Growing, staying and leading as an occupational therapist in adult social care in Manchester City Council

Context

"I’ve worked at Manchester City Council for eight years now, which is the longest I’ve ever stayed in one job. I joined originally as an Occupational Therapy Team Manager in the Equipment and Adaptations Service. For the last two years, I’ve been the Principal Occupational Therapist, the first POT role the council has had, which meant building the role from scratch.

"Before Manchester, I worked as a locum across the UK and in permanent roles in Australia. I qualified as an occupational therapist in Australia 18 years ago and have worked across health and social care, in hospitals, community rehabilitation, vocational rehabilitation, moving and handling, equipment, adaptations, Blue Badges and hospital discharge. I’ve worked across children’s and adults’ services, in rural and urban settings, across Western Australia, Scotland, London, the South East and the North West.

"My last locum role was at Manchester Royal Infirmary. When I accepted a permanent role with the council, it was a deliberate shift into social care, and it’s one I’ve stayed with."

What it’s like working here, and why I’ve stayed

Manchester City Council is a genuinely good place to work. What has mattered most to me is trust. I have the trust and support of my manager. I manage my own time and workload, and I’m given space to think strategically and to focus on transformation, not just day-to-day firefighting.

That doesn’t mean it’s been easy. Social care can be a very social work-dominated environment, and in wider therapy spaces it can feel very health-led. There are still moments where I’m the only social care OT in the room. Other times, I’m not around the table when the social care OT perspective could add value.

But over the last two years, I can see the impact of the POT role. Occupational therapy is more visible. Our voice is stronger. We’re part of more conversations, however there is more work to do.

Progression, flexibility and being supported when it matters

Just after COVID, I was starting to burn out and considered leaving my previous role. What made the difference was being offered a career break. I took it, travelled back to Australia to see my family and it helped me reset.

When I returned, I was appointed as the Principal OT role not long after. That opportunity for progression and growth was really important. It gave me space to develop, to influence, and to face new challenges that would positively impact OT.

I’ve also experienced the other side. In a previous role elsewhere, I had a manager who regularly cancelled supervision, where communication was poor, confidentiality wasn’t always respected, and decisions affecting my team were made without discussion. That was the unhappiest I’ve been at work, and it showed me just how critical good management is to retention.

In Manchester, supervision is acknowledged as vital. There’s guidance from my Manager when I need it, but also trust. That balance has been fundamental to me staying.

The work itself and why it still matters

I feel like I’m making a real difference here. No two days are the same. Manchester is a very diverse city, and the work reflects that. I’m constantly building relationships, spotting opportunities, and helping shape services.

Some of the things I’ve been involved in include:

growing the OT workforce
building strong relationships with universities, increasing capacity for student placements and developing OT apprenticeships in the organisation
building business cases for investing OTs into teams where they hadn’t previously existed, such as the Autism team and Entrenched Rough Sleepers Team
setting up and shaping new services like the Moving and Handling Optimisation team and Early Intervention/Front Door OT role.

These are teams that are now making a significant difference for people to enhance their independence and quality of life, and for the wider system.

Culture, belonging and being able to be yourself

Culture really matters. Senior leaders, including executive and deputy directors, are approachable and value my expertise. I can be myself at work. Engaging with staff networks is encouraged, and diversity is actively embraced.

I’m supported by two excellent OT Team Managers operationally, and the relationships with the people I manage matter just as much as my relationship with my own manager. There’s a balance of humour, empathy and support that makes difficult work feel sustainable.

Community is important too. There are days when I deliberately base myself in the office with team members rather than working remotely because connection matters. Things like informal peer support, having Principal OTs from other Local Authorities to talk to and occasional social events all help reduce isolation.

What I’ve learned about staying and retaining others

What keeps me here won’t be unique to me.

Having a POT or senior OT lead around the table is vital. It drives change and helps OTs feel valued and celebrated. Being kept in the loop matters more than people often realise. Communication isn’t a nice extra, it’s a fundamental retention issue.

Social care OT is still misunderstood. There’s a lingering idea that people only move into social care later in their careers, and some OTs aren’t even aware that working in social care is an option. We’re actively trying to challenge that through student placements and working with universities, however capacity for placements can be harder in small teams with large community caseloads. Social care OT roles are also harder to find when people are job searching. The professional identity needs strengthening.

What we’re doing in practice

Alongside day-to-day leadership, I’m working on practical retention and culture-building work, including:

developing a recruitment and retention plan with HR
increasing OT visibility through bulletins, sharing examples of great practice and OT week events
using a shared Padlet for therapy resources and CPD opportunities
monthly POT update and welcome emails
offering work experience opportunities, OT student placements & OT apprenticeships
promoting staff networks, the employee assistance programme and wider benefits; both to existing and prospective OTs
ensuring the continued payment of HCPC registration fees
being visibly present and accessible, and promoting a positive work culture
learning from exit interviews
collaborating with other local authorities through local and national Principal OT networks
developing and driving a supported year in practice for OTs, recently launched by the North West ADASS POT network.

None of these things in isolation are transformative. Together, they contribute to a culture I want to work in and one I hope others do too’.

Linked practice example

A physiotherapist’s experience in Manchester City Council adult social care

"I’m a physiotherapist working in the Moving and Handling Optimisation team at Manchester City Council. I’ve been in the role for just under two years and was previously a Falls Prevention Coordinator in the NHS.

"I believe I was the first physiotherapist to become a permanent member of staff at Manchester City Council. My role involves reviewing care packages to see whether they can be safely optimised from two carers to one.

"The role is autonomous, but I also feel well supported. My manager is extremely knowledgeable and experienced, and there’s a strong culture of encouragement to make professional decisions.

"The office environment is welcoming, and the support we receive as a team is second to none. The work can be stressful at times, but the support network makes a real difference.

"That combination of autonomy, trust and support is the reason I’ve stayed."

Why this matters for rentention

Manchester’s story shows how retention is shaped less by single initiatives and more by:

trust-based leadership
professional autonomy
visible, credible senior roles
flexibility at critical moments
meaningful, skilled work
everyday culture and belonging.

It also shows how OT and physio roles in social care can be attractive, sustainable and professionally rewarding when the conditions are right.