Mapping the role of occupational therapy within primary care services: A scoping review

Abstract

Introduction:

Occupational therapy is named a key profession within primary care, with growing demand due to an ageing population and increase of people living with long-term conditions. Despite this, occupational therapy within primary care remains an evolving, under researched area of practice. This scoping review explored the role of occupational therapy within primary care including the populations and interventions currently provided.

Methods:

The Joanna Briggs Institute (JBI) methodology for scoping reviews was followed with systematic searches conducted across CINAHL, PubMED and AMED databases with grey literature also sourced. The findings are presented in tabular format and analysed using descriptive statistics and frequency counts to identify patterns and trends alongside narrative reporting.

Findings:

This scoping review identified 40 relevant articles, with older adults reported as the most frequent population supported by occupational therapists. Interventions focused on physical health including providing equipment/assistive devices, supporting mental health through stress and anxiety management, with limited reported interventions with children and young people.

Conclusion:

This review has highlighted key interventions provided by occupational therapists and the breadth of the role within primary care. Research and sharing of best practice is required to showcase occupational therapists evolving contribution within primary care.

Keywords

Occupational therapy primary care

Background

Occupational therapy is named a key profession within primary care (European Commission, Directorate-General for Health and Consumers, 2015), with growing demand due to an ageing population and increase of noncommunicable diseases (World Health Organization [WHO], 2018). Across both health and social care sectors, there is ambition to protect and improve health outcomes and reduce health inequalities to lower National Health Service (NHS) and social care reliance (Public Health England [PHE], 2019). Despite this, the role of occupational therapy within primary care remains an area of practice that is under researched, with a need to promote best practice, based on evidence worldwide (Freeman et al., 2025). Across Europe, the development of primary care and the services within this area differ dramatically, with varying degrees of occupational therapy uptake within primary care (Bolt et al., 2019). As primary care continues to adapt to the changes of population demands, the multidisciplinary offering will need to also adjust to ensure primary care is adequately meeting the needs of the people it serves. Increased evidence will add clarity to showcase what different health professions can provide, ensuring every primary care network is designed to meet local and regional needs.

General practice is under surging pressure due to high workload, an ageing population and increasingly complex patients (Primary Care Workforce Commission, 2015). Not only have General Practitioners (GPs) seen a substantial increase in their workloads, but the nature of appointments is also becoming more complex. Many are presenting to primary care services with concerns and conditions linked to issues managing their day-to-day lives effectively, including living with multiple or chronic conditions, mental health, cost-of-living crises and retaining or gaining employment. As primary care evolves to meet the demands of a modern society, the opportunities to utilise a wider multidisciplinary team grow, with recognition that allied health professionals, including occupational therapists, can offer expertise in managing daily life when faced with a range of barriers to participation. The Royal College of Occupational Therapists (RCOT, 2021), in a document presented to the House of Commons Health and Social care Committee inquiry, identified occupational therapists holding three key ‘superpowers’ when working within primary care relating to supporting: frail older adults, people experiencing mental health problems and working age adults with employment difficulties. In order to share practice development within primary care, RCOT have a growing evidence base on their website including an evaluation of occupational therapy in primary care for older adults (RCOT, 2023a).

Additionally, traction is being gained with occupational therapists in First Contact Practitioner (FCP) roles and as Primary Care Advanced Practitioners (Health Education England [HEE], 2021). FCP roles were developed in response to optimising integrated primary care teams and to ensure patients were ‘seeing the right person in the right place at the right time’ (HEE, 2021: 8). FCPs are clinicians working at the top of their clinical scope of practice and have underpinning knowledge to assess and manage patients with undifferentiated and undiagnosed presentations (HEE, 2021). Additionally, Primary Care Advanced Practitioners can be from a range of professions including but not limited to pharmacists, dieticians and occupational therapists who demonstrate advanced clinical capabilities, with the skills and knowledge to expand their scope of practice to meet the needs of the population they work with (HEE, 2021). The development of these advanced clinical roles were created to support GPs and to enhance the patient care pathway (HEE, 2021). However, uptake is sporadic and barriers to successful integration exist with limited evaluation of these roles to date. Primary care often has misunderstandings of the role of occupational therapists and their unique contribution in a range of areas across physical health, mental health and social care. As a result, the profession is too often underutilised within primary care (Dahl-Popolizio et al., 2017).

There is growing evidence demonstrating that occupational therapists have the skillset to work within primary care (Dahl-Popolizio et al., 2017; Donnelly et al., 2023). A cross-sectional study highlighted that although occupational therapists have the necessary skillset, there are a multitude of barriers that inhibit occupational therapists from working within primary care, including perceptions of other healthcare workers, uncertainty of the contribution of the profession, role clarity and the heterogeneity of how services are funded in this area (Dahl-Popolizio et al., 2017). These factors contribute to the perceived lack of scope to work within primary care. Bolt et al. (2019) further built on these challenges that identified unfamiliarity from the public of the profession, lack of clarity from policymakers and health professions of what services occupational therapists can offer and lack of support for occupational therapists working within primary care. Despite some useful developments, a deeper review of the literature is needed to fully understand the role occupational therapists have within primary care teams. A role for occupational therapists within primary care is being identified in the United Kingdom and includes aspects of holistic care, health promotion and prevention (Chamberlain et al., 2019).

Despite research spanning over a decade, occupational therapy is still in its infancy within primary care, and it is imperative to explore why there is still a lack of occupational therapists working within this area of practice. A previous scoping review by Donnelly et al. (2023) of occupational therapy services in primary care, identified assessments and interventions. This scoping review sought to build on the review by Donnelly et al. (2023) by further exploration into the specific areas of primary care that occupational therapists work in and the life stages occupational therapists work with.

This scoping review explores the role of occupational therapy within primary care, which can help to inform evidence-based practice and support the role expansion into this area of practice, including the populations regularly supported and interventions used within primary care by occupational therapists. This scoping review aims to delve into the interventions that help address the research question of ‘What interventions are provided by occupational therapists within primary care?’

Method

The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews (Peters et al., 2020) that follows a contemporary methodological framework.

Review question

−What interventions are provided by occupational therapists in primary care?

Research objectives

−To outline the interventions currently used by occupational therapists in primary care.

−To identify the life stages occupational therapists support within primary care.

Inclusion criteria

The PCC (population, concept and context) framework was adopted to establish the population, concept and context of this scoping review (Peters et al., 2020).

Population: studies of all ages, genders and conditions, and professionals who hold the title of ‘Occupational therapist/s’, ‘First Contact Practitioner’ and ‘Advanced Practitioner’.

