A National summary report of the Employer Standards Survey for occupational therapists - August 2024

The social care workforce is responsible for supporting thousands of individuals, children, and families to improve their well-being and their chances in life. Occupational therapy is essential in helping people of all ages overcome challenges in completing everyday tasks. The support occupational therapists provide can help give people a renewed sense of purpose and improve their lives.

This survey helps organisations to better understand critical questions about the experiences of their employees: 

• How well do employers deliver the employer standards?
• How do employees perceive their working environment?
• What factors influence engagement at work and increase the likelihood of employees staying with organisations?

The employer standards for occupational therapists set out the shared core expectations of employers which will enable occupational therapists in all employment settings to work effectively and safely.

Please note that this summary report relies on data collected from occupational therapists employed by local authorities and related agencies. While the results are considered to represent a reasonable, national sample, no claims are made for generalisation of the results to other areas of the UK.

This year, the survey received over 15,000 responses, including 1,902 occupational therapists, from over 160 organisations. The full list of participating organisations can be seen in Appendix D. 

This document will outline the key findings from the survey. A full report of the findings at a national and regional level is available on the Knowledge Hub site. This summary compares the standards with the previous year’s survey (2022/3) and summarises some key findings that have emerged from the responses, including: 

• a decrease in satisfaction in five out of the eight standards.
• a positive response to questions on engagement with my job and organisation.
• a 12 per cent drop in score for standard 3 (safe workloads and case allocation), driven by new questions on caseload weighting tools and workload allocation policies.
• a significant difference in level of satisfaction between occupational therapists who had experienced a mental health condition in the last 12 months and those who had not.
• effective workforce planning systems has dropped to the lowest scoring standard.

The overall results from the survey suggest that there has been a decline in response across five of the standards, however overall mean scores remain high, and we saw an increase in standard 5 (supervision). The decline in response to questions on safe workloads and case allocation is notable. This result was influenced by the introduction of new questions, which give a more detailed picture of how occupational therapists perceive how their employers manage workloads and ensure fair allocation.

Standard 1 – Strong and clear occupational therapy framework

This standard is about promoting a clear statement about the principles that constitute good occupational therapy practice.

Standard 2 – Effective workforce planning systems

This standard is about using effective workforce planning systems to make sure that the right resources are available to meet current and future service demands.

Standard 3 – Safe workloads and case allocation

This standard is about ensuring employees do not experience excessive workloads, resulting in unallocated cases and long waiting times for individuals.

Standard 4 – Wellbeing

This standard is about promoting a positive culture for employee wellbeing and supporting occupational therapists to practice effectively and safely.

Standard 5 – Supervision

This standard is about making sure students and qualified practitioners can reflect critically on their practice through high quality, regular supervision.

Standard 6 – Continuing professional development (CPD)

This standard is about occupational therapists being provided with the time and opportunity to learn, keep their knowledge and skills up to date, and critically reflect on the impact on their practice. 

Standard 7 – Professional registration

This standard is about supporting occupational therapists to maintain their professional registration with the regulator.

Standard 8 – Strategic partnerships

This standard is about creating strong partnerships and good collaboration between employers, higher education institutions, and other training providers.

The survey was carried out from February 2024 to April 2024. It received 1,902 responses from occupational therapists, who contributed 12 per cent of the total survey responses. Based on feedback from previous health checks, this year’s survey presented a revised set of questions with enhanced questions on workplace experience and more detailed questions on each of the standards. As a result, we have been able to capture a more detailed understanding of satisfaction amongst occupational therapists and their perception of the employer standards.

Methodology

The data from the survey was interpreted using a mean average score for each question as the survey sought to measure attitudes and opinions on a scale. Respondents were asked to select options from ‘strongly disagree’ to ‘strongly agree’. The mean score is used to determine the average performance of a question so it can also be referred to as the average satisfaction score and can be converted to the same number as a percentage to indicate the average percentage of the score relative to the total score.

Scores or percentages for a question between 0-50 indicate a low outcome, scores between 51-74 indicate a moderate outcome and scores between 75-100 indicate a good outcome.

