Support worker

• These are unqualified roles that allow future physios to gain valuable experience and insights. As support workers, they cannot call themselves a physiotherapist (as it is a protected title) and they do not need to be registered with the Health and Care Professions Council (HCPC). However, they are expected to adhere to the professional values and behaviours as set out by the Chartered Society of Physiotherapy (CSP).
• Physiotherapy support workers may be eligible to study for a Level 6 apprenticeship which will enable them to qualify as a physiotherapist.

Registered Physiotherapists

• Qualified physiotherapists through University degree or apprenticeship routes are required to register with the HCPC and CSP.
• They start their clinical practice at Band 5 and will be able to start working on progressing in their career pathway within 12-18 months into Band 6 roles.

Specialised areas of Physiotherapy practice

• Through masters degrees (MSc) physiotherapists are able to progress into specialised areas of clinical practice such as musculoskeletal physiotherapy, neurological physiotherapy, podiatry, respiratory, etc.
• Specialised skills such as injection therapy and non medical prescribing can also be acquired through

Musculoskeletal First Contact Physiotherapy Practitioners (Enhanced practice level)

• Registered physiotherapists with experience in Musculoskeletal physiotherapy can progress and choose to work as First Contact Physiotherapists subject to meeting the requirements set by the Health Education England and NHSE.
• https://www.england.nhs.uk/gp/expanding-our-workforce/first-contact-physiotherapists/
• https://www.hee.nhs.uk/our-work/allied-health-professions/enable-workforce/roadmaps-practice-0

Advanced Practitioner

An AP is a clinician working at an advanced level across all four pillars of advanced practice at master’s level.
The four pillars include: Research, Leadership and Management, Education and Clinical Practice.

• https://www.hee.nhs.uk/our-work/allied-health-professions/enable-workforce/roadmaps-practice-0
• MSc in Advanced Clinical Practice https://www.lincoln.ac.uk/course/adclprms/
• https://www.hee.nhs.uk/sites/default/files/documents/multi-professionalframeworkforadvancedclinicalpracticeinengland.pdf

Support worker

• These are unqualified roles that allow future OTS to gain valuable experience and insights. As support workers, they cannot call themselves an OT (as it is a protected title) and they do not need to be registered with the Health and Care Professions Council (HCPC). However, they are expected to adhere to the professional values and behaviours as set out by the Royal college of occupational therapists.
• support workers may be eligible to study for a Level 6 apprenticeship which will enable them to qualify as an OT.
• https://www.rcot.co.uk/about-occupational-therapy/become-an-occupational-therapist/become-ot-support-worker

Registered OTS

• Qualified occupational therapists through University degree recognised by the HCPC, accredited by the RCOT and World Federation of OTS or apprenticeship routes are required to register with the HCPC.
• They start their clinical practice at Band 5 and will be able to start working on progressing in their career pathway within 12-18 months into Band 6 roles.
• https://www.rcot.co.uk/about-occupational-therapy/become-an-occupational-therapist/career-faqs

Specialised areas of Occupational therapy practice

Through clinical placements in specialised areas, such as elderly care or services for children, OTS can practice in specialised areas. This could be furthered by an MSc degree.

Currently, OTs are not able to train as independent prescribers. A case has been made in 2021 about why OTS should be provided with an opportunity to train as prescribers but a decision hasn’t yet been made.

https://www.rcslt.org/wp-content/uploads/2023/02/Q-A.pdf

First Contact and Advanced Practice Roadmap for OTS

Registered OTs with experience in their occupational therapy practice can progress and choose to work as First Contact OTS subject to meeting the requirements set by the Health Education England and NHSE.

They can also work towards getting the digital badge for AP registration through the portfolio or university taught routes.

https://www.hee.nhs.uk/our-work/allied-health-professions/enable-workforce/roadmaps-practice-0

https://www.hee.nhs.uk/sites/default/files/documents/multi-professionalframeworkforadvancedclinical practiceinengland.pdf

After Completing School

Bachelor’s Degree: Obtain a degree in dietetics or a related field from an accredited university. Programs typically last three to four years and must be approved by the Health and Care Professions Council (HCPC).

Master’s Degree (optional): Some of you may choose to pursue a master’s degree in dietetics or a related area.

Band 5 Dietitian: Begin as a newly qualified dietitian, usually starting at Band 5 on the NHS Agenda for Change pay scale. Responsibilities include providing dietary advice, conducting nutritional assessments, and developing care plans for patients.

Progression based on experience and skill set to Band 6 and above as with other AHP roles in NHS and private settings.

https://nationalcareers.service.gov.uk/job-profiles/dietitian

Specialised areas of practices

You could specialise in a clinical area, such as cancer or diabetes or  work with particular groups; such as elderly people or those with learning difficulties. Teaching and health education are also options.

Leadership and Specialist roles: This could include Band 8a-8b / Consultant positions managing teams, working at strategic planning levels, conducting advanced research.

Academic/ Education sector roles: This could include working at University/ research sectors.
You could take on a management role where you would supervise the work of a team of dietitians. Eventually, you could be responsible for controlling a budget and planning and marketing a dietetic service.

Dietitians are not able to train as independent prescribers currently as like OTs. They can prescribe under an agreed Clinical management plan.