Concept: Occupational Therapy interventions

Context: Primary Care

This review only considered studies conducted in the United Kingdom, Ireland, Canada, Australia and New Zealand as they are higher-income countries, and all have healthcare systems underpinned by public insurance; however, the level of public insurance may vary across these countries, and some may have elements of private practice within their healthcare systems. Therefore, to maintain clarity, private practice was excluded from this scoping review. Only research conducted in English language were included as there were no translation resources available.

Types of evidence sources

The search strategy aimed to locate both published and unpublished studies. This scoping review included primary research and grey literature including opinion papers. However, this review excluded systematic reviews, meta-analysis, scoping reviews and conference abstracts although reference lists of relevant systematic reviews and scoping reviews were scanned. Literature published between July 1989 to January 2024 were considered for this review, starting from Bumphrey (1989) as the first published research exploring occupational therapy within the primary care team.

Search strategy

A three-step search was adopted to uncover published and unpublished studies as per the JBI manual (Peters et al., 2020). An information specialist assisted to refine the search strategy. An initial limited search of CINAHL (EBSCOhost) and PubMed was undertaken to identify literature (first phase). The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles were used to develop a full search strategy (second phase). Table 1 shows a preliminary search example undertaken in CINHAL (EBSCOhost).

Table 1.

An example of preliminary search undertaken on CINHAL (EBSCOhost) database.

	Key term		Key term		Key term		Key term		Key term
Concept	Occupational therapy	OR	Occupational therapy*	OR	OT	OR	First-contact practitioner	OR	Advanced practitioner
Context	Primary care	OR	Primary healthcare	OR	Primary Health care	OR	Primary care sector	OR	Primary care organisation

CINAHL (EBSCOhost), PubMed and AMED (Allied and Complementary Medicine Database) were used to conduct the searches. Grey literature was sourced using the PCC framework and investigated the first 50 returns of Google Scholar were investigated.

The search strategy, including all identified keywords and index terms, was adapted for each included database. For phase three, 10% of the articles included in the full-text search were searched for relevant articles which resulted in six further articles sourced one of which were included. Duplicate and articles with their full-text unavailable were excluded. Boolean operators, truncation and Medical Subject Headings were used in the search strategy. All database search strategies and their subsequent generated results are available in Supplemental Appendices 1–3.

Evidence screening and selection

All identified references were collated and uploaded to Endnote Online (Clarivate Analytics, PA, USA) reference manager and duplicates were removed. The titles and abstracts were screened for eligibility against the inclusion criteria for this review by the primary researcher and 10% by a secondary reviewer. The full text of selected sources were assessed against the inclusion criteria by the primary researcher and 10% by the secondary reviewer. Five disagreements arose between the reviewers and were resolved through discussion and with a third researcher. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram (Page et al., 2021) outlines the search and the study inclusion processes (see Figure 1).

Figure 1.

PRISMA 2020 flow diagram for new systematic reviews, which included searches of databases, registers and other sources (Page et al., 2021).

Data extraction

Data were extracted using a modified version of the JBI data extraction tool (Peters et al., 2020). The data extraction from databases into Microsoft Excel gathered the following details: author(s), year of publication, title, country, study aim, methodology and methods, client group, area of practice and interventions. The data extraction tool was modified and revised as necessary during extracting data from each included evidence source, therefore adopting an iterative approach.

Data analysis

This review analysed data via descriptive statistics which entailed using a simple frequency count of the data. Extracted data were presented in tabular format and a narrative summary of the studies included. A frequency count of the following areas were undertaken which link to the objectives of this review; areas of practice, client group and interventions. A summary of all data included in this review can be found in Tables 2 and 3.

Results

This scoping review aimed to summarise and map the findings for occupational therapy interventions within primary care in the United Kingdom, Ireland, Canada, Australia and New Zealand.

Review of the selection process

Forty sources were included in this review. Table 2 provides a summary of the research literature included. Table 3 illustrates the data extraction of key information from the grey literature search included in this review. Tables 2 and 3 provide overviews of the data included, some sources highlighted more than one intervention used therefore, only the main intervention has been highlighted.

Table 2.

Data extraction table of key information from literature of database search.

