Occupational Therapy in the Reformed NHS: The Views of Therapists and Therapy Managers

This article describes an exploratory study which considered the effect of the recent reforms of the National Health Service on the professional position of occupational therapists working within NHS trusts. The term ‘reforms’ refers to the overall Impact of Government legislation following the Influential Griffiths report of 1983, up to and including the NHS and Community Care Act 1990. In the absence of any other published empirical data on this subject, an exploratory study was carried out. Sixteen in-depth interviews were conducted over a 2-month period during the summer of 1995 (10 therapists, 6 managers). The sample was drawn from four separate trust sites in the South East of England. The findings suggest that clinical autonomy remains unchanged, although there are fears that it may be under threat in the future. Managerial autonomy appears to have been adversely affected by the loss of the district therapist posts. Managers were concerned about the long-term effects of fragmented services on supervision and support networks and the recognised problems associated with a flat career structure. Job satisfaction was still high among therapists. Both managers and therapists were, however, less secure in their jobs and felt that their morale had been affected by the recent changes.