This article makes the case for increasing the reach and the impact of children's occupational therapy in the United Kingdom, through inclusion of universal and targeted services alongside specialist provision. It is proposed that achieving a greater balance between these different levels or tiers of provision can promote the health, well-being and participation of all children, including those with additional needs. During a time of austerity, we argue that a broader offer also distributes finite public resources more effectively – potentially reducing pressure on scarce specialist resources. Sustainable options for meeting greater population need are proposed and occupational therapists are encouraged to evaluate the effect of changing the balance of provision to inform future commissioning.
CarrierALevasseurMMullinsG (2010) Accessibility of occupational therapy community services: A legal, ethical and clinical analysis. Occupational Therapy in Health Care24(4): 360–376.
DunfordCBanniganK (2011) Children and young people’s occupations, health and well-being: A research manifesto for developing the evidence base. WFOT Bulletin64: 46–52.
6.
DunfordCRichardsS (2003) ‘Doubly disadvantaged’: Report of a survey on waiting lists and waiting times for occupational therapy services for children with developmental coordination disorder, London: College of Occupational Therapists.
Gascoigne MT (2015) “Commissioning for speech, language and communication needs: Using the evidence from the better communication research programme” better communication CIC supported by the communication trust. Available at: http://www.bettercommunication.org.uk/index.php?page=commissioning-guide (accessed 6 September 2015).
9.
HuttonE (2008) ‘Back to school’ – piloting an occupational therapy service in mainstream schools in the UK. Reflective Practice9(4): 461–472.
10.
KingsleyKMaillouxZ (2013) Evidence for the effectiveness of different service delivery models in early intervention services. American Journal of Occupational Therapy67(4): 431–436.
11.
KolehmainenNMacLennanGFrancisJ (2010) Clinicians’ caseload management behaviours as explanatory factors in patients’ length of time on caseloads: A predictive multilevel study in paediatric community occupational therapy. BMC Health Services Research10: DOI: 10.1186/1472-6963-10-249.
MorrisCJanssensAAllardA (2014) Informing the NHS outcomes framework: Evaluating meaningful health outcomes for children with neurodisability using multiple methods including systematic review, qualitative research, Delphi survey and consensus meeting, health services and delivery research. National Institute for Health Research2(15): . http://dx.doi.org/10.3310/hsdr02150.