Author/s (Year)Country	Study method(Methodology)	Study aim	Key Findings (Area of practice (physical health or mental health), Client group (children, adult and older adult) and Main Intervention)
Bumphrey (1989) UK	Case study (Quantitative)	This article outlines the scheme introduced by the Norwich Health Authority and the occupational therapist’s role within it.	Area of practice – Physical and Mental health Client group – Children, Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = providing equipment/assistive devices
Baker (1994) UK	Lecture/Professional discussion (Qualitative)	To understand the role of occupational therapy in Mental health in primary care settings	Area of practice – Mental Health Client group – not specified Interventions – not specified
Tyrrell (1995) UK	Lecture/Professional discussion (Qualitative)	To understand the role of occupational therapy in primary care	Area of practice – not specified Client group – Older adults Interventions – Measuring functional abilities
Hales (1996) UK	Conference Presentation (Qualitative)	To look specifically at developing occupational therapy services in primary care	Area of practice – Not specified Client group – Older adults Interventions – Not specified
Tyrrell and Burn (1996) UK	Evaluation	The study had three aims: 1. A review of the annual caseload, to examine the characteristics of patients referred to the primary care occupational therapist, and the interventions needed 2. To identify functional problems and measure outcomes of occupational therapy interventions in a prospective 3-month study 3. To identify the benefits Primary care occupational therapy, as perceived by other members of the primary care team.	Area of practice – Physical health Client group – Children, Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = Activities of daily living
Beresford (2004) UK	Evaluation	A primary care trust in Lancashire has developed an easy to access continence service combining physiotherapy, nursing and occupational therapy expertise, and set up a female urinal lending library in what are thought to be the first initiatives of their kind in the UK.	Area of practice – Physical health Client group – Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = Providing education and advice to patients regarding incontinence
Cook and Howe (2003) UK	Case Study Design, Pre-test, post-test feasibility study (Mixed methods)	To investigate a new model of primary care service that included occupational therapy and was designed to engage clients with enduring psychotic conditions who were not in contact with a secondary care-based community Mental health team in an inner-city area.	Area of practice – Mental Health Client group – Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = environmental modifications
Gaines et al. (2008) Canada	Pre- and post-project surveys, quantitative measures, questionnaires and focus groups (Mixed Methods)	This study was designed to determine the feasibility and impact of an educational outreach and collaborative care model to improve chronic disease management of children with developmental coordination disorder	Area of practice – Physical Health Client group - Children Interventions – Providing education and advice to patients and family members regarding developmental coordination disorder
Myers et al. (2010) UK	Delphi study	To identify clinical questions and assessments regarded by health care practitioners as important when assessing undifferentiated hand pain or problems in adults aged 50 years and over presenting to primary care	Area of practice – Physical Health Client group –Adults and Older Adults Interventions – Not specified
Richardson et al. (2010) Canada	Randomised controlled trial (Quantitative)	To determine whether adults with a chronic illness within a primary care setting who received a rehabilitation intervention in this setting showed greater improvement in health status and had fewer hospital admissions and emergency room visits compared with adults who do not receive the intervention.	Area of practice – Physical Health Client group – Adults and Older Adults Interventions – Multiple Interventions highlighted, main intervention = providing equipment/assistive devices
Dziedzic et al. (2011) UK	Multicentre two-by-two factorial randomised controlled trial (Quantitative)	Aims to address the following questions: Is joint protection delivered by an occupational therapist more effective in reducing hand pain and disability than no joint protection in people with hand OA in primary care? • Are hand exercises delivered by an occupational therapist more effective in reducing hand pain and disability than no hand exercises in people with hand OA in primary care? • Which of the four management approaches explored within the study (leaflet and advice, joint protection, hand exercise, or joint protection and hand exercise combined) provides the most cost-effective use of health care resources	Area of practice – Physical Health Client group – Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = joint protection
Letts (2011) Canada	Lecture/Professional discussion (Qualitative)	Aims to explore the following questions: • How proximal is occupation in the role? • How strong is the evidence to support occupational therapy in the role? • Is the timing right?	Area of practice – Physical Health and Mental Health Client group – Not specified Interventions – Multiple interventions highlighted, main intervention = Health promotion and prevention
Mackenzie et al. (2013) Australia	Expert opinion	The purpose of this viewpoint is to outline the opportunity for occupational therapy services to be offered to prevent falls among older people in the community, taking into account the evidence for the effectiveness of occupational therapy services and the findings of current studies relating to the practical barriers of developing such services.	Area of practice – Physical Health Client group – Older Adults Interventions – Falls prevention
Moore (2013) Canada	Expert opinion	This article describes the new role of a wellness navigator and highlights how occupational therapists are well suited to perform such a role.	Area of practice – Physical Health and Mental Health Client group – Not specified Interventions – Multiple interventions highlighted, main intervention = emotional wellness program
Lapointe et al. (2013) Canada	Expert opinion	The Nine Circles Community Health Centre is a prime example of an interprofessional primary health care setting that recently integrated occupational therapy services. This not-for-profit organisation provides coordinated medical and social support services for those living with and affected by HIV and acquired immunodeficiency syndrome (AIDS).	Area of practice – Physical Health Client group – Not specified Interventions – Multiple interventions highlighted, main intervention = safety adaptations of home, work or leisure settings
Tracy et al. (2013) Canada	Evaluation	The primary objective of the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic was to design and evaluate a new interprofessional model of care for community dwelling seniors with complex health care needs. A secondary objective was to explore the potential of this new model as an interprofessional training opportunity.	Area of practice – Physical Health Client group – Older Adults Interventions – Not specified
McGrath and O’Callaghan (2014) Ireland	Cross-sectional survey (Quantitative)	To explore occupational therapy assessment and intervention practices for people with dementia in Ireland.	Area of practice – Mental Health Client group – Older Adults Interventions – Multiple interventions highlighted, main intervention = environmental modifications
Moule et al. (2014) UK	Pre and post test questionnaire (Qualitative)	This short report presents an evaluation of the efficacy of a primary care educational intervention aimed at improving the detection, diagnosis and appropriate treatment of patients with complex regional pain syndrome (CRPS).	Area of practice – Physical Health Client group – Not specified Interventions – Not specified
Donnelly et al. (2014) Canada	Multiple case study. Interviews; document analysis; questionnaires (Qualitative)	To describe the emerging role of occupational therapy in Family Health Teams, a model of interprofessional primary care	Area of practice – Physical Health and Mental Health Client group – Children, Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = chronic disease management
Pritchard (2014) Canada	Expert opinion	To explore the role of occupational therapy with spinal cord injuries in a primary care environment.	Area of practice – Physical Health Client group – Children, Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = home modifications
Garvey et al. (2015) Ireland	Pragmatic feasibility randomised controlled trial (Quantitative)	To investigate the effectiveness of an occupational therapy-led self-management support programme, OPTIMAL, designed to address the challenges of living with multiple chronic conditions or multimorbidity in a primary care setting.	Area of practice – Physical Health Client group – Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = self-management plans
Donnelly et al. (2016) Canada	Cross-sectional survey (Qualitative)	To describe occupational therapy roles and models of practice used in primary care.	Area of practice – Physical Health and Mental Health Client group – Children, Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = providing equipment/assistive devices
Mackenzie et al. (2018) Australia	Pre-test and post-test survey (Qualitative)	To examine current practice in preventing falls among older people living in the community prior to attending a home safety workshop; explore the outcomes of the workshop on fall prevention practice and investigate self-reported changes in practice three months after the workshop.	Area of practice – Physical Health Client group – not specified Interventions – Multiple interventions highlighted, main intervention = falls prevention
Mackenzie and Clifford (2018) Ireland	Face to face and telephone interviews (Qualitative)	This study aimed to explore the perceptions of general practitioners, occupational therapists and physiotherapists working in the primary care setting about falls prevention in their practice.	Area of practice – Physical Health Client group – Older Adult Interventions – Falls prevention
Burley et al. (2018) Australia	Ethnographic study using observations (Qualitative)	This study aimed to explore the practice of occupational therapists within Primary Contact Occupational Therapy Hand (PCOTH) Clinics from an occupational perspective.	Area of practice – Physical Health Client group – Not specified Interventions – Hand therapy
Liddle et al. (2018) Australia	Interviews (Qualitative)	This study aimed to explore how allied health professionals were making fall prevention practice routine in primary care and the factors that influenced their fall prevention practice.	Area of practice – Physical Health Client group – Older Adults Interventions – Falls prevention
Thomas et al. (2019) UK	Cross-sectional survey (Qualitative)	This study explored how UK-based therapists conceptualise poststroke fatigue (PSF) in current practice.	Area of practice – Physical Health Client group – Not specified Interventions – Not specified
Drummond et al. (2020) UK	Feasibility study Assessment data and stakeholder interviews. (Mixed Methods)	To test the feasibility of delivering OTVoc to provide return to work advice and support for people with musculoskeletal conditions and mental health problems, in primary care.	Area of practice – Physical Health Client group – Adults and Older Adults Interventions – Multiple interventions highlighted, main intervention = vocational clinics
Tran et al. (2020) Canada	Feasibility randomised controlled trial Qualitative: Interviews & focus groups (Mixed methods)	To explore the feasibility of conducting a RCT of an occupational therapy-led mindfulness-based stress reduction programme within primary care.	Area of practice – Mental Health Client group – Adults and Older Adults Interventions – Mindfulness based stress reduction
Fox et al. (2021) Ireland	Feasibility study, multiphase explanatory sequential design Quantitative: pre-test post-test intervention Qualitative: Interviews (Mixed methods)	To explore the feasibility of a future RCT of the ReDO-10 program in Ireland and the contextual factors that would influence future implementation	Area of practice – Physical Health and Mental Health Client group – Adults Interventions – Multiple interventions highlighted, main intervention = Redesigning Daily Occupations (ReDO^®-10) programme
Fox et al. (2022) Ireland	Evaluation	This paper describes a qualitative evaluation of the Redesigning Daily Occupations (ReDO^®-10) programme as it was implemented for the first time with women with stress-related issues in a primary care setting in Ireland.	Area of practice – Physical Health and Mental Health Client group – Adults Interventions - Redesigning Daily Occupations (ReDO^®-10) programme
Gillespie et al. (2022) Ireland	Economic evaluation and randomised controlled trial (Quantitative)	This study examines the cost-effectiveness of a 6-week occupational therapy-led self-management support programme (OPTIMAL) for adults with multimorbidity	Area of practice – Physical Health Client group - Adults Interventions – Multiple interventions highlighted, main intervention = providing education to patients relevant to the management of their condition
Usher et al. (2022) Ireland	Evaluation Quantitative: pre- and post- test questionnaires Qualitative: focus group discussions (Mixed methods)	This study aimed to evaluate the impact of delivering education using the ECHO model on occupational therapists and physiotherapists self-reported confidence in their clinical knowledge and skills in addressing the palliative care needs of patients they work with in primary care settings.	Area of practice – Physical health and Mental Health Client group – Not specified Interventions – Multiple interventions highlighted, main intervention highlighted = providing equipment/assistive devices to patients
Tran et al. (2023) Canada	Feasibility randomised controlled trial Qualitative: focus group discussions (Mixed methods)	This study’s primary objective was to evaluate the feasibility of an occupational therapist-led mindfulness-based stress reduction program, for community-dwelling older adults living with SCD or MCI, in primary care. The secondary objective was to evaluate the acceptability of using technology (e.g., computer tablets and App Insight Timer®) as a tool for program delivery and home practice.	Area of practice – Mental Health Client group – Adults and Older Adults Interventions – Mindfulness based stress reduction

