Working as an employee outside statutory services
Jou Yin Teoh looks at a different kind of independent practice.
N
ot all routes into independent practice begin with self-employment. For a growing number of occupational therapists, the first step is an employed role in a private, third-sector or contracted organisation. That shift alone can open up new career possibilities, a different relationship with your work and a stronger sense of professional identity.
It is worth noting that employment status is not always what it appears. Occupational therapists employed by organisations that hold contracts to deliver statutory services, including those working in primary care networks, are often considered to sit within the independent practice sector rather than within statutory services. RCOT’ s membership includes practitioners represented by trade unions such as UNISON, many of whom work in precisely this contracted space, and who may not realise the professional context they are already operating in.
Dinuli Senaratne, Founder, Function First Care, RCOT Communities Independent Practice Lead for Work and Health, Becky Gale, Trainee ACP Weymouth and Portland PCN, RCOT Communities Network Lead for Primary Care, and Nicola Murphy, Consultant Occupational Therapist at Accora, have each built their careers in this space. Here, they share what they have learned.
Understanding the business you work within
Commercial awareness can feel at odds with occupational therapy values. In reality, it tends to protect them.
Employed practitioners working in private or contracted organisations often find that productivity, client satisfaction and income generation are part of the culture in a way that statutory settings are not. Rather than sitting outside professional practice, that awareness can sharpen it.
‘ Even as an employee, you may need to understand that your work sits within a business model. There may be more emphasis on productivity, efficiency, income generation and client satisfaction,’ says Dinuli.
For Nicola, that commercial context became a genuine clinical asset: her patient-facing expertise shaped product development in ways a non-clinical colleague could not.‘ This awareness allows me to influence the products that are going out there, using my experience of patientfacing work to ensure equipment meets realworld clinical needs,’ she comments.
The takeaway
Commercial awareness is not the opposite of person-centred care. It is often what makes it sustainable.
Ask yourself: Do I understand how my organisation generates income and how my professional contribution supports that?
Connecting with others through RCOT’ s Independent Practice Professional Network can help you think through the professional boundaries involved.
The hidden job market: conversations open more doors than adverts
Many roles in independent practice are never formally advertised. Organisations often do not know they need an occupational therapist until someone shows them what is possible. Both Nicola and Becky found their roles through proactive contact rather than job listings.
‘ It wasn’ t the traditional route of seeing a job advert. It was about putting myself forward, highlighting my experience and skills, and showing what I could bring to the company,’ reflects Nicola. While Becky adds:‘ I reached out to my current manager to ask could I come and shadow her team, and she said:“ I can do better than that. We have a job listed for a frailty OT”, suggesting I apply for the job role”.’
This is particularly relevant in areas such as occupational health, where job descriptions still commonly list nursing registration as a requirement even for roles where occupational therapy skills are directly applicable.
6 Occupational Therapy in Independent Practice