Almost a third of OTs say they cannot provide the equipment and adaptations children need

The cost-of-living crisis is contributing to delays which are affecting the health, development and wellbeing of children, young people, and their families, according to a new report by the Royal College of Occupational Therapists (RCOT).

The Children’s survey report 2023, which surveyed 698 occupational therapists working with children and young people across the UK, reveals the devastating impact of the cost-of-living crisis.

Almost two-thirds of paediatric occupational therapists (OTs) say the cost-of-living crisis is making it more difficult for children and young people to access the therapies and interventions they need.

Since the start of 2023, OTs have noticed an increase in the number of families struggling with their finances, such as financial distress. Nearly half said families are so worried about money that they cannot prioritise occupational therapy or follow occupational therapy recommendations.

Around half said families were affected by work-related constraints and are either unable or unwilling to take time off work to attend occupational therapy appointments.

More than half of paediatric OTs said families have had to cut back on recommended activities that would support their child’s development and wellbeing, such as swimming lessons. Additionally, 66 percent of those surveyed said families are now living in unsuitable housing conditions.

RCOT says, as a result, children and young people are not receiving timely access to the necessary interventions, which has far-reaching consequences. It not only impacts children’s mental health, education, and development but also affects the mental wellbeing of their parents and family life as a whole.

A staggering four in five children’s OTs who responded to the survey reported that limited access to occupational therapy services is adversely affecting the mental health of children. Also, more than 70 percent cited a negative impact on children’s education, while almost two-thirds noted that children’s and young people’s needs are becoming more acute.

Of those surveyed, 85 percent reported an increase in demand for occupational therapy since July 2022, with over one third indicating that children and young people were waiting on average for more than 18 weeks for targeted or individual occupational therapy services.

These delays mean that children may not receive essential equipment at home, miss out on additional support for improving their writing skills, or even miss school due to heightened mental health needs, says RCOT. These delays also mean that children and young people require a higher level of support when they are eventually seen, increasing the burden on services and contributing to further delays.

Findings also reveal pressure on OTs is not only external. Three-fifths of OTs said their teams are not fully staffed, and, even if they were, two-thirds indicated that their teams would still not be able to meet growing demand. In addition to this, almost a third said they cannot provide the equipment and adaptations children and young people need, when they need it – for most, this is due to budget and funding issues.

Director of Practice and Innovation at the Royal College of Occupational Therapists, Karin Orman, commented: “The cost-of-living crisis is exacerbating already challenging circumstances, limiting access to essential occupational therapy services and significantly impacting the mental health and wellbeing of children.

“Our report paints a bleak picture of how individual financial challenges are wreaking havoc on children and young people’s access to the occupational therapy they need. Families are forced to make heartbreaking choices, and children are bearing the brunt of it.

“We know that health inequalities start at an early age, and can impact a child’s health later and their economic future, so not being able to access the therapies they need now can have an impact on a child for the rest of their life.

“What’s more, the report is a stark reminder of the challenges faced by occupational therapists in providing essential care to children and young people. The increasing demand, coupled with staffing shortages and financial pressures, has created a critical situation that must be addressed urgently.

“The report underscores the urgent need for comprehensive reforms in children’s occupational therapy services to ensure that children and young people receive the care and support they need, when they need it. Urgent action is required to ensure that every child has equitable access to the interventions they need to flourish.”

RCOT’s recommendations for political and health and care leaders include understanding the rising demand for children’s occupational therapy services and address capacity gaps to ensure timely access for children and young people.

Positioning occupational therapy for impact is also recommended, which entails placing OTs where they can have the most impact, including schools, hospitals, early intervention services, and specialist services.

In addition, promoting integration within health, education, and care systems to ensure resources are utilised efficiently and referral pathways are clear and coordinated in order to meet individual needs, and expanding the occupational therapy workforce to ensure adequate staff with the necessary skills to support children, young people, and families are also recommended.

Finally, investment in equipment is recommended; RCOT recommends streamlining and investing in housing, equipment, and adaptation services to provide prompt assistance to children and young people so they can take part in everyday life.

A survey is seeking the views of occupational therapists (OTs) working in community-based or adult social care settings with older people who are already using a smartphone or other internet-linked technology at home.