Workforce planning is every OT’s business

Who have you worked with to deliver this workforce transformation? 

We have now established two amazing team leads: Lee Allen (Team lead – occupational therapist), and Rachel Blake (Team lead physiotherapist) and to embed the model above we part-time seconded Jo Johnson (Service manager occupational therapist) from children and families services.  We have really grown from the variety in our leadership team.  

Having a service manager who was operationally savvy was crucial to get past some of the big barriers we faced with the new model. For example, our AHPs work across 11 different teams, with separate staffing, budgets and management. We needed to find a way to work with those sometimes-differing views and priorities. As a single team we can now flex resource, invest in development, and evidence the impact of our work.

Background information to your role/interest in population health: 

I have over 15 years of experience in clinical practice and have progressed into leadership roles within NHSE and local NHS Trusts. I now work at Nottinghamshire Healthcare Foundation Trust, where my focus is on quality improvement.

My interest in population health began during my MBA in Healthcare Management, which allowed me to combine my occupational therapy background with academic study in strategy and operational delivery. Through this, I started to explore the disconnect between health service delivery, workforce models, and the actual needs of the population.

I believe that social determinants of health, such as education, housing, and lifestyle play a critical role in health outcomes and should inform clinical pathways, workforce planning, and service delivery. Despite strong policy and evidence in this area, I’ve noticed a gap. Frontline teams often have limited skills and time to invest in delivering a true population health approach, meaning services aren’t always developed in a way to meet local population needs.

Currently, workforce planning tends to take a broad-brush approach, allocating resources without considering local population data or workforce skill sets. For example, OT services are often distributed evenly rather than tailored to community needs, which leads to mismatched demand and capacity. This creates frustration for staff and limits the quality of care.

I advocate for using granular data and engaging with communities to design workforce models that reflect local needs. Doing so would improve both patient and staff experience. The Government’s 10-Year Health Plan for England supports this vision, calling for integrated neighbourhood teams (INTs) to act as hubs for addressing health inequalities and supporting social determinants of health.

Can you give us some examples of how population health could be incorporated more into workforce planning? 

One example of incorporating population health into workforce planning comes from my work on NHSE’s Core20PLUS programme, which focused on addressing health inequalities. As part of this initiative, I was involved in a project that brought local stakeholders together, coordinated by the Integrated Care Board (ICB). This collaborative approach enabled us to gain a deeper understanding of local population needs and align workforce planning accordingly.

We began by analysing patient feedback to identify gaps in service delivery and areas for improvement. These insights were then mapped against workforce skill sets to determine where adjustments were needed. Importantly, this process was designed to be continuous rather than a one-off exercise, as population needs evolve over time. Embedding feedback mechanisms into routine practice ensured services remained responsive and relevant.

Data played a critical role in this work. We transformed complex datasets into accessible infographics for frontline teams, highlighting key demographic information such as age, gender, referral reasons, and deprivation index scores. Understanding deprivation is essential because it reveals gaps in service access and informs targeted workforce deployment. Every NHS Trust can access this data through their analysts, and it should be a standard component of workforce planning.

Alongside data-driven insights, we delivered health inequalities training to staff to empower them to make meaningful changes. We emphasised the importance of evaluating the impact of any changes to service delivery to ensure they do not inadvertently widen inequalities.

Another example relates to DNA (Did Not Attend) rates. While missed appointments might seem like a small issue, they often tell us something important. In my experience, people who miss appointments are more likely to face greater challenges related to the social determinants of health and as such experience poorer health outcomes.

By looking closely at DNA patterns, we can better understand the barriers and challenges to accessing care. This might mean offering more flexible options, improving communication, or providing extra support where it’s needed most. Ultimately, this approach helps design services that work better for everyone and ensures people get the right care at the right time.

In summary, incorporating population health into workforce planning requires a combination of community engagement, continuous feedback loops, robust data analysis, and staff development. These elements ensure services are equitable, responsive, and aligned with the needs of the populations they serve.

Who have you worked with to deliver a better understanding of population health? 

To deliver a better understanding of population health, I have worked collaboratively with a wide range of stakeholders across health and care systems. This includes the voluntary sector, primary care networks, public health teams, secondary care, social care, local authorities, and acute services. Building strong relationships has been essential to ensure sustainable transformation and true co-production.

I place significant emphasis on engaging patients, carers, and local communities from the outset of projects, rather than as an afterthought. Their input is critical to designing services that reduce inequalities and meet population needs.

Voluntary sector partners have been invaluable in facilitating dialogue with communities, while public health colleagues have provided expertise in defining population needs, such as areas of deprivation, unemployment, and disease prevalence.

In addition, I have worked with teams to interpret and use data effectively, triangulating national datasets with local intelligence to identify gaps and underserved groups. This approach ensures workforce planning and service design are informed by both quantitative evidence and lived experience, leading to more equitable and responsive care.

From your experience, what advice or tips would you give to others about using population health as part of workforce planning? 

From my experience, three key principles are essential when using population health in workforce planning:

• Engage with Communities – Understand local needs and move away from a broad-brush approach to service delivery. Co-production with communities ensures services are relevant and equitable.
• Build Strong Stakeholder Relationships – Collaboration with partners across health, care, and voluntary sectors is critical for sustainable transformation. 
• Adopt Data-Driven Decision Making – Use robust data to inform planning, establish baselines, and measure impact. This creates accountability, supports continuous improvement, and ensures decisions are evidence-based.

