When health needs spill beyond the GP surgery, community hubs are stepping in and OTs are proving to be game changers. Here, occupational therapy apprentices Claudia Sowter and Charlotte Hord share their placement experience on a South London estate, where they witnessed first-hand how we can help tackle loneliness, empower residents and spark lasting change.
Preventing health crises and ensuring that those in need can access community support is imperative. There is a growing need for occupational therapists to be based primarily within communities and RCOT’s Occupational Therapy Workforce Strategy 2024-2035 (RCOT 2024) outlines a vision to make this a reality.
By positioning occupational therapy in community hubs, we can combat social isolation and loneliness through occupational participation and engagement. Cowen et al (2024) support this notion, emphasising the importance of individuals feeling a sense of community, connection and belonging in the places they call home, which can be achieved through occupation within their local community hubs.
NHS England neighbourhood health guidelines (2025) propose a new approach is needed, as one in five GP appointments are taken up for non-medical reasons, such as loneliness or to seek advice on housing or debts.
First impressions
For our intermediate practice placement, we were situated at a community hub on an estate in south London. The estate has a population of approximately 3,700, with a high proportion of people on the estate from BAME groups.
An Age UK study (2024) classified individuals aged 65 and over as being at high risk of loneliness and social isolation; this estate has a high representation of this population.
The community hub aims to combat inequality and foster a sense of togetherness within the community to address some of the challenges identified above. It provides advice and support in areas such as housing, while also running a therapeutic programme and distributing food to people in the community.
The hub’s mission is to prevent isolation and it is accessible to individuals of all ages and backgrounds.
Our first day at the community hub proved to be an eye-opening experience. The high demand and diverse range of needs created an overwhelming atmosphere, which was initially challenging.
Staff were frequently occupied with a range of tasks, which meant there was a lack of time to gather information and plan thoroughly as a team. With limited resources, the staff manage multiple responsibilities, which added to our curiosity of how they allocate tasks between them.
As apprentices, we recognised a gap for occupational therapy, but due to resource constraints and minimal links with local OT services, this was an initial barrier to support service users.
However, as we became more involved, it was clear that our skills could be of tremendous value in the development of the hub, as well as educating staff and service users about the role of occupational therapy and how we can support them.
Managing expectation
We could see that both staff and service users had different assumptions of what occupational therapy can offer. As a result, educating the team on what occupational therapy is became a crucial part of our role.
To address this, we delivered a presentation to explain what ‘occupations’ are and how they are strongly linked to wellbeing. We introduced concepts of occupational science, including Wilcock’s (1998) concept of doing, being, becoming and belonging, to highlight the complexity of occupation and its relationship with health and wellbeing.
We recognised that service users using the hub experienced a strong sense of occupational injustice, such as people experiencing language barriers and migrants facing challenges of unemployment and underutilisation of skills.
As OTs, our role is to empower individuals to live a fulfilling life and access the opportunities they deserve. We explained how occupational therapy can support disadvantaged individuals within a community through the promotion of occupations to support wellbeing. Therefore, we asked staff to think of service users who would benefit from occupational therapy input.
We then introduced the Kawa Model (Iwama et al 2009) as, due to its holistic nature and accessibility for additional languages and cultures, this felt an appropriate model to share. It has an empowering, storytelling element, which helps capture an individual’s identity, strengths and needs.
We successfully related the model to a client, enabling staff to better understand how it can be used to explore occupational therapy-based solutions.
In the short time the student occupational therapists have been with us, they have integrated so seamlessly into our service and supported numerous service users. Imagine how many more people could lead fulfilling lives with occupational therapists based in community centres?”
What we achieved
During our time at the hub, we were able to offer personalised advice and interventions to a number of service users, helping them overcome challenges related to daily activities.
One individual had recently been discharged from the hospital after a fall. They regularly used the hub, however it was reported that they had stopped attending, so we arranged a home visit. During the visit, we discovered that their confidence was impacted by the fall, preventing them from accessing their local community.
We also identified causes of trips and falls within the home and proceeded to make practical recommendations to ensure they were no longer at risk.
Following this, we were approached by several service users with both physical and mental health diagnoses, seeking advice from occupational therapy. We adapted our communication style to be sensitive to each client’s needs, while consistently assessing and managing the associated risks.