Table 3.

Data extraction table of key information from literature of grey literature search.

Authors (Year)Country	Study design/type of evidence	Study aim/purpose	Key findings
Greer and Symington (2022) UK	Expert Opinion	Look at how a small test of change to assess the impact of occupational therapy in GP surgeries was grown into a successful service.	Area of practice – Physical Health and Mental Health Client group – Not specified Interventions – Not specified
Stevens and Rostron (2022) UK	Expert Opinion	The authors are primary care network occupational therapists working in Somerset. Here they talk about their ‘exciting and unique’ role.	Area of practice – Physical Health Client group – Older Adults Interventions – Not specified
Cameron et al. (2023) UK	Expert Opinion	A group of occupational therapists reflect on the development of a new service within certain GP practices in NHS Ayrshire and Aran and share some of the achievements of the past year.	Area of practice – not specified Client group – Children, Adults and Older Adults Interventions – not specified
Borthwick and Atkinson (2023) UK	Expert Opinion	The authors look at the establishment of a vocational rehabilitation occupational therapy service in a London-based primary care network and argue that occupational therapy assessment and intervention skills demonstrably improve return to work rates.	Area of practice – Physical Health and Mental Health Client group – Adults Interventions – Multiple interventions highlighted, main intervention = vocational rehabilitation
Pasokhy-Holmes et al. (2023) UK	Expert Opinion	A look at how the first-contact practitioner approach is being explored in Dorset to provide an upstream service for children and their families in the area, reducing demand on GPs.	Area of practice – Physcial Health and Mental Health Client group – Children and Adults (only up to the age of 19) Interventions – Multiple interventions highlighted, main intervention = signposting to other services
Smith et al. (2024) UK	Expert Opinion	The authors share how they have been exploring Tai Chi/Qi Gong and acupuncture as interventions to provide a return to meaningful occupations.	Area of practice – Physical Health and Mental Health Client group – Not specified Interventions – Multiple interventions highlighted, main intervention = Tai Chi/Qi Gong and acupuncture

Descriptive summary

Of the 40 included sources, the majority of the studies were qualitative studies (n = 12), followed by expert opinion (n = 10), mixed/multiple methods (n = 7), evaluation (n = 4), quantitative (n = 6) and a Delphi study (n = 1). Spanning from 1989 to 2024 (35 years), most of the research carried out was in the UK (n = 18), Ireland (n = 7), Canada (n = 11), Australia (n = 4) and no studies were found from New Zealand (n = 0). In the following sections the area of practice, life stages and interventions used in primary care are explored in tabular format, including a frequency count of the data.

Areas of practice

Please see Table 4 for a frequency count of the specific domains within Physical Health and Mental Health areas of practice identified. Some sources highlighted working within more than one area of healthcare practice. Of the 40 sources included in this review, 25 physical areas of practice were highlighted, and 10 mental health areas of practice. Six studies highlighted working in both physical and mental health areas with no further explanation on the specific domains within these. Three studies did not specify if they focused on physical or mental health needs.

Table 4.

Specific domains within physical health and mental health areas of practice identified that occupational therapists work within.