Statistically significant

This term describes a mathematical measure of difference between groups. Throughout the report, the term ‘statistically significant’ may be used. A difference of five percentage points demonstrates that a difference in a response is statistically significant. A difference of less than five is not considered statistically significant, but these responses may still be shown to make comparisons.

The employer standards for occupational therapists set out the shared core expectations of employers which enable occupational therapists in all employment setting to work effectively and safely. There were changes from the 2022/23 questions so no overall comparison can be made. We can however, see a decrease in the average mean score across five of the eight standards.

In 2023, the overall performance of the standards across adults, children’s and integrated adults and children’s occupational therapists were similar. Those whose specialism was integrated adults and children (78 per cent) and children (78 per cent) had slightly higher average responses across Standards 1-8 than those whose specialism was adults (76 per cent).

The most favourably received standard for 2023 was standard 7 (professional registration) with a mean score of 84 per cent. Standard 5 (supervision) and standard 4 (wellbeing) also had high mean scores of 83 per cent and 80 per cent respectively.

The least favourably received was standard 2 (effective workforce planning systems) with a mean score of 68 per cent. Standard 6 (continuing professional development) received a lower mean score of 71 per cent.

The survey also tried to give a picture of variations across different groups. There were differences in responses across different employers (local authority, NHS Trust, and others). Those employed by local authorities gave an average mean score of 77 per cent, compared to an average mean score of 85 per cent from those employed by NHS trusts.

The Mean score generally declined with length of service. Occupational therapists with less than one year of service gave an average mean score of 82 per cent compared to the mean score of occupational therapists with other lengths of service  75/76 per cent.

The only standard that saw the biggest change in satisfaction from the year before was standard 3 – safe workloads and case allocation (average mean score 73 per cent). There was a decrease of 12 per cent from last year’s score of 85 per cent. We also saw a significant decrease in average mean score for standard 2 – effective workforce planning systems of seven per cent There were marginal declines across three standards.

There was an increase in average mean score of 2 per cent for standard 5 (supervision) and average mean score stayed the same across standard 6 (continuing professional development) and standard 8 (strategic partnerships).

The overall performance of the employer standards for each region is shown in shown in Appendix A in table format. A bar chart is also shown below. 

The national average mean score alongside the mean score received from seven out of the eight regions were in the ‘good’ range (75+). Two regions (East Midlands and Yorkshire and Humber) received a mean score within the ‘moderate’ range that indicates capability for improvement.

Occupational therapists in the North East of England responded to the standards most favourably (mean score of 79 per cent) in comparison to occupational therapists from Yorkshire and Humber who responded to the standards least favourably (mean score of 71 per cent). 

Even though they were not both the lowest scoring, the East Midlands and Yorkshire and Humber saw the biggest decrease in satisfaction since last year. Both decreases were of statistical significance. Both saw an eight per cent decrease, with East Midlands going from 81 per cent (2022/23) to 73 per cent (2023/24) and Yorkshire and Humber from 79 per cent (2022/23) to 71 per cent (2023/24).

Professional registration - standard 7

This standard received an overall mean score of 84 per cent and saw no change from 2022/23. The North West of England received the highest mean score for this standard at 88 per cent.

Occupational therapists have found the registration/re-registration process with the Health Care Professionals Council straightforward (86 per cent) and feel their organisations support and encourage a working environment that upholds ethical practice and quality standards (86 per cent).

Safe workloads and case allocation - standard 3

This standard received an overall mean score of 73 per cent and saw the biggest decrease since 2022/23 of 12 per cent. This was heavily influenced by two new questions which received low responses. 

The results from these new questions show that organisations are not regularly using a caseload weighting tool to confirm that caseloads and allocations are fair (37 per cent). 67 per cent identified that an allocations/caseload management policy is used in their organisation.

Questions around support for health and wellbeing all scored highly. Five questions in this set received a mean score in the ‘good’ range over 80 per cent.

