Whilst a person “sits” on a list waiting to be seen, assessed, triaged… their story is on pause.  Risk sits within the waiting list waiting to be addressed. 

The longer people wait the greater the risk longer term, someone waiting for a grab rail fall and be admitted to hospital.  Another, who may be waiting for equipment could result in loss of confidence.  All this has a wider impact – care providers who are struggling to manage care and support for someone; the impact of this could be to increase care therefore dependency and reduce dignity and control.

What does this mean?

I have worked with therapists over the years who feel the pressure of the waiting list.  They often feel that they “own it” and are responsible for it.  Teams and therapists will squeeze in that extra visit, explore creative solutions to ensure that people are seen at the right time with the right intervention.

The reality of this is that without investment into Occupational Therapy Services Teams will constantly be firefighting.

What can we do?

We can problem solve!  (though the irony is not lost on me!). We as OTs are trained to problem solve, to do what we do best..  Look at the waiting lists with new eyes and consider creative ways to support those whose lives are on pause waiting.  Waiting to reach the top of the list or become “a priority” by which point much of what we could have done to prevent, delay and avoid could be a missed opportunity.

Many Local authorities are exploring implementation of OT first or Reablement first approach to ensure that those entering services for the same time are assessed in a strength based or asset-focused approach.  Exploring what the person CAN DO and identifying clear set goals to work with them.  This may mean they do not go onto a long-term waiting list for further assessment; or if they do their need may in part have reduced due to a Reablement approach in the first instance.   The only way to do this is by investing in more occupational therapy resource.

Others have explored engaging private companies to provide a waiting list cleanse and “mop up” the back log…however from experience all this does is moves demand from one place to another, whereas other companies “cleanse” which takes collaboration and integration in order to ensure the demands are actually met.

How can we make this go further?

Working in partnership between health and social care to ensure that services and resource are maximised.   We need to be aware of what is available to us across the board from public sectors, Private sectors and the third sector we cannot survive without each other

To ensure that a truly OT first approach is taken we should have confidence and faith in our colleagues’ assessments from Health to Social care and vice versa.  By working in partnership and ensuring shared goals we will ensure equality across the system.

It is essential to ensure a robust triage at the point of entry into services.  This will ensure unnecessary waits for people to only find out that if they chose to, they could have explored adaptations themselves or privately purchased equipment.  Equally if the perceived “need” is not reasonable or practicable support can be provided early on to prevent a long wait and further adding stress and pressure to both clients and professional’s lives.

Trusted assessor models are hugely beneficial to ensure that people do not wait unnecessarily where need could be met through another professional with the skills to assess and recommend; and we as OTs have the skills to empower and identify those around us that could be key to providing early intervention.

The reality of the world that we live in now sees increasing demand and increasing need.  The time for Occupational Therapy has never been greater.  We have a unique set of skills that allow us to see solutions not problems or barriers.

Occupational therapy requires investment to ensure that we can help support to deliver these outcomes for our communities.  Whether that be appropriate training, reviews of waiting lists, or triaging of new referrals.  Occupational therapists are central to ensuring those with long term complex health conditions continue to live in a dignified way as well as those who may have less complex need, but the solution will significantly impact on their quality of life.

Occupational therapy and Reablement are KEY to ensuring the person is seen through a lense of “what outcome are we looking to achieve” adaptations and equipment may not always be the solution.

OT Show

The OT show is an opportunity to show case solution focused approaches and is always a fantastic opportunity to connect and hear from others in similar positions.  There are diverse topics and opportunities to hear about strategic solutions to support service design.

We are especially excited to have input from occupational therapists from around the UK to help shape the 2026 programme to ensure it is capturing the challenges that clinicians face across all sectors.

In conclusion

The growing demand within social care is unlikely to ease any time soon. Waiting lists, in some form, will remain part of the landscape. But within that reality, there is still space for reflection. Behind every referral is a person seeking to maintain their independence, their safety, and their sense of normality.

For occupational therapists, the challenge is not only to respond to need, but to navigate the space in between—to hold risk, manage uncertainty, and continue to find practical solutions in less-than-ideal circumstances.

Until the gap between demand and capacity begins to narrow, the work will continue much as it does now: quietly, consistently, and often under pressure. And while the lists may grow longer, the focus remains the same—supporting people to live well in the places and routines that matter most to them.

 Local authorities and NHS trusts need to take explore positive solutions because if nothing changes… nothing changes.  Now is the time for OT to shout about our incredible profession.