Occupational Therapists (OTs) are gradually creeping into the Occupational Health (OH) profession. When you look at the job title, it makes perfect sense but in the UK, OTs have generally been engaged in helping the elderly and infirm back into their homes after a stay in hospital. Home Care Therapist would make more sense as a job title. The situation is very different in many southern hemisphere countries such as Australia and South Africa where OTs play a significant case management role in workplace health. But it is the insurance market that has driven this, not the employers.
Back in Blighty, the inevitable question is starting to be asked. Who is better? The only place that you would be able to do such a study in the UK would be within one of the big providers but it’s still unclear whether they are employing significant numbers. About 8 years ago, when I was working for one such provider we did some work comparing the cost and effectiveness of different OH teams. We looked at the office based case management team who were mostly unqualified and inexperienced and the newer remote (home based) case management team who were more experienced and had a further qualification in occupational health. The remote team were paid more due to qualifications and experience which rather concerned the finance director, trying to budget for a rather large and prestigious contract. However after some analysis, it became clear that the remote team provided better advice, closed cases quicker with better outcomes so were in fact cheaper. Although we were one of the first providers to employ an OT and a physiotherapist, they were for slightly different roles so it wasn’t possible to do any comparisons. It wouldn’t have been fair anyway as all we would have ended up doing was comparing individuals rather than groups.
My experience is that the employment of large numbers of OTs in UK OH is still a long way off. The overwhelming majority of our OH clinical staff still start out as nurses and doctors in the NHS who at some point, want a change in career and find their way into OH – usually by accident in my experience. Whether it is right that this should be the only route in is another big question. Many within OH are vehemently opposed to the idea that an OH Adviser be anything other than a nurse first. I am not so sure. OH Advisers are a scant resource and if we are serious about improving health at work, more resources need to come from other routes. OTs Physiotherapists and graduates with good health science degrees could all play a bigger role in occupational health in the next 5 – 10 years. Then reasonable comparison won’t just be possible, it’ll be essential.