Service users have not only gained insights from us, but we have also learned a great deal from the perspectives shared in their stories, touching on themes such as culture, religion and mental health. We considered it a privilege to hear such personal and intimate accounts, which also reflect how much they valued our support.
We also co-facilitated several wellbeing groups aimed at increasing participation in occupation, while fostering group cohesion. RCOT promotes community-focused interventions as an effective way to enhance people’s mental and physical health by promoting social participation and creating a sense of belonging (RCOT 2021).
Throughout our placement, one event that particularly stood out to us was the celebration of International Women’s Day. This truly represented the meaning of community and highlighted the shared theme of empowerment and belonging.
Additionally, we worked closely with staff to promote safe working practices, implementing strategies and addressing barriers to ensure their safety. This involved establishing clear boundaries for staff, updating relevant resources and considering the physical and social environment.
While it was humbling and saddening to hear about the challenges many individuals face, the resilience and support within the community remain a constant source of strength. The experience left us with a deep sense of admiration for the estate and its community.
As stated by Brunwin (2024), we feel strongly that ongoing advocacy for the role that occupational therapy can play in the public health agenda is integral. This is evidenced through the work we have accomplished on this placement.
At a recent stakeholder meeting, including the Director of Children’s Services, Head of GP Practice and the Cabinet Lead for Children, the hub advocated for an occupational therapist to be based on site. This felt like a significant development after only having two OT learners on a six-week placement.
Professional development
Our background as occupational therapy apprentices was instrumental in supporting and enhancing our work within the community. We were able to apply the foundational knowledge and practical skills we gained during our apprenticeship to real-life situations.
By implementing theories, conducting assessments and maintaining a holistic, clientcentred approach, we were able to develop the occupational therapy process and support the diverse needs of the community.
We developed our problem-solving skills, which proved invaluable in adapting to the varied challenges we encountered. And with the guidance and support of our educator, we gained the knowledge, skills and confidence to collaborate effectively with the community and make a meaningful impact.
Our time at the community hub has profoundly shaped our professional and personal growth, and we will carry these experiences throughout our future practice.
We identified some future opportunities for the hub to explore, including:
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Develop student placements across the allied health professions, enabling the hub to access varied skill sets and promote a multidisciplinary approach.
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Continue developing an OT education pathway, to support future students during their placements, enabling them to get started more efficiently.
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Set up a small disability equipment provision within the hub, allowing people to access the equipment they need to carry out their occupations.
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Continue to develop and implement the hub’s policies and procedures.
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Develop the marketing of the hub’s profile, increasing people’s access to the services it provides.
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Research student project opportunities to support the evidence base for occupational therapy and other allied health professions.
As a final reflection, the Hub Centre Lead commented on the placement experience: ‘In the short time the student occupational therapists have been with us, they have integrated so seamlessly into our service and supported numerous service users. Imagine how many more people could lead fulfilling lives with occupational therapists based in community centres?’
Age UK (2024) You are not alone in feeling lonely. Available at
https://bit.ly/47pjsjc [accessed 27 March 2025].
Brunwin J (2024) You can be a changemaker, OTnews 31(12): 16-17.
Cowen K, Collins T, Carr S and Wilson Menzfeld G (2024) The role of occupational therapy in community development to combat social isolation and loneliness. British Journal of Occupational Therapy, 87(7): 434-442.
Iwama MK, Thomson NA, Macdonald RM (2009) The Kawa Model: The power of culturally responsive occupational therapy. Disability and Rehabilitation, 31, 1125-1135.
NHS England (2025) Neighbourhood health guidelines 2025/26. Available at https://bit.ly/467hxNV [accessed 11 March 2025].
RCOT (2021) Roots of recovery: occupational therapy at the heart of health equity. Available at
https://bit.ly/3VgK8eN [accessed 27 March 2025].
RCOT (2024) Occupational Therapy Workforce Strategy 2024-2035. Available at
www.rcot.co.uk/support-the-profession/workforce-strategy [accessed 5 September 2025].
Wilcock AA (1998) Reflections on doing, being and becoming. Canadian Journal of Occupational Therapy. 65(5): 248-256.
Words CLAUDIA SOWTER and CHARLOTTE HORD, second-year apprentices at the University of Brighton, supported by SUE WHEATLEY, Senior Lecturer and OT at the University of Brighton. Charlotte and Claudia both bring valuable experience from working in NHS community paediatrics and mental health services