Ahead of the Spending Review, the Local Government Association (LGA) is calling for urgent action to increase the number of Occupational Therapists (OTs) employed by councils, thereby boosting community wellbeing, promoting independence, and achieving government health goals.
Currently only seven per cent of OTs work in councils, though if this were increased, the LGA says in its new report “Occupational Therapists in Councils: Unlocking Capacity and Driving Change” - it would improve health, care, and prevention strategy outcomes and strengthen councils’ ability to meet their duties under the Care Act 2014.
With councils under sustained financial pressure and services stretched to capacity, the LGA warns that the contribution of OTs — particularly in prevention and community-based care — remains underutilised.
To explore the wider role of OTs in councils, the LGA commissioned new research in partnership with national occupational therapy leaders, the Royal College of Occupational Therapists, and others.
The report sets out how OTs are well-placed to deliver across government missions — from health and care integration to the shift towards neighbourhood models of care and the delivery of inclusive, accessible homes, through:
- Preventing avoidable hospital admissions and enable faster discharges, helping to relieve NHS pressures.
- Supporting people with physical and mental health needs to return to work, helping to close the disability employment gap.
- Adapting homes and environments, making communities safer, more inclusive and better prepared for an ageing population.
- Delivering person-centred, preventative care, reducing long-term care needs and supporting health and care integration.
- Promoting wellbeing and independence, improving population health and reducing inequalities, by supporting people to remain active, independent, and well in their communities.
Despite their vital role in helping people live independently, there are only 3,200 council-employed occupational therapists across England, a figure that has remained unchanged since 2020.
OTs work with people of all ages to overcome barriers to everyday life caused by physical and mental health challenges. They are a science-based, registered profession that plays a critical role in supporting public health, preventing hospital admissions, enabling recovery, and reducing long-term care needs. OTs employed in councils are uniquely positioned to work across both health and local authority services, making them a vital bridge for delivering integrated, person-centred care in communities.
They already play a vital role in supporting the Government’s ambitions to reform health and social care, tackle health inequalities, and promote employment and housing.
However, councils have not been sufficiently resourced to deliver on the Care Act 2014 — and as a result, their ability to recruit, retain and professionally develop OTs has been constrained.
To respond to this, the LGA is calling on the Government to:
- Provide financial stability and parity, ensuring local authority-employed OTs receive the same pay and working conditions as their NHS counterparts;
- Take concrete action to expand and support the OT workforce in councils;
- Focus on funding prevention and early intervention to reduce long-term care needs and improve outcomes.
Cllr David Fothergill, Chair of the LGA’s Community and Wellbeing Board, said:
“We all want to live in the place we call home, with the people and things we love, doing the things that matter to us. Occupational therapists help make that possible.
“But too many people are missing out”.
“Councils don’t have the funding to grow and retain the OT workforce they need — or to compete with the NHS on pay and conditions.”
“The Spending Review is the moment to fix that. Investing in OTs now would help more people live independently, relieve pressure on the NHS, support disabled people into work, and build stronger, more resilient communities.”
Jess McGregor, President of the Association of Directors of Adult Social Services (ADASS), said:
“Occupational therapy enables people to stay independent, reduce unnecessary hospital stays, and live well at home for longer. But councils struggle to recruit and retain enough OTs, as they often cannot compete with NHS pay scales.
“Providing more OTs would ensure people get the support needed to prevent their health and wellbeing deteriorating, and it will also contribute to the Government being able to deliver its aspirations to shift care from hospitals to community.
“We urge the Government to provide local authorities with the funding councils need to train, employ and retain more occupational therapists so we can create a more sustainable, prevention-focused adult social care system that works for all of us.”
Karin Orman, Director of Practice and Innovation at the Royal College of Occupational Therapists, said:
“Occupational therapists are uniquely positioned to deliver on some of the most pressing challenges facing councils, from reducing delayed hospital discharges and preventing avoidable admissions, to supporting people who face barriers getting into work and enabling healthy ageing at home. But right now, too few work in local government, which means many people are missing out on the right support at the right time.
“If the Government is serious about transforming care and supporting people to live independently in the community, then the upcoming Spending Review is the moment to act. Councils urgently need more funding to grow and keep this vital workforce. Pay and working conditions must match those in the NHS so councils can recruit and retain staff.
“With the right support, occupational therapists can be central in preventing ill health, reducing pressure on the NHS and helping people live in homes and communities that work for them. In this way, occupational therapists can help deliver the Government’s ambitions for prevention, integration and tackling health and care inequalities."
Image credit: iStock