Effective workforce planning systems – standard 2

Effective workforce planning systems received an average mean score of 68 per cent. This is in the ‘moderate’ range (51-74). Three new questions were added to the Standard which got quite low responses impacting the Standard average.

Standard 2 was the least favourably received standard across the eight employer standards, in 2022/23, the standard received a score of 75 per cent, showing that this standard has decreased significantly over the last year. There was some variation in response across service area. Children and integrated Adults and Children occupational therapists responded slightly more favourably with mean scores of 68 per cent. These differences are not of statistical significance.

Four out of five questions for standard 2 received a ‘moderate’ score (51-74). Occupational therapists do not entirely feel that consultation informs and influences change within their organisations (mean score 60 per cent). They also did not entirely feel their employers understand the barriers and challenges that are getting in the way of doing their best work and promotes solutions to address these (mean score – 67 per cent). 

The survey also asked occupational therapists some supplementary questions to understand how they engage with their job and organisation. The set of questions asked in this section sought to answer how occupational therapists feel about their job role and how they are supported by their organisation in doing so.

The overall mean score for workplace experience was at the lower end of the ‘good’ range at 75. There were scores in the ‘moderate’ range (51-74) across five questions. Occupational therapists largely felt confident carrying out their role (89 per cent) and felt a sense of pride in their jobs (90 per cent).

The questions included in this section are different from previous years, so no direct comparison is available for overall mean score. We have seen similar mean scores on every question that has been repeated this year with no significant decreases. For example, we can see a significant decrease (five per cent) in response to the statement: ‘I feel positive and able to cope with work most of the time’.

The survey also asked occupational therapists whether they had experienced or witnessed bullying, harassment, or discrimination during the last 12 months. 18 per cent of occupational therapists said they had been bullied by people who use social care, relatives, or the public, three per cent by a manager and five per cent by a colleague. 17 per cent of occupational therapists said they had experienced racism or discrimination from people who use social care, relatives, or the public, five per cent from managers and six per cent from a colleague.

Ethnicity

The number of survey respondents by ethnic groups and scores of the overall standards can be seen in Appendix A and C. Occupational therapists who were from a Black and Asian background responded most favourably (both with a mean score of 83 per cent). In comparison, those from another ethnic group responded less favourably (75 per cent respectively). Those who preferred not to state their ethnic group responded the least favourably (mean score of 66 per cent).

Disability

23 per cent of occupational therapists responding to the survey said that they had a physical condition in the last 12 months that has impacted their ability to work effectively. Those who answered that they had responded less favourably than those who had not, 73 per cent compared to 79 per cent. This is a statistically significant difference. Those who preferred not to say answered the least favourably (mean score of 70 per cent).

6.3 per cent of occupational therapists surveyed said that they had a mental health condition in the last 12 months that has impacted on their ability to work effectively. Those that had a mental health condition had a significantly lower mean score of 69 per cent, 10 percentage points lower than occupational therapists that have not had a mental health condition in the last 12 months. Again, those who preferred not to say had a similarly lower mean score of 69 per cent.

In last year’s survey, occupational therapists who declared they were disabled responded less favourably to the standards with a decrease in satisfaction of seven percentage points. While it is not directly comparable, due to new questions focussing on mental and physical conditions in the last 12 months, we can see that this difference has increased slightly.

Across occupational therapists who have had both mental and physical health conditions in the last 12 months, we can see significantly lower satisfaction compared to those that have not. 

Gender

83 per cent of occupational therapists surveyed identified as female, nine per cent as male and less than one per cent as non-binary. These are similar to last year’s breakdown with a slight reduction in the proportion of respondents who identify as female (from 87 per cent to 83 per cent).

The performance of the standards across male and female occupational therapists was similar, with average mean scores of 77 and 79 per cent respectively. There was not enough data to generate an average mean score for those who identify as non-binary. Occupational therapists who preferred not to state their gender responded the least favourably to the standards overall (mean score of 66 per cent).