Specific domains	Studies
Physical Health (n = 25)
Incontinence	Beresford, 2004 (n = 1)
Developmental Coordination disorder	Gaines et al., 2008 (n = 1)
Hand pain (including but not limited to; hand clinics)	Myers et al., 2010; Burley et al., 2018 (n = 2)
Arthritis (including but not limited to; osteoarthritis)	Tyrrell and Burn, 1996; Dziedzic et al., 2011; Pritchard 2014 (n = 3)
Chronic conditions/illness	Tyrrell and Burn, 1996; Richardson et al., 2010; Letts, 2011; Lapointe et al., 2013; Tracy et al., 2013; Donnelly et al., 2014; Donnelly et al., 2016; Gillespie et al., 2022 (n = 8)
Chronic Pain	Richardson et al., 2010; Letts, 2011; Donnelly et al., 2014 (n = 3)
Spinal cord injury	Pritchard 2014 (n = 1)
Complex regional pain syndrome	Moule et al., 2014 (n = 1)
Developmental disability	Donnelly et al., 2014 (n = 1)
Falls	Letts, 2011; Mackenzie et al., 2013; Donnelly et al., 2014; Pritchard 2014; Donnelly et al., 2016; Mackenzie et al., 2018; Mackenzie and Clifford, 2018; Liddle et al., 2018; Greer and Symington, 2022; Smith et al., 2024 (n = 10)
Stroke (including post-stroke fatigue)	Pritchard 2014; Thomas et al., 2019 (n = 2)
Mobility impairments	Pritchard, 2014 (n = 1)
Multiple sclerosis	Tyrrell and Burn, 1996; Pritchard, 2014 (n = 2)
Cerebral palsy	Pritchard, 2014 (n = 1)
Multimorbidity	Garvey et al., 2015 (n = 1)
Musculoskeletal conditions	Drummond et al., 2020; Borthwick and Atkinson, 2023 (n = 2)
Trauma/Orthopedics	Bumphrey, 1989 (n = 1)
Acquired brain injury	Donnelly et al., 2014 (n = 1)
Head injury	Tyrrell and Burn, 1996 (n = 1)
Motor Neuron disease	Tyrrell and Burn, 1996 (n = 1)
Cancer	Tyrrell and Burn, 1996 (n = 1)
Pain	Donnelly et al., 2016; Greer and Symington, 2022; Smith et al., 2024 (n = 3)
Fatigue	Donnelly et al., 2016; Greer and Symington, 2022; Smith et al., 2024 (n = 3)
Long-term conditions	Greer and Symington, 2022; Stevens and Rostron, 2022; Smith et al., 2024 (n = 3)
Frailty (mild to moderate)	Smith et al., 2024 (n = 1)
Mental Health (n = 10)
Sensory processing disorder	Donnelly et al., 2014 (n = 1)
Sensory impairment	Bumphrey, 1989 (n = 1)
Dementia (early and mid)	McGrath and O’Callaghan, 2014; Donnelly et al., 2014; Smith et al., 2024 (n = 3)
Subtle cognitive decline/Mild cognitive impairment	Letts, 2011; Donnelly et al., 2014; Tran et al., 2020; Greer and Symington, 2022; Tran et al., 2023 (n = 5)
Neurology	Bumphrey, 1989 (n = 1)
Mental illness	Bumphrey, 1989 (n = 1)
Mental health (mild to moderate including anxiety and stress)	Bumphrey 1989; Baker, 1994; Donnelly et al., 2014; Greer and Symington, 2022; Borthwick and Atkinson, 2023 (n = 5)
Psychotic conditions	Cook and Howe, 2003 (n = 1)
Long-term conditions	Smith et al., 2024 (n = 1)
Paediatric Mental health	Donnelly et al., 2014 (n = 1)
Mixed (Physical and Mental Health)	Letts, 2011; Moore, 2013, Donnelly et al., 2016; Fox et al., 2021, 2022; Pasokhy-Holmes, Morris and Parish, 2023 (n = 6)
General Medicine	Bumphrey, 1989 (n = 1)
Palliative conditions	Donnelly et al., 2016; Usher et al., 2022 (n = 2)
Other
Employment retention	Greer and Symington, 2022 (n = 1)
Vocational clinics	Drummond et al., 2020 (n = 1)
Not specified if physical or mental health	Tyrrell, 1995; Hales, 1996; Cameron et al., 2023 (n = 3)

Looking at physical areas of practice, the most common area of practice for occupational therapists in primary care was supporting people who fall (n = 10). The most common mental health areas of practice highlighted were mild-to-moderate mental health conditions including anxiety and stress which was highlighted in four studies. Subtle cognitive decline/mild cognitive impairment was highlighted by four studies, respectively.

Lifespan

From reviewing the literature, eight studies highlighted occupational therapists working with the client group children (0–17 years of age). Adults aged 18–65 years of age were the second most common age group identified (n = 19). Older adults aged 65 plus were the most common age group receiving occupational therapy interventions (n = 23). A total of 10 studies did not specify the client group that they worked with. Despite Tyrrell and Burn (1996) highlighting occupational therapists supported individuals across the lifespan, 87% of the patients were over 64 years of age, with occupational therapists only working at that time with a small percentage of children and adults. The following studies highlighted occupational therapists worked with individuals across the entire lifespan with children, adults and older adults; Tyrrell and Burn (1996), Donnelly et al. (2014), Pritchard (2014), Donnelly et al. (2016) and Cameron et al. (2023). Out of the 23 sources of literature identifying occupational therapists worked with older adults, nine highlighted occupational therapists solely worked with this client group. Table 5 presents the frequency distribution of the literature sources that identify the life stages occupational therapists work with.

Table 5.

Life stages identified that OTs work with in primary care.

Life stages	Studies
Children (0–17)	Bumphrey 1989; Tyrrell and Burn, 1996; Gaines et al., 2008; Donnelly et al., 2014; Pritchard, 2014; Donnelly et al., 2016; Cameron et al., 2023 (only 16 years and over); Pasokhy-Holmes, Morris and Parish, 2023 (n = 8)
Adults (18–65)	Bumphrey, 1989; Tyrrell and Burn, 1996; Cook and Howe, 2003; Beresford, 2004; Myers, Thomas and Dziedzic, 2010; Richardson et al., 2010; Dziedzic et al., 2011; Donnelly et al., 2014; Pritchard, 2014; Garvey et al., 2015; Donnelly et al., 2016; Drummond et al., 2020; Fox, Erlandsson and Shiel, 2021; Fox et al., 2022; Gillespie et al., 2022; Cameron et al., 2023; Borthwick and Atkinson, 2023; Pasokhy-Holmes, Morris and Parish, 2023 (only up to 19 years of age); Tran et al., 2023 (n = 19)
Older adults (65 plus)	Bumphrey, 1989; Tyrrell, 1995; Hales,1996; Tyrrell and Burn,1996; Cook and Howe, 2003; Beresford, 2004; Myers, Thomas and Dziedzic, 2010; Richardson et al., 2010; Dziedzic et al., 2011; Mackenzie, Clemson and Roberts, 2013; Tracy et al., 2013; McGrath and O’Callaghan, 2014; Donnelly et al., 2014; Pritchard, 2014; Garvey et al., 2015; Donnelly et al., 2016; Mackenzie and Clifford, 2018; Liddle et al., 2018; Drummond et al., 2020; Tran et al., 2020; Stevens and Rostron, 2022; Cameron et al., 2023; Tran et al., 2023 (n = 23)

Interventions

There were 66 interventions identified as used by occupational therapists in primary care. A total of 11 sources did not specify what interventions were used. Table 6 includes a frequency count of all interventions highlighted, also illustrating 10 overarching categories of interventions and then specific interventions within these are detailed in the corresponding area.

Table 6.

Interventions identified that are used by occupational therapists in primary care.