Background information: 

I’m the director of Inclusion Me. We’re an award-winning, nationwide consultancy delivering OT to children and adults across public and private sectors. The business has expanded and grown over the past 20 years, and workforce growth has been a crucial part of this. I'm also the innovation lead for the RCOT social care practice network. 
 
Can you give us an example of your workforce planning in action and how is it was delivered:  

So, we have different approach to our workforce planning based on whether it's the in-house-staff who are part of the Inclusion Me team or our subcontractors -the independent OTs who deliver the therapy.  

The difference between the two groups is the guarantees of work we offer and financial situation of both. As an employer of the Inclusion Me team, I have planned accountability around these staff as they are directly employed by us. We need a planned and stable budget because they have the contractual opportunity to work for us.

This is different for the subcontracted staff who are independent OTs and are needed at different times to meet demand. We have contract obligations we have to deliver and are always building for growth to fill availability.

We need a big network of subcontractors and try to plan for our biggest areas of demand. For example, if we got lots of enquiries in a particular geographical area, we’ll market and recruit for OTs to fill the available work.

We try to get workforce spread across the country, so we have coverage for everything that comes in as a referral. We’re upfront with the OTs about the potential volume of work they might get from us and then put them into one of our teams to see how it goes.

There’s a relationship between these two parts of our workforce. For example, we’ve just got two new contracts from a local authority, and we need to recruit OTs for these. But we’re also short of management and admin cover and need these staff to help deliver the contract.

We look at potential areas for growth, monitor budgets and plan for opportunities, setting aside budgets for obvious areas of need. We have three areas for our workforce:

1.     A business division with core contracts from local authorities which is tender based.

2.    A business division which is about creating relationships with building contractors and housing associations to deliver accessible housing.

3.    A business division which is our therapies for case management which is enquiry based.

Demand is different across these three areas. For example, the local authority work means applying for a tender and if it's awarded to us, the deliver needs to be planned with staffing resource. Contracts can be different lengths of time from three months to three years. A longer-term contract means you need longer term workforce planning to deliver this effectively.

In the therapies business arm, there may be an increase in referrals from people you’ve been marketing to, and you need an overall plan upfront about staffing levels required. Sometimes you need to increase your marketing to increase your revenue, and if you’ve got capacity, you can offer additional work.

When I started the business, our workforce expansion was very network based, focusing on OT communities. So, you got to know who you could approach and much of my workforce expansion started by directly approaching OTs to join me.

Now we have marketing support that leads this and there is a strategy behind our process. For example, we advertise in OTN, Indeed and we used LinkedIn to optimise our reach to our potential workforce.

We think of ways to spread our messages more consistently. We tell OTs what is appealing about independent work, and we tempt people to come and give it a try. We also must be aware that most independent OTs will work for a range of companies, not just one.

We have a plan for business and workforce growth and have had different aims at different points of our journey. I've developed business skills and like many companies have a strategy for growth –it doesn't just happen by itself!

For large organisations like local authorities and social care where we get most of our contracts, they must be reactive to political demands, budgets and CQC inspections. They may get a pot of money to tackle waiting lists. They need a different workforce approach for that and often need a solution as quick as possible. They often can't budget for new members of staff, but we can tender for this work.

Who have you worked with to deliver this workforce transformation? 

A lot of my personal and professional development has happened over time like doing marketing courses and building connections. We've used Bryony Thomas, a marketing and growth strategist and now use a marketing company for our online marketing. We also use storyboarding applied to OT, and this has helped develop our marketing strategy. We’ve thought about who we’re trying to talk to on social media and what resonates with OTs.

We have different people in the Inclusion Me team; this has grown and we’ve targeted staff and built networks. HR has been helpful with recruitment tasks –you need to bring in marketing and HR skills when you start to be an employer.

From your experience, what advice would you give to others about workforce planning? 

Get an operations manager. They know so much and can fast track your growth and staffing.  Same for HR; they have more of an understanding about how to build staffing when you're running your own business. You need to think about your growth over one, three and five years, not just your immediate needs.

Getting the right staff is vital; people are most important part of the business, and we now have more processes in place to support this. The wrong person can hold you back and it makes the journey harder. You need to invest in people, in your work culture. It needs to be right for both you and your staff so test out the right fit between you both. Is this the right opportunity for them? Do they have the right skill set and experience?

You also need to invest in your workforce, provide training and development, support people though learning; there needs to be opportunities on both sides. People like flexible working and you need to enable people to keep their energy levels open and receptive so you can get the best out of them. If they get this, they offer the best outcomes for clients, and everything flows smoothly. OTs can burn out, and we want to prevent this.

Think about what you personally want to get out of this. Of course, you want to pay the bills, but contracts are finite and stop. Balanced against this, you can also get more work than you can handle and then you need to think about growth. If and how you build, is up to you. My role has become less about having a caseload and more about running the business, providing quality assurance and management.

We have built more systems and processes now for workforce growth but the more staff you employ, the more your overheads are. The policies and procedures become more important as you grow. For example, you may find that other OTs levels of work are sometimes not what you’d expect, then it's useful to understand HR and data protection.

There’s lots of exciting parts of running your own business; developing your vision and journey planning. With the right workforce alignment, you can quickly reach your end goal. You need to work out the balance in your life that's right for you. You might get to a business point and think, this is enough.

Finally, we still need to promote the great work that OT can do to help systems and organisations, how much benefit we create. Often the system doesn't give our profession the credit we deserve. We need to do all we can to promote the profession and the great work we do.