Age

The number of survey respondents by age and the performance of the standards when comparing the age of respondents can be seen in Appendix A and C. Occupational therapists who are aged 24 and below responded most favourably to the standards (mean score of 85 per cent). Occupational therapists who preferred not to state their age responded least favourably to the standards overall (mean score of 68 per cent). Across all demographic measures, we can see that those who ‘prefer not to say’ responded the least favourably to the standard. This trend was also apparent in last year’s survey. 

As we face increasing demand on social care services and a high number of projected vacancies within the sector across the next decade, it is positive that we have seen overall high responses to key indicators of workforce satisfaction. In particular, the results of the survey show that occupational therapists continue to feel confident in their roles and highly satisfied with how they are supported by managers and wider professional organisations. This was shown through the continued high response to standard 4 (wellbeing), standard 5 (supervision) and standard 7 (professional registration). We also saw positive responses to questions on physical safety in the workplace, commitment to inclusion and support with mental wellbeing. 

The overall mean score nationally for all the standards did see a decrease to 76 per cent from 79 per cent, different questions mean a direct comparison cannot be made; the overall mean score across the employer standards remains in the ‘good’ range (75+). The scores across the different regions of England are still good, with two regions seeing an increase and only marginal declines across five. The declines seen in the East Midlands and Yorkshire and Humber are significant, seeing their average mean scores fall into the ‘moderate’ range (51-74). This indicates there is room for improvement. The full regional results provide a more detailed breakdown of each region, highlighting areas for improvement. These are available on the Employer Standards Health Check Knowledge Hub site.

The decline in satisfaction for standard 3 (safe workloads and case allocation) suggests that there is room for improvement in how employers are delivering this. The responses for each question show that there needs to be a strengthening of allocations/caseload management policies and wider use of caseload weighting tools to ensure the trend does not continue.

With a 7 per cent decrease in mean score, standard 2 has dropped to the least favourable standard. With increasing service pressures, effective workforce planning systems are vital to ensure that there are sufficient resources to meet demands.  There is room to improve how occupational therapists are consulted and supported when change occurs to ensure they feel as though they can have impact and influence over the direction of travel within their organisations.

The responses across the ‘engagement with my job and organisation’ section were generally positive with a mean score of 75 per cent. This section gave a general picture of how occupational therapists perceive their job roles and organisation, so is an important measure of the ‘health’ of the workforce. Respondents were presented with a revised set of questions in this year’s survey; with new questions that provide a more comprehensive understanding of their experiences. Across these new questions, the mean scores ranged from 60 to 85 per cent. Across all of the eleven questions, five received mean scores that are in the ‘moderate’ range. There were no significant changes across repeated questions. 

It is important to ensure that improvements are made across the standards to bring the overall scores on an upward trajectory. We will be making resources directly available to support organisations with action planning based on their results, you can find more resources and the full results from the survey on the Knowledge Hub

The following tables summarise results for accessibility purposes

Full list of participating bodies:

