Occupational therapy workforce strategy action plan

OT Workforce Strategy action plan – Cymru-Wales  2024–2027

We will deliver our first-ever UK wide occupational therapy Workforce Strategy, using nation-specific action plans. This action plan for Wales details:

• the position of the occupational therapy (OT) workforce
• actions to transform and modernise the OT workforce
• examples of workforce modelling that can help organise skills and make sure staffing levels are safe.

Delivering our Workforce Strategy will be a team effort. We’d like to thank the member volunteers in our Workforce Strategy advisory group in Wales who’ve helped to shape this action plan.

Along with this action plan, please refer to the Workforce Strategy on our website where you’ll also find a bibliography, useful terminology and frequently asked questions: Workforce Strategy

The position of the occupational therapy workforce

To successfully implement our Workforce Strategy in Wales, we need to understand where we are now against the growing demands on our occupational therapy workforce in Wales.

Policies in Wales have advocated for services to evolve in line with current and future population need. The argument for safely adopting artificial intelligence and technology enabled care solutions has also been made across policy and practice frameworks in Wales.

A Healthier Wales, the Welsh Government’s long term plan for health, social care and education (2018), called for more services to be delivered out of hospital, closer to where people normally live and by multi-professional teams.

To achieve this ambition, occupational therapy needs to be at the forefront of helping people live fully – providing the support they need to sustain their physical, mental and social wellbeing.

The Well-being of Future Generations Act (2015) mandates statutory health, social care and education organisations in Wales to adopt a long-term view and consider how the decisions we make today affect the wellbeing of future generations.

The Welsh Government’s National Workforce Implementation Plan (2023)Welsh Government’s National Workforce Implementation Plan (2023) emphasises the argument for better integration of health, social care, education and welfare services. It called for employers to evaluate their existing workforce models and consider repositioning our workforce and reconfiguring the multiprofessional skills within teams.

It makes the case for the role of the occupational therapy workforce in facilitating integration across:

• physical and mental health services
• primary, community and secondary care services
• health, social care and education.

Working with the occupational therapy workforce in Wales, we have identified that there is a strategic misalignment between current health, social care and education policy and the reality of service delivery at the coalface.

This misalignment has challenged our growth and ability to develop services in line with demographic need and surfaced the following issues:

• funding for service innovation and improvement is often short-term and inconsistent. This contributes to variation in the quality of service provided to the populations of Wales. It also does not make the most of the skills, knowledge and creativity that is abundant within an occupational therapy workforce
• the occupational therapy workforce is not eligible to apply for some leadership and senior management roles. This hinders our potential and ability to support collaboration and system change
• patchy and inconsistent demographic data that weakens systems’ efforts to undertake effective workforce planning
• a limited understanding of the value of occupational therapy and its unique contribution to systemwide challenges and opportunities. This perpetuates fragmented access and positioning of the occupational therapy workforce within systems.

Transforming and modernising the occupational therapy workforce

Our workforce vision

Our vision is for an expanded occupational therapy workforce – positioned to have maximum impact in improving people's health and quality of life.

By 2035 we will have an occupational therapy workforce that is:

• confident and skilled in championing inclusion and advocating for occupational justice, focusing on the right of every person to have the choice and opportunity to engage in a diverse range of activities and roles
• based primarily within communities working closely with local populations to meet their health and care needs and ensuring that services are accessible to everyone
• positioned to focus on prevention and early interventions, minimising the need for crisis interventions and dependency on care services
• putting occupations at the forefront of their practice, empowering people to do the occupations that they value, manage their health and care needs and contribute to society.

We recognise that there’s much to do to prepare the occupational therapy workforce in Wales for modernisation and transformation. Guided by demographic need, policy and practice direction, this three-year action plan will focus on key ambitions for the occupational therapy workforce in Wales.

The Primary Care Model for Wales (PCMW, 2014) highlighted the need for whole system approaches to providing local, sustainable and easily accessible healthcare services.

By focusing on place-based care, delivered to people in their usual places of residence, and multi-professional working, the occupational therapy workforce in Wales have been pioneers in developing services to meet this requirement. We need more teams to adopt this model to enhance its scope and scale in provision.

Data has suggested that over two-thirds of health and social care in Wales is delivered in inpatient (secondary care) services, while a third is delivered in the community (NHS Wales, 2021). Furthermore, while 90% of NHS activity occurs within primary and community care, primary and community care services only receive 6% of the NHS budget (NHS Wales Planning Framework 2022 – 2025)

Our action plan promotes the adoption of the universal, targeted and specialist framework of service provision. By improving the proportion of services across these levels, we will enable people to access the right help at the right time, in the right place and delivered by the right multiprofessional workforce.

The workforce modelling that we need

Working with the occupational therapy workforce and leaders in Wales, we have identified several principles of workforce modelling and service delivery that will help us achieve our goals.

• Having access to data and intelligence that reflects the reality of services. This will facilitate effective workforce planning and workforce transformation initiatives.
• Equitable access to jobs at all career levels of the pillars of practice.
• Occupational therapy practitioners with a strong professional identity and clear sense of their unique value and contribution to health, social care and education systems.
• A robust base of real-world and research evidence for the role of occupational therapy within multiprofessional teams.
• An occupational therapy workforce that embraces technology within their work and are digitally ready today and tomorrow.

The tables below present our action plan for delivering our Workforce Strategy in Wales.

We address the misalignment in policy and practice, propelling the healthcare reform and workforce transformation needed in Wales. The question we’ve sought to answer through the development of this action plan is – What will an excellent, inclusive occupational therapy service look like in 2035 and how do we get there?

Each workforce priority has actions with measures and timings.