Interventions (n = 66)	Studies
Physical Health – 19 interventions
Providing equipment/assistive devices	Bumphrey, 1989; Tyrrell and Burn, 1996; Beresford, 2004; Richardson et al., 2010; Dziedzic et al., 2011; McGrath and O’Callaghan, 2014; Donnelly et al., 2014, 2016; Mackenzie et al., 2018; Usher et al., 2022 (n = 10)
Activities of daily living	Tyrrell and Burn,1996; McGrath and O’Callaghan, 2014; Pritchard, 2014; Donnelly et al., 2016; Fox et al., 2021, 2022 (n = 6)
Energy conservation	Lapointe et al., 2013; Garvey et al., 2015; Usher et al., 2022 (n = 3)
Measuring functional abilities	Bumphrey, 1989; Tyrrell, 1995 (n = 2)
Funding applications for equipment for patients	Donnelly et al., 2014; Pritchard, 2014 (n = 2)
Wheelchair/mobility	Bumphrey 1989; Donnelly et al., 2016 (n = 2)
Redesigning Daily Occupations (ReDO^®-10) programme	Fox, Erlandsson and Shiel, 2021; Fox et al., 2022 (n = 2)
Behaviourial programs	Bumphrey 1989; Dziedzic et al., 2011 (n = 2)
Splinting	Bumphrey 1989; Donnelly et al., 2016 (n = 1)
Providing seating	Donnelly et al., 2014 (n = 1)
Life skills	Donnelly et al., 2016 (n = 1)
Joint protection	Bumphrey, 1989; Dziedzic et al., 2011 (n = 1)
Hand therapy	Burley et al., 2018 (n = 1)
Exercise program	Mackenzie et al., 2018 (n = 1)
Transfer training	Mackenzie et al., 2018 (n = 1)
Pressure care and positioning	Usher et al., 2022 (n = 1)
Frailty support	Smith et al., 2024 (n = 1)
Tai chi/Qi Gong	Smith et al., 2024 (n = 1)
Acupuncture	Smith et al., 2024 (n = 1)
Mental Health – 8 interventions
Stress and anxiety management	Bumphrey, 1989; Lapointe, James and Craik, 2013; Garvey et al., 2015; Gillespie et al., 2022; Usher et al., 2022 (n = 5)
Counselling	Bumphrey, 1989; Tyrrell and Burn, 1996; Cook and Howe, 2003; Donnelly et al., 2016 (n = 4)
Mindfulness-based stress reduction activities (including lying down (body scan), sitting (attention on the breath), and mindful movement (yoga and walking)	Tran et al., 2020, 2023 (n = 2)
Emotional wellness program	Moore, 2013 (n = 1)
Promotion of cognitive functioning	McGrath and O’Callaghan, 2014 (n = 1)
Mental health support	Donnelly et al., 2016 (n = 1)
Cognitive behavioural therapy	Cook and Howe, 2003 (n = 1)
Dementia support	Smith et al., 2024 (n = 1)
Work – seven interventions
Return to work planning/recommendations	Lapointe, James and Craik, 2013; Donnelly et al., 2014; Donnelly et al., 2016; Borthwick and Atkinson, 2023 (n = 4)
Filling out fit notes and allied health professionals' health and work reports	Drummond et al., 2020; Borthwick and Atkinson, 2023 (n = 2)
Advice on adjustments to work role	Drummond et al., 2020; Borthwick and Atkinson, 2023 (n = 2)
Vocational rehabilitation	Borthwick and Atkinson, 2023; Smith et al., 2024 (n = 2)
Advice on adjustments to work environment	Lapointe et al., 2013; Borthwick and Atkinson, 2023 (n = 2)
Fitness for work reviews	Borthwick and Atkinson, 2023 (n = 1)
Vocational clinics	Drummond et al., 2020 (n = 1)
Environment – 6 interventions
Environment/Home modifications	Cook and Howe, 2003; Dziedzic et al., 2011; McGrath and O’Callaghan, 2014; Pritchard, 2014; Mackenzie et al., 2018 (n = 5)
Minor adaptations	Tyrrell and Burn, 1996 (n = 1)
Safety adaptations to home or leisure settings	Lapointe, James and Craik, 2013 (n = 1)
Home safety	Donnelly et al., 2016 (n = 1)
Task modifications	Dziedzic et al., 2011 (n = 1)
Selection, grading, adaptation and sequencing of activities	Cook and Howe, 2003 (n = 1)
Management – 6 interventions
Self-management monitoring/plans	Richardson et al., 2010; Dziedzic et al., 2011: Garvey et al., 2015; Donnelly et al., 2016; Drummond et al., 2020; Borthwick and Atkinson, 2023 (n = 6)
Fatigue management	Lapointe et al., 2013; Garvey et al., 2015; Gillespie et al., 2022; Smith et al., 2024 (n = 4)
Pain management	Lapointe et al., 2013; Donnelly et al., 2016; Smith et al., 2024 (n = 3)
Management of physical activity	Donnelly et al., 2014; Richardson et al., 2010; Gillespie et al., 2022 (n = 3)
Chronic disease management	Donnelly et al., 2014, 2016 (n = 2)
Chronic pain management	Donnelly et al., 2014 (n = 1)
Support and education – 4 interventions
Providing education and advice to patients and family members	Bumphrey, 1989; Tyrrell and Burn, 1996; Beresford, 2004; Gaines et al., 2008; Dziedzic et al., 2011; Pritchard, 2014; Mackenzie et al., 2018; Gillespie et al., 2022 (n = 7)
Carer support and education	Bumphrey, 1989; Tyrrell and Burn, 1996; Cook and Howe, 2003; McGrath and O’Callaghan, 2014; Donnelly et al., 2016; Usher et al., 2022 (n = 6)
Advocacy for patients	Tyrrell and Burn, 1996; Pritchard, 2014 (n = 2)
Training and development of skills, education and rehabilitation	Cook and Howe, 2003 (n = 1)
Liaising – 4 interventions
Linking to community programs and resources – including community integration	Donnelly et al., 2014, 2016 (n = 2)
Liaising with wheelchair services	Tyrrell and Burn, 1996 (n = 1)
Liaising with housing associations	Tyrrell and Burn, 1996 (n = 1)
School health liaison	Donnelly et al., 2016 (n = 1)
Paediatric – 3 interventions
Advising and delivering paediatric specific written material	Pasokhy-Holmes et al., 2023 (n = 1)
Providing direct access to sensory based advice, parent handouts, picky eating advice, useful links and sensory parenting online training	Pasokhy-Holmes et al., 2023 (n = 1)
Directing parents to local parenting courses and early help services	Pasokhy-Holmes et al., 2023 (n = 1)
Signposting and referrals – 2 interventions
Signposting to other services	Tyrrell and Burn, 1996; Moore, 2013; Lapointe et al., 2013; Borthwick and Atkinson, 2023; Pasokhy-Holmes et al., 2023 (n = 5)
Referral to other services	McGrath and O’Callaghan, 2014; Mackenzie et al., 2018; Pasokhy-Holmes et al., 2023 (n = 3)
Promotion and prevention – 2 interventions
Falls prevention	Letts, 2011; Mackenzie et al., 2013; Lapointe et al., 2013; Donnelly et al., 2014, 2016; Mackenzie et al., 2018; Mackenzie and Clifford, 2018; Liddle et al., 2018; Smith et al., 2024 (n = 9)
Health promotion and prevention	Letts, 2011; Lapointe et al., 2013; McGrath and O’Callaghan, 2014; Donnelly et al., 2016 (n = 4)
Other – 4 interventions
Goal setting	Cook and Howe, 2003; Richardson et al., 2010; Garvey et al., 2015; Fox et al., 2021, 2022; Gillespie et al., 2022 (n = 6)
Delivering therapeutic programs	Bumphrey, 1989 (n = 1)
Discharge support	Donnelly et al., 2014 (n = 1)
Health care team facilitation	Donnelly et al., 2016 (n = 1)

