An open letter from AbleOTUK for Occupational Therapy Week 2026
This Occupational Therapy Week, our profession is celebrating the theme Participation Changes Everything. As occupational therapists, we recognise the importance of meaningful occupation for health, wellbeing, identity and belonging. We also understand that participation is not simply a matter of individual ability or motivation. It depends on the opportunities, environments and support available to people.
Yet disabled people across the UK are experiencing significant difficulties with Access to Work, a government scheme intended to help disabled people and those with health conditions enter and remain in employment. The scheme can fund practical support, including specialist equipment, assistive technology, support workers and additional travel costs. However, lengthy application and renewal delays, poor communication and interruptions to essential support are creating further barriers to employment.
A scheme designed to enable participation should not become another barrier to it.
For the people accessing occupational therapy, the consequences can be significant. Someone may have worked towards returning to employment following illness or injury, secured a job after a period of unemployment or developed the confidence and skills to pursue a new career. Yet without timely access to essential workplace support, these opportunities may be lost. The consequences extend beyond employment, affecting financial security, health, wellbeing, occupational identity and participation in everyday life.
As occupational therapists, we need to consider what this means for our practice. When we support someone to identify occupational goals, develop skills or prepare for employment, are we also recognising the structural barriers that may prevent them from achieving these goals? Are we asking about Access to Work, understanding the difficulties people may be experiencing and considering how we can advocate alongside them? These questions are relevant across occupational therapy practice, not only within vocational rehabilitation.
These barriers also affect disabled occupational therapists within our own profession, including those working in clinical practice, education, research and leadership. For some, moving into education or other professional roles has provided an opportunity to continue contributing their expertise after experiencing inaccessible clinical environments. However, difficulties securing or maintaining Access to Work support can create further barriers, including prolonged absence, pressure to work without essential support and risks to health and wellbeing.
Newly qualified occupational therapists may be particularly vulnerable when expected to begin employment before necessary support is in place. Experienced practitioners may face similar difficulties when changing roles or renewing existing arrangements. The consequences can include burnout, worsening health conditions and people leaving the profession. At a time when our workforce faces significant pressures, we should be enabling disabled occupational therapists to contribute and progress, rather than allowing preventable barriers to exclude them.
This is an issue of occupational justice. Disabled people should not be denied opportunities for meaningful employment because the systems intended to support them are failing. These difficulties also reflect wider institutional ableism, where policies and processes fail to accommodate disabled people’s needs, reinforcing exclusion rather than enabling equitable participation.
These concerns are supported by parliamentary scrutiny. In its June 2026 report on Access to Work, the House of Commons Public Accounts Committee highlighted serious administrative failures, including average application processing times of 106 working days and applicants being advised that they could wait up to 37 weeks. The Committee also identified the consequences of delays for employment, income, health and wellbeing.
AbleOTUK is calling on the Government and the Department for Work and Pensions to take urgent action to reduce delays, protect continuity of essential support, improve accessible communication and meaningfully involve disabled people in decisions about the scheme’s future.
Employers must also fulfil their legal responsibilities to provide reasonable adjustments under the Equality Act 2010. Access to Work should complement these responsibilities, not replace them.
We are also calling on the occupational therapy profession to act. We ask occupational therapists to reflect on whether difficulties with Access to Work are affecting the people they support or their disabled colleagues. We encourage conversations within teams, greater awareness of the scheme and consideration of how occupational therapy assessment, intervention and advocacy can address barriers to employment.
We also call on the Royal College of Occupational Therapists (RCOT), employers, educators and professional leaders to recognise these concerns and use their influence to advocate for change.
We invite you to read and sign this open letter, share it widely and write to your MP to raise awareness of these issues. We encourage you to discuss the letter with colleagues and professional networks and consider what action you can take within your own area of practice.
We recognise that not everyone can or wishes to undertake paid employment. A person’s value is never determined by their ability to work, and meaningful participation extends far beyond employment. However, those who wish to work should have equitable opportunities to do so, without unnecessary barriers created by the systems intended to support them.
This Occupational Therapy Week, we are asking our profession to do more than celebrate participation. We are asking occupational therapists to consider what participation means for the people they support, recognise the barriers that prevent it and use their professional knowledge and collective voice to challenge them.
Participation changes everything, but access makes participation possible.
Yours sincerely,
AbleOTUK
A network for occupational therapists, students, educators and researchers with lived experience of disability, neurodivergence and long term health conditions.
A note on language
Throughout this letter, we use the term disabled in recognition of the legal definition of disability under the Equality Act 2010. However, we recognise that not everyone who falls within this definition identifies as disabled or uses this language to describe themselves. This includes some people with long-term health conditions and neurodivergent people. We respect individuals’ choices about how they identify and describe their own experiences.
Show your support and help us make a difference
Please leave a comment below this letter to show your support and add your voice to our call for change. You do not need to have personal experience of Access to Work to support this campaign.
If you feel comfortable doing so, we would also welcome you sharing your own experiences of Access to Work. This might be a positive experience demonstrating the difference Access to Work has made to your ability to enter employment, remain in work or progress in your career. Alternatively, you may wish to highlight difficulties you have experienced, such as delays, poor communication or interruptions to essential support, and the impact these have had on your life and occupational participation. Please only share what you feel comfortable making public.
We also encourage you to write to your local MP, sharing a link to this open letter and asking them to raise these concerns with the Government. Template letter here . You can find your MP and their contact details by entering your postcode on the UK Parliament website.
Please share this letter with your colleagues, professional networks and others who may wish to support our call for action.
Together, we can raise awareness and challenge the barriers that prevent disabled people from participating in employment.
