F E AT U R E
Where is the profession heading? Perspective from an early career therapist Harley Hayes, Occupational Therapist, Everyday Independence
Workforce
Occupational therapists are in significant demand across Australia, with their talent and skills required across multiple sectors including disability, health, aged care, mental health and welfare. This demand is providing occupational therapists with more opportunities and choice around career direction and progression than ever before. This demand does not look like slowing – not with Australia’s ageing population and ongoing funding for therapy services through the NDIS. The disability sector has seen significant growth since the introduction of the NDIS. The NDIS workforce strategy indicates there is going to be continued growth in the sector over many years, and this is going to require a significant increase and development of the therapy workforce (Commonwealth of Australia, 2021) – providing new and exciting opportunities for occupational therapists. For early career occupational therapists, I feel your pain with the ongoing pressure to meet this high demand for services. Arriving to the profession from university or a different sector, there is a steep learning curve to feel comfortable and confident working in this space. However, I have seen significant career growth opportunities for therapists who are passionate about working in the disability field.
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I appreciate the hard work of experienced occupational therapists to upskill early career therapists like myself, and their efforts in spreading a finite amount of talent to achieve the greatest impact. They would have spent many late nights and long days providing these additional supports. Since the sector has moved to individualised funding, many would have faced challenges pivoting to a commercial environment while ensuring evidence-based and high-quality services were provided. Increased demand has presented significant challenges in the face of ever-increasing wait times. Being unable to access occupational therapy services in a timely manner has a significant impact on outcomes, and people being able to fully utilise their therapy plan budget. This presents a major risk to the profession, as early intervention and capacity building is a critical component of the NDIS success (NDIA, 2020). As a profession, we have the opportunity to build a workforce that is leading disability practice and achieves high impact outcomes for people living with disabilities. But it will require the profession to be innovative and committed to ensuring that all Australians have access to occupational therapy services. While we have such significant workforce shortages, it is critical to be working at the top of our scope of practice to achieve the greatest impact with our valuable time. This will ensure therapists are delegating, and building the capacity of others to embed therapy into everyday life. Working at top
of scope involves occupational therapists providing services that align with their skills and professional training. Initially, I found it challenging to utilise my full scope, as it took time to develop confidence in building the capacity of natural and formal supports. However, it has allowed me to continue to practise my craft through working more often at a higher level.
Opportunity
The NDIS is the first scheme in the world in which people living with disabilities are provided with individualised funding that is tailored to the person and their support needs. The NDIS is a unique system in that it utilises an insurance-based model and takes a lifetime approach for participants. Currently, the NDIS is simply viewed as a funding body for disability-related services. The original architecture of the scheme was based on social insurance principles, and the main function was to fund long-term high-quality care and support. Currently the scheme is purchasing hours of service and support, not outcomes. Occupational therapists have a responsibility to realign the scheme with its original intent, and deliver evidence-based, high-quality services that will change people’s life trajectories and build a more inclusive community – a better Australia. In addition, the value of occupational therapy interventions should be linked to positive impacts, a return on investment for the Commonwealth, and a reduction in costs
