A First Contact Occupational Therapist (OT) brings diverse expertise to primary care, ensuring patients receive timely, appropriate support. Using population health approaches, they design tailored, proactive, and preventative interventions that help people stay active, independent, and engaged in life.

OTs work holistically across the lifespan, addressing physical, mental, and social needs. They look beyond diagnoses to focus on what matters most to each person—enabling them to do the things they need, want, and are expected to do, at home, work, and in the community.

In primary care, OTs often focus on three key areas:

• Frailty and ageing
• Mental health
• Work and employment challenges

Their practical, person-centred approach helps individuals overcome barriers, achieve meaningful goals, and improve quality of life.

For more information please read NHSE Roadmap to practice and the NHSE Occupational therapist in primary care

They provide new expertise to primary care teams to ensure patients get fast access to the right care at the right time.

Occupational therapists are clinically trained to work holistically with patients with physical, mental, and social needs.

Using health population approaches, occupational therapists offer bespoke services for specific patient groups that is proactive and preventative.

Occupational therapists can help GPs target the biggest causes of reduced life expectancy in primary care.

They can work across the life span with patients with heart disease, COPD, stroke, diabetes, dementia, mental illness, rheumatoid and osteoarthritis, cancer, learning disabilities, palliative care, obesity and smoking.

RCOT royal College of occupational therapist : What occupational therapist offer

The scope of practice for First Contact Occupational Therapist is  set out in the NHSE Roadmap to practice for First Contact and Advanced Practitioners. These roadmaps provide a clear educational pathway from undergraduate study through to Advanced Practice, detailing the knowledge, skills, and professional attributes required to work as an FCP or Advanced occupational therapist in primary care. They also outline the supervision structures and clinical governance arrangements necessary to support safe and effective practice.

By defining the capabilities of FCPs and Advanced occupational therapist the roadmaps help employers and workforce planners understand the value these roles bring to a multi-professional team, supporting high-quality, patient-centred care.

Occupational therapists see three main patient groups in primary care.

Frail older adults

• Use of frailty indexes to identify people needing a proactive approach.
• Rapid crisis response to prevent hospital admission or to speed discharge.
• Assessment and interventions to ensure people can cope at home, including support for carers.
• Short term rehabilitation interventions and referral onto specialist services if indicated.
• Use of digital and assistive technology to ensure safety at home.

People with mental health problems

• Risk assessment for acute distress.
• Personalised care plans for self-management.
• Patient activation to achieve personal goals.
• Social prescribing, and signposting or referral onto recovery support and services.

Working age adults with health and work difficulties

• Vocational rehabilitation.
• Use of fit note for sick pay.
• Tailored, specific advice about workplace modifications.

They work with patients with reduced functioning and social isolation; frailty and dementia; mental health or cognitive problems; vocational and workplace problems; children with developmental delay; high intensity users; neurodiversity; people with chronic pain; and fatigue; people recovering from injury or with life limiting illness.

Capabilities for Primary Care Occupational Therapy

Recruiting First Contact occupational therapist through ARRS

Primary Care Networks (PCNs) can recruit First Contact occupational therapist FCPs) via the Additional Roles Reimbursement Scheme (ARRS). This scheme funds a range of roles to help build bespoke, multidisciplinary teams that meet local population needs. All PCNs are eligible for reimbursement, with funding allocation based on their weighted population share.

Through ARRS, PCNs can employ FCPs and be reimbursed for 100% of the specified salary and associated on-costs. This makes it a cost-effective way to integrate dietetic expertise into primary care teams, improving access and outcomes for patients.

More information can be found in:

• DES contract.
• Additional Roles at a Quick Reference Summary.
• CQC Mythbuster.

To practice as a First Contact Occupational Therapist, clinicians must be registered with the Health and Care Professions Council (HCPC), which requires a a BSc in or pre-reg MSc in Occupational Therapy under a training programme approved by the Royal College of Occupational Therapists

Occupational Therapist,working at Advanced Practice level are generally expected to hold a Master’s degree or equivalent postgraduate qualification to support extended clinical decision-making, supplementary prescribing, and leadership responsibilities.

NHS England recommends that Occupational Therapist  have 3–5 years of post-qualification experience before entering primary care training to become a First Contact Practitioner. This ensures they have the clinical expertise needed to manage patients safely and effectively in a first-contact setting.

In addition, First Contact Occupational Therapist should:

• Hold aMaster’s-level qualification or demonstrate equivalent specialist knowledge, skills, and experience.
• Be able todemonstrate Level 7 capability in Occupational Therapy including advanced assessment, diagnosis, and treatment.

Further information can be found here.

RCOT : Occupational therapy in primary care

NHSE Occupational therapist in Primary care

Occupational Therapists can train to be a First contact practitioner via 2 routes:

University taught route – there are several fully funded courses available for Occupational Therapists to attend:

Occupational Therapists can also undertake the portfolio route, this route is aimed at individuals with previous post graduate training and / or primary care experience. 

Further Information on Education and Training can be found here.

RCOT : Occupational therapy in primary care

Job Description

Example of interview questions

Mental Health Occupational Therapy in Primary Care

Dorset training hub additional roles – Occupational Therapy webinar

BJGP; Occupational Therapy: an emerging role in primary care

Occupational Therapist in Primary Care Podcast

Supervision under ARRS

The Network Contract DES specifies the minimum supervision requirements for staff hired through the ARRS. The table below outlines the recommended minimum frequency for supervision meetings and identifies who can provide this supervision. Each clinical supervision session should last at least one hour.

These recommendations are based on the Network Contract DES requirements, professional regulatory standards, and expert guidance.

More information can be found in NHS England’s’ supervision guidance for primary care network multidisciplinary teams.

Supervision of the MDT.

FCP Portfolios

• Agilio (Clarity)

Portfolio Blank Templates

• Audio COT
• FCP Verification Form
• Level 7 Module Performa
• Multi source feedback form
• Patient Satisfaction Questionnaire
• Personal Development Plan
• Patient survey questionaire and multi source feedback form via accuRx guide
• Tutorial Evaluation
• Tutorial Record