You could work in sports nutrition or the food industry. Some dietitians move into marketing roles such as publishing, sales and public relations.

https://www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/roles-allied-health-professions/dietitian

First Contact and Advanced Practice Roadmap for Dietitians

Similar to other AHP roles, the roadmap for enhanced and advanced Podiatry practice has been set by the HEE and NHSE.

https://www.hee.nhs.uk/sites/default/files/documents/Dietetic-Nov21%20FILLABLE_1.pdf

After Completing School

• Like with Physiotherapy and OT, after completing school, you can go through the University or Apprenticeship route to complete your Podiatry degree and registration. https://www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/roles-allied-health-professions/podiatrist#
• Through the Podiatrist support worker route, the following routes can be taken to become qualified podiatrist.

1. Taking the podiatry degree apprenticeship (in England), whilst still working as a support worker
2. Speaking to the nearest podiatry school to ask them at what level their current training maps onto their degree programme; it may be possible to complete the degree in less time, if a support worker already holds certain core skills or knowledge
3. If a support worker already holds a degree in any other subject, they can do the pre-registration Masters and become qualified after two-years of full-time study. (https://rcpod.org.uk/careers/support-worker-pathways)

• After successfully completing the required qualification through any of the routes above, you will need to register with the Health and Care Professions Council.

Specialised areas of practices

• This could include specialised practice through placements and practice experience in the field of professional sports, podiatric surgery, diabetes, wound care, rehabilitation, forensic podiatry, education and research. This can be in the NHS or within private healthcare organisations or through Private practice.
• https://www.prospects.ac.uk/job-profiles/podiatrist
• Within the NHS, there is a structured career path. With experience and further training, you can progress through the grades:
• entry level podiatrist (band 5)
• specialist (band 6)
• team leader or advanced podiatrist (band 7)
• specialist registrar in podiatric surgery (band 8a – d)
• consultant podiatric surgeon (band 9).
• Podiatrists can undertake non-medical prescribing training and become independent
• prescribers while working within their scope of practice.

Occupational Therapists in Primary Care

Occupational Therapists have become an increasingly valuable part of the Primary Care multi-professional team within general practice, with their numbers growing significantly since 2021 following the introduction of funding via the NHS England » Network Contract Directed Enhanced Service (DES).

These roles vary greatly – from practice-based clinical work focusing on functional assessments and interventions, to community-based health promotion roles, rehabilitation services, and everything in between. The Occupational Therapy pathway typically includes higher and post-graduate education at Masters’ level, with many Occupational Therapists pursuing advanced clinical practice qualifications to enhance their ability to provide comprehensive care within the primary care setting.

Why Occupational Therapy in Primary Care?

Occupational Therapists bring unique skills and perspectives to the primary care setting that benefit both patients and practices:

Holistic Approach to Health: OTs address the physical, cognitive, psychosocial, and environmental factors that impact a person’s ability to engage in meaningful daily activities

Reducing GP Workload: Evidence suggests that OTs in primary care can help reduce GP appointments by addressing functional and social issues that might otherwise require physician time

Falls Prevention: Specialist assessment and intervention strategies can help reduce falls and associated emergency admissions

Self-Management Support: OTs excel at empowering patients with long-term conditions to develop sustainable self-management strategies

Social Prescribing Integration: OTs complement social prescribing by addressing functional barriers to community engagement

Frailty Management: Comprehensive assessments and practical interventions for older adults help maintain independence

Mental Health Support: Activity-based interventions for anxiety, depression, and stress management

Career Development in Primary Care

Primary care offers unique opportunities for Occupational Therapists:

• Autonomous Practice: Develop advanced clinical reasoning and independent decision-making skills
• Professional Growth: Opportunity to expand scope of practice and develop specialist expertise
• Varied Caseload: Work with diverse patient populations and conditions
• Work-Life Balance: Predictable hours and flexibility not always available in acute settings
• Career Progression: Clear pathways to advanced practice and leadership roles

There are number of Occupational Therapists working throughout Lincolnshire in Primary Care roles. These roles vary greatly – from practice-based clinical work focusing on functional assessments and interventions, to community-based health promotion roles, rehabilitation services, and everything in between. The Occupational Therapy pathway typically includes higher and post-graduate education, with many Occupational Therapists pursuing advanced clinical practice qualifications to enhance their ability to provide comprehensive care within the primary care setting.

Support for Occupational Therapists in Primary Care

The Lincolnshire Training Hub offers a range of support for Occupational Therapists working in primary care:

• Networking opportunities – Connect with experienced Occupational Therapists who have networks and connections throughout Lincolnshire and wider, including the Royal College of Occupational Therapists.
• Career advice and signposting – General practice is a unique environment with diverse career opportunities. Some Occupational Therapists focus on developing clinical expertise, others move into management roles, while some develop portfolio careers including research, leadership, and more. LTH is available to provide advice or act as a sounding board for your career goals and aspirations.
• Lincolnshire Occupational Therapists in Primary Care Network Events – Evening events held around the county with a meal, training and networking. A fabulous opportunity to meet your colleagues in a less formal environment whilst keeping up to date.
• Training Options – The LTH team will be happy to discuss suitable training options with you to support your development and career progression.

Lincolnshire Training Hub is committed to supporting Occupational Therapists in primary care through:

• Tailored CPD Opportunities: Access to specialised training courses designed specifically for OTs working in primary care settings
• Clinical Supervision: Structured supervision framework with experienced primary care OTs
• Peer Support Networks: Regular opportunities to connect with fellow OTs facing similar challenges
• Career Development Planning: Support with creating and implementing personal development plans
• Research Opportunities: Connections to research networks and opportunities to participate in practice-based research
• Digital Resources: Access to online libraries, assessment tools, and intervention materials

Further Useful Links:

• Royal College of Occupational Therapists
• Health and Care Professions Council