ges
© SolStock via Getty Images
P
reventing 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.
September 2025 OTnews 47