Councils lack tools to manage OT caseloads, survey finds

Councils lack tools to manage the caseloads of occupational therapists, a survey has found.

The 2024 ‘health check’ measuring practitioners’ views of authorities’ performance against the Local Government Association’s standards for employers of occupational therapists in England revealed falling satisfaction in relation to five of the eight standards, compared with the previous survey.

The only area of improvement was in relation to supervision, for which the average score rose from 80 to 82, making it the second highest scoring standard behind professional registration (83).

Caseload management concerns

The biggest fall in satisfaction between 2022-23 and 2024 came in relation to the standard on safe workloads and case allocation, where the average score fell from 85 to 73.

This was driven by responses to two new questions, in relation to caseload management.

A question on whether practitioners had a caseload weighting tool to confirm whether their workloads were fair scored just 37, while a question on whether there was an allocations or caseload management policy in their organisation scored 66.

“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,” said the LGA’s report on the health check.

OTs were more satisfied in relation to a related question, asking whether they were usually allocated work through a fair process that took account of their workload, capabilities and health and wellbeing, which scored 83, up from 80 in 2022-23.

There were also high scores for whether they could discuss workload and stress with their supervisor and agree satisfactory ways forward (85) and whether they knew where to go to get help in their organisation if they were concerned about their workload (84).

Falling satisfaction in relation to involvement of workforce

However, there was also a sharp decline, from 75 to 68 points, in relation to OTs’ satisfaction with workforce planning systems, a standard that covers how far they are involved in decision making within their organisations.

This was also driven by relatively modest responses to three new questions:

• Whether employee consultation informed and influenced change within the organisation (60).
• Whether employers made sure that employees understood why change occurred in the organisation (68).
• Whether organisations understood the barriers and challenges that were getting in the way of OTs doing their best work and promoted solutions to address these (67).

“With increasing service pressures, effective workforce planning systems are vital to ensure that there are sufficient resources to meet demands,” said the LGA report. “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.”

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OTs ‘proud and confident’ but feel they have to do ‘more with less’

Meanwhile, there were mixed responses to a set of general questions on job satisfaction, with relatively low scores on whether OTs were satisfied with their employment deal (51) and whether they were not often required to do more with less (60).

However, much more positively, there were scores of 90 for whether practitioners felt a sense of pride in their job, and 89 for whether they were confident carrying out their role. The average score for whether practitioners would recommend their employer to a friend was 80, a slight drop on the figure for 2022-23 (81).

High workloads ‘bad for OTs and people needing services’

In response to the health check results, Suhailah Mohamed, head of practice and workforce at the Royal College of Occupational Therapists, said: “It’s concerning to see the social care occupational therapy workforce reporting higher caseloads, and workloads that may no longer be safe in some instances.

“This is not only bad for the occupational therapy workforce – potentially affecting their wellbeing and morale – but also for the people accessing their services, who we support with daily living.

“If the occupational therapy workforce doesn’t have the capacity to do their jobs properly, it means people don’t have the support they need at home, and their quality of life could get worse. It could also lead to more pressure on an already-stretched healthcare service and workforce. Having more occupational therapists and support workers in communities – where they’re needed – could ultimately save money and reduce waiting lists.

“Employers of a social care workforce, including local authorities, need to invest in the training needs of that workforce. They need to address the low morale, and the diminished sense of pride and wellbeing if we are to see our social care workforce bounce back from the pressures of the pandemic, industrial action and austerity that’s ensued.”