Occupational therapy roles and responsibilities: Evidence from a pilot study of time use in an integrated health and social care trust

Introduction: Occupational therapists undertake a broad spectrum of activities, yet no mechanism exists to record how working time is distributed across them. This is a hindrance to research, evaluation and evidence-based practice. Method: A new diary schedule was piloted by 151 qualified and assistant-grade practitioners working in multiple adult health and social care settings in an integrated NHS and social care trust in England. Time use relating to 37 occupational therapy tasks was recorded in 30 minute intervals for one week. Results: Almost 5000 hours of activity were recorded. For the average working week, 39% of time was spent in direct care with clients, 31% involved undertaking indirect casework such as liaison and administration, whilst a further 22% was in team/service activity. Only modest differences were observed between qualified and assistant-grade respondents, whilst occupational therapists in traditional social care roles spent significantly longer in liaison and administrative duties. Individual tasks capturing ‘therapeutic activity’ accounted for just 10% of practitioner time. Conclusion: The new diary tool is a viable data collection instrument to evaluate practice and the impact of service redesign. However, further work is needed to evaluate its measurement properties in more detail