Occupational therapist

Occupational therapists work on the everyday things a person can no longer manage: getting out of bed, cooking, holding down a job, sitting through a school day. The answer is rarely the condition itself. It is changing the task, the equipment or the room until the person can do the thing again, and most of that judgement happens in someone's kitchen rather than in a clinic.

What the job actually involves

Assess what someone can and cannot manage, usually by watching them try it rather than asking.
Agree goals in the person's own words, so progress means something to them and not only to the file.
Recommend and fit equipment such as rails, perching stools, wheelchairs and bathing aids.
Suggest changes to a home, a school or a workplace, and make the case to whoever pays for them.
Break a task into steps and rebuild it a different way when the old way is out of reach.
Decide whether a patient is safe to go home from a ward, and say so plainly when they are not.
Work with families, teachers and employers who all want different things from the same plan.
Write assessments and risk decisions clearly enough for a funding panel to follow without you there.

On a normal day

You ask someone to climb their own stairs twice, because the second attempt is the honest one.
You measure a doorway with the tape from your bag and work out that the chair will not fit.
You argue, politely, that a discharge planned for Friday cannot happen until the ramp is in.
You spend an hour with a sixteen year old planning how to get through a school day with fatigue.
You write a report for a housing panel knowing the wording decides whether a wet room gets funded.

What it is actually like

Reading about a job only gets you so far. Career Lab drops you into one real situation from it: Assess Marion's home without taking over. Marion came home six days ago with a hospital list of equipment she has no intention of using. You have one visit to work out what she actually needs.

You respond to the situation, then see what the work asked of you and what your choices changed.

Try being a occupational therapist

Pay and hours

Starting: £32,000 a year
Typical: £40,000 a year
Experienced: £48,000 a year

Source: National Careers Service (occupational therapist profile). The service publishes a starter and an experienced figure and no median, so the median here is the midpoint of that band., checked 2026-07-29.

Usually 35 to 40 hours a week, regular pattern.

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Skills that matter

Breaking a task apart. The job is taking an ordinary activity to pieces and finding the step that has stopped working, which is often not the step the person blames.
Watching rather than asking. People overestimate what they manage at home, so the only reliable assessment is seeing it done, kindly and without making it feel like a test.
Negotiation. Wards, families and funding panels all want different answers, and the plan only happens if you can carry all three.
Writing to be believed. Adaptations are paid for on the strength of your report, so a vague sentence costs a real person a real ramp.
Practical problem solving. Half the solutions are cheap and obvious once you are standing in the room: move the bed, turn the chair, change the handle.
Judging risk. You decide which risks are worth taking, because a life with every risk removed from it is not the goal and nobody thanks you for it.
Starting from what someone cares about. Effort comes from the activity mattering to the person, so the goal has to be theirs even when it sounds small to everyone else.

How people get in

University (Degree). An approved BSc in occupational therapy, which mixes university terms with around a thousand hours of supervised placement across different settings, and leads to a place on the HCPC register. Usually 3 years.
University (Postgraduate). If your first degree is in something else, a pre-registration masters gets you to the same registration in less time. Usually 2 years.
Apprenticeship (Level 6). The occupational therapist degree apprenticeship is paid, usually taken by therapy assistants already working in a service, with study around one day a week. Usually 4 years.
Working towards this role (Level 3). Many people start as an occupational therapy support worker or therapy assistant on the strength of a health and social care qualification, then apply for the apprenticeship from inside the service. Usually 1 to 2 years.

Experience that helps

Courses expect you to have seen the work, so a few days shadowing an occupational therapist in a hospital and again in a community team is closer to a requirement than a bonus. Paid or voluntary work as a therapy assistant, care worker or support worker gives you both the hours and something honest to write about in a personal statement.

Who employs occupational therapists

NHS hospital trusts
Community and intermediate care teams
Local authority social care and housing teams
Schools and specialist education services
Charities, hospices and case management firms
Prisons and secure mental health units

Where the work happens

A mix of hospital wards, people's homes, schools, mental health units, prisons and workplaces. Community posts mean a car, a boot full of equipment and several visits a day. Hospital posts mean ward rounds, discharge meetings and a caseload that turns over fast. Standard weekday hours are usual, with some rota cover in acute services.

Where it leads

Specialist practice in an area such as hand therapy, neurology, paediatrics or mental health.
Clinical lead or team lead, holding a caseload and supervising other therapists.
Advanced practice, which can include prescribing and running your own clinics.
Moving out of the NHS into housing, social care or vocational rehabilitation.
Teaching and research at a university, or independent practice taking case management work.

Common questions

Is occupational therapy the same as physiotherapy?

No, although they overlap and often share a corridor. Physiotherapy works on movement itself: strength, balance and range. Occupational therapy works on the activity you wanted the movement for. If someone cannot get upstairs, the physio may build the strength, while the occupational therapist looks at the rail, the second bannister, the order of the steps and whether the bed should come downstairs for a month.

What subjects do I need?

Most degrees ask for around three A levels or a BTEC at the same level, usually with a science or social science among them, and biology or psychology are the safest choices. GCSE English and maths at grade 4 or above are nearly always required. The T Level in Health is accepted by a growing number of universities, and Access to Higher Education diplomas are standard for people returning to study.

Do occupational therapists only work with older people?

No. Older people make up a lot of hospital and community work, but the profession also covers children's services, mental health units, prisons, schools and workplaces. Paediatric work with autistic children and children with cerebral palsy is one of the largest specialisms, and vocational rehabilitation, which is getting people back into work, is growing.

Is the pay any good?

It is a graduate profession on the NHS pay scale, so you start at Band 5 and most therapists reach Band 6 within a few years. That is a stable, pensionable salary rather than a large one. The usual ways to increase it are specialising, moving into advanced practice, or taking private case management and expert witness work alongside an NHS post.

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