What inspired you to focus your OT Show 2026 session on sustainability and professional responsibility?

The climate crisis is a health crisis that affects us all. The impact of climate disruption in healthcare in recent years, particularly this summer with record numbers of admissions to A&E in the heatwaves has impacted on Occupational Therapists. Health issues have changed; pollution is as big a cause of stroke as smoking, and directly linked to heart disease, children’s respiratory issues and increased heat and damp cause health problems for older people, babies and people with disabilities. Not only this but supply chains have been disrupted - we need to be prepared to deliver our services in a changing world now and for future generations. Most Occupational Therapists feel that this is important and want to do something, but don't know how or where to start.  It’s important to provide a focus on this - OTs can save the planet but need to have the confidence to get started!
 

Why should sustainability be considered a core professional responsibility for occupational therapists?

Occupational security, choice and ability depend on environmental stability. Sustainability is a clear professional responsibility as set out in the RCOT Code of Ethics, is a key principle in the AHP Strategy and is part of the World Federation of Occupational Therapists Guiding Principles and Position Statements. WFOT states:

“Environmental sustainability supports all aspects of human well-being, ...basic material satisfaction, freedom of choice and action, health, security and good social relations. 

Incorporating a perspective on sustainability will enable occupational therapy to play an important role towards a vision of environmentally sustainable, fair and healthy societies."

We as OTs are at the frontline of climate challenges, experiencing physical health impacts, mental health impacts, occupational safety impacts, and impacts on workforce capacity and resilience. It is a responsibility for all of us to do what we can to provide a professional service, that includes considering environmental sustainability. It’s also an opportunity – we have so much already available to us that we can draw on.
 

What does sustainable occupational therapy look like in everyday practice?

The first principle of sustainable clinical practice is prevention; the “greenest” hospital bed is the one which is empty.  Occupational therapists can support people to return to what matters to them, be part of communities, stay well and thrive – we are a sustainable solution already, we just need to recognise that!

Being trained in mental and physical health, supporting people to live as they want to live in a meaningful way, we provide a low cost, high impact interventions. Many people feel better when connected to nature and we can support this through green walking, gardening groups, activity within a community etc. OTs can keep people out of hospital and in their own homes, can provide therapy to support participation or through rehabilitation a return to purposeful lives. This is sustainable healthcare.
 

Where can occupational therapists make a huge environmental impact without compromising quality of care?

Better care is most often more environmentally friendly, it is early intervention, appropriate provision and cooperative work. Many examples show occupational therapists making huge environmental impacts and benefiting quality of care; connecting people with nature, “Green Walking” for mental health recovery and increasing appropriate virtual care all have strong evidence to back them up and good outcomes for those taking part.

Online fatigue management groups for people recovering from stroke, have been so effective, that patients chose to continue participation after formal intervention finished, providing valuable ongoing social interaction, people were able to manage their own health, reducing demands on services.

Reduction of waste through more careful purchase of sustainable items, collaborative prescription, reuse and repair of equipment is key, but has an added benefit of saving time and money.

Keeping people healthy through sports opportunities for people with disabilities for instance provides social, physical and mental support. Similarly with falls prevention services, the OT impacts in prevention are massive.
 

How can OTs balance sustainability goals with clinical priorities, time pressures and limited resources?

Lord Darzi said in his report in 2024; “There is no trade-off between climate responsibilities and reducing waiting lists... often health and climate are mutually reinforcing goals: cleaner air is good for the environment and good for respiratory health.”

Often more sustainable practices reduce work for therapists, reduce duplication, support working together as a team with other professionals and reduce time pressures.  For example, everyone in a community service doing one or two virtual appointments in a year would save an average of 250 hours of travel a year – equivalent to a whole-time post. This is providing a clinically effective and robust service while saving time and reducing pollution

Return and reuse of equipment saves time ordering and waiting for delivery and saves money while reducing the many thousands of items sent to landfill unnecessarily every year.
 

Could you share an example of a small change that has delivered meaningful benefits for clients, services or the environment?

Yes sure, in one Trust, changing to virtual sessions where appropriate for neuro rehabilitation appointments, was only 2% of appointments a year. That small change saved 10,000 travel miles, £7,000, and cut waiting lists down from one year wait to five weeks in a year with identical patient outcomes. Patients reported they like the flexibility and support, to manage their fatigue through frequent short interventions and have their family members attend appointments despite living far away. The service is now resilient in the face of flooding and staff can continue their treatment, remotely providing an adaptive solution as well as mitigating risks.
 

What ethical challenges can arise when environmental sustainability, client choice and professional responsibilities appear to conflict?

The best interests of clients/patients should be at the centre of OT practice. Client choice is about informed choices that are right for them. Time and again in polls across very diverse ranges of people, it has been shown that the public dislikes waste and will opt for the sustainable option, the flexible solution and the local solution. Are we giving people the information and providing these options?
 

What practical tools, frameworks or resources would you recommend to occupational therapists who want to make their practice more sustainable?

Talk to fellow OTs and join the RCOT Sustainability Community – a free online community of OTs from around the country sharing best practices, evidence-based interventions, problem solving and resources and supporting each other. Welcome | Sustainability network. Check out practical resources available through the Centre for Sustainable Healthcare which has sustainable quality improvement frameworks, look at the Canadian OT Sustainability playbook by Janet Craik (Cascades) and read the World Federation of Occupational Therapy Position Statement and guidelines on sustainability.
 

What is the single most important idea or action you hope attendees will take away from your session at The OT Show 2026?

This is not only a challenge it’s an opportunity so no-one needs to be perfect, but we do all need to do a bit and it will make a huge difference, we all have a climate superpower as OTs and together we can move mountains!