An occupational therapist is a healthcare practitioner who works with patients to make their daily lives, at home and at work, more manageable following injury or sickness, or whilst dealing with a chronic and inhibiting condition.
An occupational therapist works with disabled, post-operative patients or persons with a chronic condition which impacts their life at home or at work. By modifying habits and the person’s environment as well as improving the ability of persons with an ongoing condition, enhancements can be brought to every facet of their personal and professional lives, making things much easier for them day to day. The ‘occupation’ to which the job title refers is not just about work; occupation in this context can refer to any interaction with human environments brought about by positive change in the patient’s circumstances. A large part of the job is working with the patient on a one-to-one basis, setting realistic goals and evaluating their progress in terms of being able to complete simple and complex daily tasks.
Jobs in the National Health Service (NHS) are covered by the Agenda for Change. Occupational therapists starting their career as allied health professionals in the NHS typically start at Band 5 (£20,710-£26,839), moving to Occupational Therapist Specialist (Band 6, £24,931-£33,436) and then Occupational Therapist Advanced (Band 7, £29,798-£39,273). Pay progression operates through the Knowledge and Skills Framework (KSF). There are two pay 'gateways' in each pay band, and to progress up the pay scale staff must demonstrate that they can effectively apply the required knowledge and skills. Consultant occupational therapists (Bands 8A and 8B) can earn between £37,996 and £54,714. Salaries in local government are at similar levels, although there can be significant variations. Applicants may need to be flexible about the geographical area in which they are willing to work. New occupational therapist-related initiatives, such as Pathways to Work (a government scheme to help the long-term unemployed back into the workplace), have also led to more opportunities for occupational therapists.
- Understand the nature of the patient’s sickness, disability or limitations
- Modify the patient’s home or work environment to facilitate ease of use and progression where possible.
- Complete a realistic and measureable plan of maintenance or improvement for the patient
- Work with the patient during the course of the treatment with the aim of improving awareness, mobility and occupational effectiveness
- Complete ongoing patient evaluations and modify improvement strategy as and when required
There is a minimum academic entry requirement for occupational therapy professionals who are seeking to work full-time following undergraduate occupational therapy courses. This usually means at least five GCSE pass grades (or an equivalent level qualification), and two A levels (or three Highers for candidates who studied in Scotland). The minimum requirements usually stipulate that at least one science subject must be included within qualifying grades. The NHS recommend an A level qualification in the field of biology as being very helpful, and it is a requirement for some universities. For graduates with a First Degree, it is possible to study for a short course in occupational therapy with a much accelerated course module sequence.
- Have strong patient empathy and sophisticated approach to patient care and management
- Be familiar with, and know how to help patients with, an unlimited range of health limiting conditions
- Exhibit compassionate understanding to patients in conditions of severe difficulty
- Have a flexible approach to work with regular home visits, and work in evenings and at weekends as and when required
- Maintain a positive attitude and drive the patient towards improvement and the desire for continuing betterment
- Have an understanding of how to work with patients who have difficult or aggressive behaviour
- Have a keen sense of planning, monitoring and modifying patient care strategies
- Be able to report on demand, and understand the requirements of current internal and external legislation affecting occupational therapists
The standard working hours are between 36 and 38 hours each week, with a majority of permanent occupational therapists working a “standard” nine-to-five, on weekdays. Conversely, there are some positions, particularly in mental health community services, acute hospitals, A&E and in non-NHS positions where regular evenings and weekends work is essential. For therapists who deliver external care, a lot of local driving is required to reach patients.
Experienced therapists may choose to specialise in a particular area of care based on their skill set and past care roles. There are several specialisations within the career, including paediatric occupational therapy, military occupational therapy, supervisory care, sports, fitness and reconditioning and those who specialise in independent living for seniors.
The UK’s National Health Service provides a detailed and supportive framework of career betterment, allowing for rapid stepping stones and pay improvement under the “Agenda for Change” programme. In AFC, the health service vocation evaluation system apportions a points tally which is then used as a basis for matching job roles to one of 9 possible “pay bands” (predetermined scales which allow the setting of various levels of basic salary based on experience and level of responsibility).Staff usually will progress to the following pay band at the end of each year until the candidate reaches the very top of the relevant pay scale. As well as the standard remuneration, additional financial support is often provided to healthcare workers in certain areas, for example, London, where the cost of living is higher.
The National Health Service (NHS) is by far the largest employer of occupational therapists in the UK. Some opt to work in private practices, but the NHS supports its staff as they continue to learn and build their careers, not something always made available to those practising in non-public health centres and surgeries.
Matthew Box is a highly experienced occupational therapist and disability access auditor. He practises in Tunbridge Wells, Kent.
What made you decide or choose to get into this sort of career?
A mix of reasons including an interest in people, my personal experience and a desire to make a difference. There’s also the benefit of an incredibly varied work role and intrinsic job security which are also hugely important career benefits that the profession offers. They differentiate it from a number of other roles that candidates may be considering.
Do you have a standard day or a standard type of `exercise'?
Unfortunately not. Sometimes I’d love this but every day is different and can include visiting someone’s home to look at equipment, or adaptations to improve their independence, or looking at business plans and development and supervision for members of our team.
What is the most common type of problem/call-out/enquiry to which you must attend?
Adapting someone’s home to increase their independence or visiting a business to advise on ways they can improve their accessibility and usability for as many people as possible.
What do you like most about the job?
The variety and mix of roles and people we work with every day, and helping people change their lives for the better.
What do you like least about the job?
The numerous layers of government guidance and legislation which often limit the impact we can make. This can really get in the way, but is part of the nature of the regulatory framework.
What are the key responsibilities?
There are lots to be honest. The best thing is to visit the British Association Of Occupational Therapists website as they should have a code of conduct that you can look at, in addition to this guide.
What about academic requirements? Any formal demands, eg A Levels?
This varies, but you will need to get a degree or similar qualification in Occupational Therapy and requirements will differ from course to course; there’s a lot of competition, so it's best to talk to the course leaders before committing to any expensive long term schooling.
What is the starting salary, and how does this increase over time with promotion?
Again this varies, but somewhere between £20,000 to £25,000 sounds about right to start with. This can rise with experience fairly quickly, and there’s a lot of scope for career development.
What advice do you have for someone who is looking to get into this as a career?
Get some experience and a clear understanding if this is what you want to do; it’s a vocation not just a course to do to fill some time. Make an informed decision and then see where it leads you.
What are the most important qualities an applicant must and should possess?
Decision making skills, pride in their work, being a people person, innovation and creativity.
Any closing questions, comments or additional advice?
It’s a great career choice and something that’s allowed me to grow and change as a person, and also something that has kept growing and evolving with me.