I am writing to you on behalf of the Royal College of Occupational Therapists (RCOT) about the current challenges on workforce retention, and the role of occupational therapists (OTs) in addressing this problem.
As you will be aware, more people are dropping out of the workforce because of ill-health. Between 2021 and 2022, the number of new working-age disability claimants had doubled (IFS 2022). Additionally, NHS data shows 8.3 million people received at least one prescription item for antidepressant drugs in 2021/22 – 22 percent more than in 2015/16.
This has ultimately contributed to the growing number of people who say they are too ill to work. According to the ONS, between June and August 2022, roughly 2.5 million people reported long-term illness as the main reason for economic inactivity, up from around 2 million in 2019.
Occupational therapists are well-positioned to help people stay in work and reduce the number of people taking early retirement because they are trained in physical and mental health care. They can help people negotiate changes to their job, so their specific needs are addressed. Additionally, occupational therapists are also able to make adaptations in the workplace, which can make it easier for people to remain in the workforce.
To prevent the number of people dropping out of the workforce, we are calling on the UK Government to expand the number of occupational therapists in GP surgeries and the funding for this across the whole UK. This is so every patient can benefit from earlier job retention advice by occupational therapy in primary care before they fall out of work.
The current situation shows that:
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Most GP surgeries do not have access to occupational therapy. For example, there are about 6500 GP surgeries in England and only 200 occupational therapists (NHS Digital 2022).
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A recent survey showed that most occupational therapists in primary care cover three to five GP surgeries. To get this level of national coverage in England, we need another 1400 occupational therapists.
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40% of GP appointments are for mental health (Mind, 2018). Occupational therapists can work across both physical and mental health and can assess people’s needs and advise on activities and strategies to build resilience, health, and wellbeing.
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Occupational therapists can assess and sign the Fit Note and DVLA Medical questionnaire, advising people on how to manage their health condition and daily activities. Evidence shows that when compared to GP-written fit notes, OTs make much higher use of the “may be fit for work” option, rather than signing the person off sick (Drummond et al, 2020).
Expanding the number of occupational therapists in primary care through deployment and integrated service delivery is vital to alleviating the current challenges on workforce retention due to health reasons. They can provide a wide range of practical approaches to help people stay in work and reduce the number of people taking early retirement through earlier intervention. This makes best use of public money by maintaining a healthy workforce that will help support the UK economy.
I met with the two previous postholders of your role, Chloe Smith MP and Justin Tomlinson MP, who we worked closely with on the successful legislation change to allow occupational therapists to complete the GP fit note and ensure that the profession is recognised as vital when it comes to supporting people back into work.
Therefore, we would like to meet with you to discuss our workforce priorities and how investing in our profession can support people with ongoing health conditions to remain in work.
Kind regards,
Karin Orman
Director of Practice and Innovation
Royal College of Occupational Therapists