Occupational therapy workforce report

This report provides an overview of the occupational therapy workforce in Victoria in 2016-2017. It is based on survey responses from 1,217 individual occupational therapists (approximately 25 per cent of Victorian occupational therapists with registration with the Occupational Therapy Board of Australia (OTBA) in December 2016 (OBTA, 2017)), five focus groups involving 20 participants, two individual interviews, and surveys from 270 government, non-government, and private organisational respondents that provide occupational therapy services across Victoria. When contrasted with 2015 data from the Australian Institute of Health and Welfare (AIHW) (2016), the respondent cohort included an over-representation of individuals employed in the public sector, individuals over 35 years, and people living in regional and rural areas.

The occupational therapy workforce in Victoria is a young, female dominated and growing workforce. Participants to this research reported strong job satisfaction. Key contributors to this satisfaction included the holistic nature of their work and opportunities to work across different populations, in diverse roles, and for a range of different sectors. Within the workplace, individuals reinforced the importance of being able to make a difference to their clients, a positive team environment, supportive management, and opportunities to continue learning across their career.

Despite these positive observations, the occupational therapy respondents explained that services are under-resourced to meet current demands. Consequences were reported to include long waiting lists, an inability to meet agreed benchmarks for assessment and intervention, compromise to clinical outcomes through an inability to deliver evidence-based practice, concerns regarding service quality, concerns regarding client safety following hospital discharge or while waiting for services and equipment, risks for readmission, and an inability to deliver primary and secondary prevention services. Impacts on staff were also reported to be significant, including increasing unpaid over-time to meet clinical demand, reducing job satisfaction, increased sick leave, and burn out. The challenges of meeting clinical demand were reported to be exacerbated by the fact that many organisations do not provide backfill during staff leave.

When recruiting occupational therapists, numerous organisations reported receiving up to 50 applications for junior positions. Even so, a handful of organisations still reported having unfilled junior positions. Significant concerns were expressed by many respondents about the increasing numbers of new graduates potentially resulting in challenges securing employment. However, no strong evidence was found to support this concern. Recruiting to intermediate and senior positions was reported to be more difficult. Applicant numbers were markedly lower than for junior positions and it appeared to be difficult to attract a person with appropriate skills and experience. Career progression was raised as an important issue for the profession. Many respondents expressed frustration at the minimal opportunities to advance beyond grade 2. Where these opportunities existed, they typically required relinquishing a focus on clinical work in favour of a management or project-based role. Professionals reported that choosing to retain a clinical focus often meant sitting at the grade 2 level for the duration of your career, despite decades of experience and increasingly specialised clinical experience.

Although a clear majority of occupational therapists reported they have the skills and tools to carry out their roles, only half agreed they have access to adequate training to progress their career and mentorship to support career growth. The requirement for specialised training in specific areas of practice, to supplement the holistic foundations on which occupational therapy is built, was reported as a specific need. Occupational therapists employed in generic roles articulated the need for more discipline-specific training opportunities. Access to more affordable and accessible professional development opportunities was raised as an issue by many respondents. This was particularly problematic for part-time workers and professionals from regional and rural areas.

Key areas of consideration for the occupational therapy workforce going forward include: (1) Improving community and professional understanding of the benefits of meaningful occupational engagement as a key contributor to maintaining and improving physical and mental health, and the role of occupational therapy in this process; (2) Need to strengthen the evidence and knowledge base of the profession to improve referrals and develop business cases for optimal staffing levels to help improve patient outcomes; (3) Reviewing funding models and models of care to optimise clinical outcomes and client safety by enabling delivery of services consistent with current evidence-base; (4) Developing career structures that recognise and encourage expertise and experience; (5) Exploring mechanisms that will facilitate improved capacity to meet workforce demand at the intermediate and senior levels; (6) Review of pay, entitlements and rebates where different professions are delivering an equivalent service; (7) Exploring holistic nature and skill set of profession and how this can be leveraged to support workforce demand; and (8) Exploring settings within which occupational therapists can create greatest impact (e.g. paediatrics) for improving patient/client outcomes.

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