Delivering the best care

Access to vital therapies for children and young people impacted by cost-of-living crisis

RCOT
04 October 2023

The cost-of-living crisis is making it more difficult for children and young people to access the therapies and interventions they need, say almost two-thirds (65%) of paediatric occupational therapists.

These results stem from our newly released children and young people's survey 2023. The survey also found the cost-of-living crisis is contributing to delays, which are affecting the health, development and wellbeing of children, young people, and their families. 

The report, which surveyed 698 occupational therapists working with children and young people across the UK, reveals the devastating impact of the cost-of-living crisis. Since the start of 2023 occupational therapists have noticed an increase in the number of families struggling with their finances, such as: 

  • Financial distress: just under half (47%) said families are so worried about money that they can't prioritise occupational therapy or follow occupational therapy recommendations.
  • Work-related constraints: around half (49%) said families are either unable or unwilling to take time off work to attend occupational therapy appointments. 

  • Reducing activities: more than half (56%) said families have had to cut back on recommended activities that would support their child's development and wellbeing, such as swimming lessons. 

  • Unsuitable accommodation: two-thirds (66%) of those surveyed said families are now living in unsuitable housing conditions. 

As a result, children and young people are not receiving timely access to necessary interventions, which has far-reaching consequences.

It not only impacts children’s mental health, education, and development but also affects the mental wellbeing of their parents and family life as a whole. A staggering four in five (78%) children's occupational therapists who responded to the survey reported that limited access to occupational therapy services is adversely affecting the mental health of children. Additionally, more than 7 in 10 (71%) cited a negative impact on children's education, while almost two-thirds (63%) noted that children's and young people's needs are becoming more acute.

Amber's story

Natasha Campbell from Dagenham, whose daughter, Amber, was born with limb loss and has a myoelectric arm, says: 

‘Amber has had occupational therapy since she was six months old, when she got her first prosthesis. We’d built up a rhythm for going to appointments and managing her schedule around my other children's schedules. Over the past few months, getting to appointments has got a lot more expensive, especially since the centre moved to a location that was further away. It means we have to prioritise her appointments, and sometimes aren’t able to do other things we would have liked to have done as a family, especially over the summer holidays.’ 

More than four in five (85%) of those surveyed reported an increase in demand for occupational therapy since July 2022, with over one-third (36%) indicating that children and young people were waiting on average for more than 18 weeks for targeted or individual occupational therapy services. These delays mean that children may not receive essential equipment at home, may miss out on additional support for improving their writing skills, or even miss school due to heightened mental health needs. These delays also mean that children and young people require a higher level of support when they are eventually seen, increasing the burden on services and contributing to further delays. 

Pressure on occupational therapists is not only external. Three-fifths (60%) of occupational therapists said their teams aren’t fully staffed, and even if they were, two-thirds (66%) indicated that their teams would still not be able to meet growing demand. In addition to this, almost a third (30%) said they can’t provide the equipment and adaptations children and young people need, when they need it – for most, this is due to budget and funding issues (65%).

Comment from Director of Practice and Innovation, Karin Orman

‘The cost-of-living crisis is exacerbating already challenging circumstances, limiting access to essential occupational therapy services and significantly impacting the mental health and wellbeing of children. Our report paints a bleak picture of how individual financial challenges are wreaking havoc on children and young people's access to the occupational therapy they need. Families are forced to make heartbreaking choices, and children are bearing the brunt of it. 

‘We know that health inequalities start at an early age and can impact a child’s health later and their economic future, so not being able to access the therapies they need now can have an impact on a child for the rest of their life. 

‘What's more, the report is a stark reminder of the challenges faced by occupational therapists in providing essential care to children and young people. The increasing demand, coupled with staffing shortages and financial pressures, has created a critical situation that must be addressed urgently.  

‘The report underscores the urgent need for comprehensive reforms in children's occupational therapy services to ensure that children and young people receive the care and support they need when they need it. Urgent action is required to ensure that every child has equitable access to the interventions they need to flourish.’ 

RCOT’s recommendations for political and health and care leaders

  • Understanding demand: Understand the rising demand for children’s occupational therapy services and address capacity gaps to ensure timely access for children and young people. 
  • Positioning occupational therapy for impact: Place occupational therapists where they can have the most impact, including schools; hospitals; early intervention services; and specialist services, such as CAMHS and Youth Justice services.
  • Integrated services: Promote integration within health, education, and care systems to ensure resources are utilised efficiently and referral pathways are clear and coordinated in order to meet individual needs. 
  • Workforce expansion: Expand the occupational therapy workforce to ensure adequate staff with the necessary skills to support children, young people, and families.
  • Investment in equipment: Streamlining and investing in housing, equipment and adaptation services to provide prompt assistance to children and young people so they can take part in everyday life. 

The report

The full report is available at rcot.co.uk/cyp23

This year's report and our reports from 2022 and 2021 are available on our occupational therapy for children and young people page.