input with patients so more people could be seen overall.

I’ve worked in the NHS for 40 years, 37 years of those as a qualified OT working in mostly in acute hospitals and have loved my job. However the wider health system feels broken and there are not the community/social care resources to support patients outside hospital. We’re churning patients out faster and faster, older, frailer and more complex, but given no time to rehab of improve them, knowing that they will likely get readmitted again in a few days. That is disheartening when there is so much we could do if we were be given a day or two, or there were more services in the community.”

Expand the OT workforce to ensure staff are available to fill current and future vacancies by: 

• ensuring that future public service workforce planning prioritises the shortages in occupational therapy, so that workers can provide effective support and deal with the unprecedented increases in demand
• addressing the challenges around recruitment and retention which are causing OTs to leave the profession early
• making sure that workforce planning is seen through the lens of a multi-disciplinary team so that skills are utilised appropriately, and OTs’ expertise is being used most effectively.

Invest in the OT workforce and multi-disciplinary teams to ensure workers are properly supported in their roles by:

• focusing on staff development and wellbeing to reduce the risk of OTs burning out and leaving the profession
• increasing investment in mental health support for health and care workers
• ensuring greater leadership opportunities for occupational therapists by opening-up leadership roles that would previously be restricted to other health and care professions, such as nursing
• addressing the concerns and experiences of workers that have dealt with bullying, harassment and discrimination in the workplace to ensure staff are safe and can report issues without hesitation.

Recognise investment in the NHS and social care is critical to a healthy population and therefore economic growth. 

• A well-resourced health and social care workforce are central to enabling the NHS and local authorities to make the best use of public money and providing taxpayers with timely access to high quality health and social care, as well as introduce substantial cost-savings for the public purse.
• All successful organisations do workforce planning to ensure they can meet demand. The NHS and social care system should be no exception. 

To find out more about our survey design, analysis and recommendations, please contact [email protected]

For media enquiries please contact [email protected].

Acknowledgements: Thank you to Maggie Cartwright and Charlotte Dawes, Student Occupational Therapists, for their help in compiling this report.

We’re delivering a range of projects to address the workforce challenges you’ve told us about:

• We’re developing an occupational therapy workforce strategy to influence the planning and delivery of occupational therapy services nationally and locally. The strategy will draw on the findings of the workforce survey and will be published later this year.
• We’re presenting our survey report to ministers, health leaders and policy makers in all UK nations, to call for increased investment in the training of occupational therapists and the funding of occupational therapy services.
• We’re working with Unison to review and develop the ways that we support and advise BAOT members facing workplace challenges.
• We’ve collaborated with Health Education England to develop resources to address specific workforce challenges including inclusive engagement; recruitment and retention; career development and leadership opportunities. Full details of every project and where to find the resources will be shared in the May issue of OTnews.
• Our professional enquiries service is available for any RCOT members experiencing workplace challenges.