Royal College of Occupational Therapy highlights the dehumanising effect of social care services

In News and Updates by Navin Motwani1 Comment

Our latest ‘Improving Lives, Saving Money Report released today calls for a shift from a ‘high volume, low cost’ approach to care to one which sees the whole person’s overall wellbeing. Its publication is accompanied by a moving film showing the stark reality of being dependent on social care faced by many older and vulnerable people.

In its report: ‘Living Not Existing: Putting Prevention at the Heart of care for older people’ the Royal College of Occupational Therapists seeks to show how doing the right thing for individuals can actually reduce their need for expensive care long-term. It calls for an end to the inequality of access to occupational therapy which is a barrier to people in need receiving high quality, person centred care that enables people to stay as active, independent and safe as possible.

Occupational therapists are trained to work with the whole person. Their approach is unique. They work with people to establish what matters to them and to set goals to help them maintain or regain their ability to do those things. This may mean a period of intense support or home adaptation in the short term but once goals are met, the need diminishes and support can be safely reduced or even withdrawn. The older person retains their right to self-determination, independence and self-esteem whilst the tax payer gets a saving in the long term.

In our report we make three recommendations:

  • An end to the inequality of access to occupational therapy. There are pockets of best practice but too many people miss out on high quality proactive social care that promotes independence and self-determination.
  • More occupational therapists employed within primary care proactively helping older people adapt to aging, increasing frailty and health problems. This can delay, reduce or prevent the need for expensive care and support.
  • Occupational therapists to be employed to lead on the development of person and community centred services that care for older people’s overall health and wellbeing to ensure they can live active independent lives in their communities for as long as possible.

Reports have been published for each of the four nations of the UK.

Julia Scot, CEO of the Royal College of Occupational Therapists said: “Too often, rather than seeing a whole person, social care services simply see a set of care needs which need to be addressed. Because of their unique set of skills, occupational therapists are perfectly placed to change this. In our report we set out clear, evidenced based recommendations that will deliver better care for service users that is more cost effective for taxpayers. For too long, we have collectively wrung our hands and exclaimed that something has to be done to “fix” the social care system. Now is that time.”

The film which has been released today alongside the report allows viewers to ‘toggle’ between different realities of care. One reality shows what life can be like for many older people, as simply passive recipient of care. The other shows how occupational therapist involvement can result in the best, most person centred care that empowers the older person.

The report has been welcomed by a number of groups, Mike Adamson, British Red Cross chief executive said:

“British Red Cross welcomes the report from the Royal College of Occupational Therapists. With an increasing elderly population and decreasing budgets for care, as a society we must seek to do the best we can for everyone who needs care – not just the bare minimum.

“As this research shows, early intervention can help people stay in their own homes, continue with social activities – and save money in the longer term.  Surely this is a no-brainer. It’s time to change the mind-set on care to treat the person, not a set of needs.”

Whilst LGA Health Spokesperson Cllr Izzi Seccombe, welcomed the report, she called for a wider debate about the future of social care which brings politicians from all sides together to find long-term sustainable solutions, something that we have also been calling for. She said:

“It’s great to see some examples in this report of councils providing a person-centred approach to care, and we support the emphasis on prevention and treating the whole person. Councils recognise the importance of prioritising and investing in prevention. But inadequate funding, coupled with significant demand and cost pressures, means that investment is actually reducing.”

“The Government is in the process of drawing up its plans for the promised consultation on proposals for reform in social care. This report is important material for these consultations.

“Councils stand alongside the NHS, charities and care providers in their call for Government to work out a long-term funding solution, and we need a series of proposals that works out how best to share the costs of care between the individual and the state, if we are to get serious about social care – in particular, we need to work out whether or not the cost should be met only by those who require care, or whether it should be shared more broadly.

“That’s why it is vital that a national debate on this subject has cross-party backing, and takes place urgently. Without this, any proposals to tackle the funding crisis in social care and deliver lasting reform will simply not work.”


  1. This all makes sense and my brief experience of using OT for my Dad was very helpful. . Although too brief!

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