• Barnsley Metropolitan Borough Council
• Bath and North East Somerset Council
• Bedford Borough Council
• Birmingham City Council
• Blackburn with Darwen Borough Council
• Blackpool Council
• Bolton Metropolitan Borough Council
• Bournemouth, Christchurch, and Poole Council
• Bracknell Forest Borough Council
• City of Bradford Metropolitan Borough Council
• Brighton and Hove City Council
• Bristol City Council
• Buckinghamshire Council
• Bury Metropolitan Borough Council
• Calderdale Metropolitan Borough Council
• Cambridgeshire County Council
• Central Bedfordshire Council
• Cheshire East Council
• Cheshire West and Chester Council
• Westminster City Council
• Cornwall Council
• City of London Corporation
• Coventry City Council
• Cumberland Council
• Darlington Borough Council
• Derby City Council
• Derbyshire County Council
• Devon County Council
• City of Doncaster Council
• Dorset Council
• Dudley Metropolitan Borough Council
• Durham County Council
• East Riding of Yorkshire Council
• East Sussex County Council
• Essex County Council
• Essex Partnership University NHS Foundation Trust
• Gateshead Metropolitan Borough Council
• Gloucestershire County Council
• Halton Borough Council
• Hampshire County Council
• Hartlepool Borough Council
• Herefordshire Council
• Hertfordshire County Council
• Hull City Council
• Isle of Wight Council
• Council of the Isles of Scilly
• Government of Jersey
• Kent County Council
• Kirklees Metropolitan Borough Council
• Knowsley Metropolitan Borough Council
• Lancashire County Council
• London Borough of Barking and Dagenham Council
• London Borough of Barnet Council
• London Borough of Bexley Council
• London Borough of Brent Council
• London Borough of Bromley Council
• London Borough of Camden Council
• London Borough of Croydon Council
• London Borough of Ealing Council
• London Borough of Enfield Council
• London Borough of Hackney Council
• London Borough of Hammersmith and Fulham Council
• London Borough of Haringey Council
• London Borough of Harrow Council
• London Borough of Havering Council
• London Borough of Hillingdon Council
• London Borough of Hounslow Council
• London Borough of Islington Council
• London Borough of Lambeth Council
• London Borough of Lewisham Council
• London Borough of Merton Council
• London Borough of Newham Council
• London Borough of Redbridge Council
• London Borough of Southwark Council
• London Borough of Sutton Council
• London Borough of Tower Hamlets Council
• London Borough of Waltham Forest Council
• Leeds City Council Leicester City Council
• Leicestershire County Council
• Lincolnshire County Council
• Liverpool City Council
• Luton Borough Council
• Manchester City Council
• Medway Council
• Middlesbrough Borough Council
• Milton Keynes City Council
• Newcastle upon Tyne City Council
• Norfolk City Council
• North East Lincolnshire Council
• North Lincolnshire Council
• North Northamptonshire Council
• North Somerset Council
• North Tyneside Metropolitan Borough Council
• North Yorkshire Council
• Northumberland County Council
• Nottingham City Council
• Nottinghamshire County Council
• Oldham Metropolitan Borough Council
• Oxfordshire County Council
• Peterborough City Council
• Plymouth City Council
• Portsmouth City Council
• Royal Borough of Greenwich
• Royal Borough of Kensington and Chelsea
• Royal Borough of Kingston upon Thames
• Royal Borough of Windsor and Maidenhead
• Reading Borough Council
• Redcar and Cleveland Borough Council
• Richmond and Wandsworth Councils
• Rochdale Borough Council
• Rotherham Metropolitan Borough Council
• Rutland County Council
• Salford City Council Sandwell Metropolitan Borough Council
• Sefton Metropolitan Borough Council
• Sheffield City Council
• Shropshire Council
• Slough Borough Council
• Solihull Metropolitan Borough Council
• Somerset Council
• South Gloucestershire Council
• South Tyneside Metropolitan Borough Council
• Southampton City Council
• Southend-on-Sea City Council
• St Helens Borough Council
• Staffordshire County Council
• Stockport Metropolitan Borough Council
• Stockton-on-Tees Borough Council
• Stoke-on-Trent City Council
• Suffolk County Council
• Sunderland City Council
• Surrey County Council
• Swindon Borough Council
• Tameside Metropolitan Borough Council
• Telford and Wrekin Council
• Thurrock Council
• Torbay Council
• Trafford Metropolitan Borough Council
• Wakefield Council
• Walsall Council
• Warrington Borough Council
• Warwickshire County Council
• West Berkshire Council
• West Northamptonshire Council
• West Sussex County Council
• Westmorland and Furness Council
• Wigan Metropolitan Borough Council
• Wiltshire Council
• Wirral Metropolitan Borough Council
• Wokingham Borough Council
• City of Wolverhampton Council
• Worcestershire County Council
• City of York Council
• East London NHS FT
• Live Well South West Trust
• Midlands Partnership NHS FT
• Northamptonshire Children's Trust
• Salford NHS Trust
• Sandwell Childrens Trust
• Slough Childrens First
• Together for Children
• Cheshire and Wirral NHS FT
• Worcestershire Children's First
• Lincolnshire Partnership NHS FT
• Bradford Children and Families Trust
• Torbay and South Devon