Occupational therapy interventions to support physical health were identified with the most frequency, with 19 identified. The most identified physical health interventions were providing equipment/assistive devices reported by 10 sources. Interventions relating to individuals’ mental health were the second most frequently reported with eight interventions highlighted. The most frequently reported intervention being stress and anxiety management, with five studies highlighting this in practice. Vocational interventions for adults were identified in two sources; one supporting people with musculoskeletal conditions and mental health problems and the other where occupational therapists supported people with employment retention issues due to a variety of health conditions.

From examining the subcategory of paediatrics, three interventions were highlighted, all by the same source of literature. The following interventions were highlighted: advising and delivering paediatric-specific written material, providing direct access to sensory-based advice, parent handouts, picky eating advice, useful links and sensory parenting online training and directing parents to local parenting courses and early help services.

Discussion

In this scoping review, current knowledge regarding occupational therapy in primary care is explored. Exploring the client groups including their life stage and health conditions and interventions, has offered insights into occupational therapy practice in primary care across the UK, Ireland, Canada, Australia and New Zealand. The literature explored in this review highlights that primary care is an emerging area of practice for occupational therapy. Despite only five countries being explored, it identifies the research and practice opportunities including the potential role expansion of occupational therapists within primary care. This review highlighted 66 interventions from 40 sources, identifying the depth and breadth of occupational therapy practice in primary care, including providing interventions (outlined in Table 6) across the lifespan (outlined in Table 5). The structure of the discussion follows the life stages of children, adults and older adults with the subsequent findings in the relevant life stages.

According to RCOT (2023a), occupational therapists can play a substantial role in the transformation of primary care and support the necessary growth in capacity required by national strategies; however, this review acknowledged there is limited evidence investigating occupational therapy within primary care. A theme emerged in the literature relating to occupational therapists as generalists by three studies, first explored by Bumphrey (1989) and later by Donnelly et al. (2014) and Donnelly et al. (2016). The generalist role can be explored as working within the occupational therapists full scope with individuals across the lifespan with different conditions providing a variety of interventions (Donnelly et al., 2014). Donnelly et al. (2014) further explores that this role is not unique to occupational therapy, but it is crucial to working within primary care.

It is important to highlight, this is not the first review to explore the role of occupational therapy in primary care. A literature review by Tse et al. (2003) investigated occupational therapy and primary health care in New Zealand. Although this review aimed to uncover research from New Zealand, no literature from this country was found during the data collection stage. Therefore, there is no similarity between Tse et al. (2003) and this review. There is a similarity between Donnelly et al. (2023) and this review as they both explored interventions. This review explored areas of practice and client groups in addition to interventions, further uncovering the extent of the role of occupational therapy in primary care. To the authors’ knowledge, this makes this scoping review the first to explore these specific areas in primary care.

Children: Supporting children and families

Although there was a paucity of literature in relation to children and youth identified, there has been an increasing demand for paediatric occupational therapy services across the UK (RCOT, 2023b). The results of this review found eight sources highlighting working with children, two of which were highlighted in grey literature. Despite eight sources reporting interventions with children, only one source of literature, Pasokhy-Holmes et al. (2023) detailed specific paediatric interventions delivered by a first contact practitioner. Pasokhy-Holmes et al. (2023), focused on interventions relating to the children's parents, one of the interventions featured was providing direct access to sensory-based advice, including parent handouts, picky eating advice, useful links and sensory parenting online training. This recognises the importance of parent education and involvement to enable caregivers to adequately support their children’s needs (Lin et al., 2018).

There is a need for research into occupational therapy interventions relating to children and young people to be undertaken to raise awareness for the public, GPs and healthcare professionals to understand the scope of occupational therapy with this life stage in primary care. It could be argued that the lack of information regarding interventions relating to children is not delivering patient-centred practice which is pivotal to providing high-quality care (Grover et al., 2022). Therefore, more research is required on specific interventions for children, for more understanding of the depth of the scope for occupational therapists in paediatric primary care. Pasokhy-Holmes et al. (2023) explore how the first-contact practitioner occupational therapy role in Dorset has improved children’s and family’s health and wellbeing, satisfaction and access to services as well as reduced appointments for GPs. The first contact practitioner role is a role expansion for occupational therapists and more awareness is needed in educational curricula at pre- and post-graduate levels and in healthcare settings, especially primary care.

There is literature examining paediatric occupational therapy but limited literature specifically on paediatric occupational therapy in primary care. This indicates more research is needed on this life stage, however, with consideration that this is a vulnerable population. Research undertaken needs to be focused on current and future occupational therapy practice and follow the corresponding guidelines to conduct research with children and young people.

Adults: Emerging role within supporting return to work

Interventions relating to physical health, mental health and work (employment) were highlighted with the most frequency in the literature. Adults and interventions relating to employment, were the third most frequent interventions (see Table 6). The PHE 2020–2025 strategy outlines one of the main priorities is to promote mental health to support individuals to live longer in good health (PHE, 2019). Supporting individuals to remain in, return to or obtain work is a key function of occupational therapy (RCOT, 2018). In support of this, Drummond et al. (2020) explored using occupational therapists in vocational clinics in primary care, where they provided interventions specific to the individuals needs and the provision of fit notes/ Allied Health Professions Health and Work Reports. Drummond et al. (2020) suggested that occupational therapists were a better fit and had more time in comparison to GPs to deal with mental health related work issues. Despite Drummond et al. (2020) being a small feasibility study, findings highlighted potential for occupational therapy vocational clinics to positively impact patients and GPs. Borthwick and Atkinson (2023) further explored the provision of fit notes and suggested that occupational therapy interventions in primary care for individuals with work-related issues improved return to work rates. These findings confirm there is a role for occupational therapy interventions within primary care for work-related issues. To support the development and role expansion of occupational therapy vocational clinics in GP surgeries, more research is needed, including case studies and trials to continue to highlight the benefits, challenges and effectiveness of the delivery of this intervention and also the difference occupational therapy can make when working within primary care.

