Making the case for a Principal Occupational Therapist post: West Berkshire

The government and NHS England has increasingly recognised the value of the Principal Occupational Therapists (POT) in local authorities, with the pandemic highlighting the difference this role could make. This builds on statutory guidance to the Care Act 2014 which recognises occupational therapists as effective in enabling duties to be met, particularly in terms of wellbeing and prevention. The POT role has also been recognised as essential to enable integration between the NHS and local authorities, ensuring that lived experience and inclusivity are central, whilst improving equity, diversity and belonging.

West Berkshire did not have a POT post. The longest serving and lead occupational therapist, whilst managing services, did not have capacity to proactively identify and engage in strategic decision-making opportunities. Although the CQC assessment of how the council is meeting its duties under Part 1 of the Care Act 2014 was ‘good’, it suggested there was also a need to have more focus on preventative work.

Attracting funding from the Buckinghamshire, Oxfordshire and Berkshire (BOB) Allied Health Professions Faculty, an occupational therapist manager and the lead OT in West Berkshire Council undertook a deep dive to understand who was in the Allied Health Profession and supporting workforce, identified risks and created a strategic workforce development plan with tangible supply, recruitment and retention outputs. 

The deep-dive and resulting plan effectively made the case for a Principal Occupational Therapist role, alongside actions that this role would provide leadership to, for example the development of a local preceptorship programme, enabling the council to attract newly qualified occupational therapists into social care. 

Quote from preceptee: 

When I was in my final year of university and looking for jobs, it was important for me that I found a role which offered a preceptorship. It's an exciting time to be starting your first role but there are also anxieties about that transition from student to qualified OT. I hoped that being part of a preceptorship would help alleviate those feelings - and it did!

The POT continues to increase and develop occupational therapy (OT) capability in adult social care. This includes building on the introduction of an OT assistant (OTA) role in adult social care to expand this into other teams and creating an OTA/OT focused support worker induction and competency career development framework. 

A senior practitioner role to enable the council to retain experienced clinicians and prepare for OT management roles is also being developed. The POT has also invested time trialling and revising the approach taken to supervision and appraisal using the Royal College of Occupational Therapists pillars of practice. Team members feel valued and supported by the Principal OT role:

“I’m incredibly grateful to have you batting for me and helping me develop.”

“I feel so happy that you’re here…..thank you so much for your support. We’re so lucky to have you in post and I’m really excited for the future."

The POT is engaged in further work in the Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care System to expand apprenticeship placements and has already identified and is considering changes to prevent and reduce the need for acute inpatient care through improved referral routes and access to reablement in the community. Within the council, the role is seeking to increase understanding of, and competencies in, OT practice for example basic equipment provision and technology-enabled care.

An executive director, responsible for adult social care and public health said:

a POT post...supports the professional development of a key discipline; by doing so it also supports recruitment and retention of OTs by demonstrating a commitment to that professional expertise...key if we are to avoid excessive costs on locum staff.

One of the messages I routinely convey to elected members is that Occupational Therapists provide practical solutions which are very cost effective; the role is key to helping people live their lives successfully and as independently as possible. This in turn manages the demands on our social care workforce and manages the associated costs.