7 Steps to Highly Effective Occupational Therapy Practice – Prioritisation



Working with people, you will find that there is not only one theory, model of practice or strategy that will help solve all the person’s issues or problems.

In this series of 7 blogs, I have broken down the Occupational Therapy process so that it can be used over and over again, in a macro or micro context, in any area of practice.

The blogs have been designed so that each one stands alone, and you can begin anywhere depending on your current issue.

This second blog in the series is about prioritisation.

There was a reason to start with a referral system. You need a system which helps you to be able to prioritise. Once the referral form is completed you have a list of all the potential areas you could work with your clients. You are then able to stand back and say, ‘ok all this needs doing however I only have 22 hours in the week I need to prioritise my work so I can be most effective.’

You may decide with the team or in supervision that you will prioritise falls or whatever is the most urgent for your clients and team. Who and what you prioritise may also link with your mission statement, NICE guidelines, RCOT standards and the CQC recommendations from any visits.

You will have an overview of your clients and their complexity, and everything that they need. However you can focus on immediate needs and deliver focused intervention.

Over and above this, you can create a waiting list. This may also be used as a rationale for extra staff. It’s clear the other interventions which you could deliver as an Occupational Therapist but haven’t got time evidently need extra therapy time. It’s a clear, transparent system and it will help you to focus your day and weekly priorities.

When more work comes in you have a system to be able to reprioritise, ensuring the priority 1 people get seen first.

For example,

In a care home it may be

Priority 1 is reduction in falls, with basic interventions and suggestions

Priority 2 is increase in independence in washing, dressing and eating

Priority 3 is increase in meaningful activities and constructive routines

Having this structure helps you to negotiate your time. As I said initially it can be overwhelming in MDT meetings to think everything has to be picked up by you relating to function and activity, well if you are only here 22 hours per week you have to prioritise.


In this blog I have focussed on prioritisation as you cannot do everything for everybody all the time. There are only so many hours in the day so get into the habit of prioritising your work into priority 1, 2 or 3.

Within each priority it is then easier to be able to work with the person to identify what is meaningful for them, ensuring you maintain client centred practice in a highly effective way. Right now we are ready for assessment in the next blog.

If you have questions or comments I would love to hear from you. Just email me on margaret@ot360.co.uk or you can continue to explore my website to find out more about me and my work in supervision.

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About Margaret Spencer

For the kind of collaborative supervision you have always wanted. Are you are passionate and enthusiastic about occupational therapy? Are you working in the NHS, third sector, independently or for a private company? Would you like your supervision to enhance, and develop your professional practice? If you answer yes to any of the above I would love to hear from you. Have a look at my website www.ot360.co.uk to see where we could work together. I have supported many occupational therapists in developing a service from scratch,. I have worked with OT's to design training packages for support staff in older adult falls services, I continually carriy out audits in psychiatric intensive care units, and learning disabilities forensic services. On behalf of commissioners I have completed service reviews in learning disabilities from 2002 onwards. I complete individual HCPC audits with OT staff in many different clinical areas, am involved in yearly appraisals, and monthly supervision sessions. I also critique, design and write job descriptions. I shortlist and interview for all levels of OT post from Band 5-8. What ever your needs I can support you.

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