Older adults: Falls prevention

Older adults were the main focus of the literature included in this review, with falls prevention interventions commonly identified (see Table 5). Falls not only impact an individual’s quality of life, but there is a financial impact on health services, with unaddressed fall hazards in the home estimated to cost the NHS in England £435 million per year (Office for Health Improvement & Disparities, 2022). Prevention and early intervention to prevent disease or reduce the impact of disability can support individuals to maintain a healthy lifestyle, which are key patient outcomes for occupational therapy in primary care (Bolt et al., 2019). Opportunistically asking older people and those over 50 at higher risk of falls if they have fallen in the last year, can ascertain which referral or intervention may be most relevant, including home hazard assessments undertaken by occupational therapists (National Institute for Health and Care Excellence (NICE), 2025).

Despite this review identifying occupational therapists working across the lifespan in primary care, a recent primary care research project examining occupational therapy in GP surgeries only explored older adults (RCOT, 2023a). Therefore, there is a need for the professional body to broaden their scope and explore adults and children in research, to highlight the benefit occupational therapists can have with delivering interventions to all ages. This could potentially develop the understanding of an occupational therapy role by the public, government, other healthcare professionals and occupational therapists. Considering the RCOT (2021) occupational therapy ‘superpowers’ in primary care which focuses on working with frail older adults, individuals with mental health problems and adults with employment difficulties, it has been identified throughout this scoping review that occupational therapists’ roles are broader and more diverse than these three key areas. Additionally, this review has highlighted the role of occupational therapists with children and young people in primary care, should be considered as an additional ‘superpower’. This will demonstrate the true extent of the profession’s scope, which could encourage occupational therapists to branch out into working in primary care.

Strengths and limitations

This review followed a systematic process, strengthening the consistency and robustness of the research. Also, including literature from countries where primary care services with occupational therapists are at varying stages of development enhanced the findings. Only including studies in the English language is a potential limitation of this scoping review. Also, where possible, further data extraction related to where the occupational therapists were working and the interprofessional team members they connected with may have further enhanced this scoping review. This review has brought together a significant amount of literature in this field to support the development of occupational therapy in primary care and explored what already exists and how this can be further developed in the future.

Future implications

Practice

This review highlights the breadth of occupational therapy interventions across the lifespan in primary care, while exposing gaps in potential complex areas where occupational therapy could make a difference across the lifespan. For children, evidence is limited and largely centred on parent/carer education, signaling the need for research into more child-focused interventions, to ensure that holistic and client-centred therapy is offered, highlighting the role of occupational therapy in addressing the physical, mental, social and sensory needs of children and young people and their families/carers at primary care level. For adults, vocational clinics show promise in supporting employment related health needs and reducing GP workload; however, larger studies are needed to establish impact and sustainability. For older adults, falls prevention remains a central priority, reinforcing the importance of embedding occupational therapy expertise into preventative care and the management of successful ageing. Collectively, these findings suggest the profession’s role in primary care extends beyond current priorities, with potential for children and families to be recognised as an additional occupational therapy ‘superpower’, broadening the evidence base and strengthening the case for occupational therapy across all life stages within evolving primary care.

Education

Pre- and post-registration education plays a vital role in the development of occupational therapy roles within primary care. Specifically, when developing the necessary knowledge, skills and confidence to address the unique demands of primary care. Occupational therapists need to be prepared to meet the evolving needs of individuals across the lifespan within the primary care context, potentially embracing a more generalist role and also be prepared to engage in interprofessional working for the needs of communities they serve.

Research

More research including case studies and trials are required to further investigate and support the role expansion of occupational therapists into primary care, including occupational therapy-led vocational clinics to capture the benefits this can have on patients’ lives and the reduction of workload pressures on GPs. As the life stage of children were underrepresented, research is required with consideration of the role occupational therapists can have in supporting children and young people’s development and successful participation. Developing research and service evaluations to establish how to successfully develop AHP roles in primary care, including how best to facilitate interprofessional working and to explore what primary care providers seek when developing primary care for the future health of communities is also recommended.

Conclusion

This scoping review has outlined the interventions currently used by occupational therapists in primary care and the life stages occupational therapists support in this area. Despite this, a gap in the literature has been identified for the representation of occupational therapy in primary care and more specifically relating to children and young people. This review has highlighted a breadth of occupational therapy practice in primary care, working with a wide range of physical and mental health conditions across the lifespan. Further research is required to build on this review, to facilitate further integration, understanding and awareness of occupational therapy in primary care.

Key findings

Occupational therapy has a role across the lifespan in primary care, although evidence is skewed with stronger focus on older adults and falls prevention, emerging work on vocational clinics for adults, and limited research with children beyond parent education.

Future research must prioritise child and family interventions, evaluate the effectiveness of vocational clinics, and embed occupational therapy expertise in preventative care for older adults.

Recognising children and families as an additional occupational therapy ‘superpower’ could extend the profession’s influence and strengthen its positioning in primary care.

What the study has added

This scoping review has outlined the interventions currently used by occupational therapists in primary care and the life stages occupational therapists support. By mapping occupational therapy’s contribution across the lifespan, this study highlights gaps in evidence and calls for increased research to develop in all areas which a specific area of development needed in child and family interventions within primary care.

Supplemental Material

sj-docx-1-bjo-10.1177_03080226261417185 – Supplemental material for Mapping the role of occupational therapy within primary care services: A scoping review

Supplemental material, sj-docx-1-bjo-10.1177_03080226261417185 for Mapping the role of occupational therapy within primary care services: A scoping review by Katie-Mai Davies, Alison Warren and Sam Wakley in British Journal of Occupational Therapy

Footnotes

Acknowledgements

We gratefully acknowledge the support of Kathryn Burden for her support as a reviewer in this scoping review.

Research ethics

Not applicable.

Consent

Not applicable.

Patient and public involvement data

During the development, progress, and reporting of the submitted research, Patient and Public Involvement in the research was not included at any stage of the research.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The authors declared no financial support for the research, authorship and/or publication of this article.

Contributorship

All authors were involved in the study development and KMD took a lead role in conducting the review. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

ORCID iDs

Alison Warren

Sam Wakley

Supplemental material

Supplemental material for this article is available online.

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