Roots of recovery: Occupational therapy at the heart of health equity

As we begin to emerge from the pandemic, there seems to be growing awareness of the scourge that health inequity visits upon our society. But health inequality, which had grown in the decade from 2010, has deteriorated further in recent months. The task before us is urgent, and it is serious.

It is not that health inequality is a new phenomenon. Its causes, which have their origins across the social determinants of health, have been long understood. They are multi-faceted and cannot be addressed through health and social care alone. But we must play our part.

There is considerable work going on to understand how health inequality is exacerbated by other structural imbalances, to measure its impact and to recommend solutions. That is useful for three reasons: first, the better we understand, the more effective we can be. Second, shifts in technology may mean shifts in who is excluded. We need to know how the landscape is changing. Third, the greater the spotlight that is directed onto this area, the harder it is for politicians to ignore it.

But our health and social care systems are dealing with huge imbalances between demand for care and our ability to supply it. It can be difficult for local managers to take an eye away from the day-to-day of waiting lists and workforce shortages and widen their lens. Paradoxically, this is a time both of great change and little time in which to design that change

That is why we have taken a different approach in this report. It seeks less to make the case against health inequalities than to set out practical ways in which decision-makers and system designers can use the skills offered by occupational therapy to make better use of existing resources.

Since I joined the Royal College of Occupational Therapists (RCOT) six months ago I have been struck by the passion, breadth of expertise and reach of occupational therapists. Occupational therapy is centred on people's day to day living - what they want and need to do and where and how they live. The profession thinks beyond health and focuses on the wider social determinants, making occupational therapists key players in rethinking how and where we deliver health and social care.

RCOT is asking members – who see health inequalities daily – what support and tools they need. Over the next 12 months we will work with our fellow professionals to co-create and deliver a plan of action which includes sharing examples of good practice and learning.

We hope that this report will be a useful tool for health and social care colleagues as we seek to limit, and then reduce, the health inequalities which afflict our nation.

Steve Ford
Chief Executive, Royal College of Occupational Therapists