Brian Trotter | The Occupational Therapy Service

Through effective proportionate care reviews, The Occupational Therapy Service (TOTS) is delivering high-impact strategies to release social care savings and frontline capacity for several councils across the UK.

TOTS is a respected independent occupational therapy service offering a portfolio of clinical and commercial services. A vital part of its remit is supporting local authorities and health organisations in ensuring that domiciliary care provided is proportionate to the person’s needs. All public sector bodies are facing unprecedented financial challenges in adult social care with escalating costs and rising demand for domiciliary and Continuing Healthcare packages. A recent survey* found 9 in 10 directors of adult social care in England have been forced to overspend to meet their Care Act statutory duties, with home care packages being a primary driver of this pressure.

Financial strain is being compounded by significant healthcare system-wide challenges. An ageing population is driving demand for more complex care, while historic care packages often remain unchanged, locking vital care capacity into inefficient provision. This creates a cascade of issues including longer waiting lists and severe delays in hospital discharges. Nationally, around 14,000 hospital beds per day are occupied by patients who are medically fit to leave but are awaiting social care. The reassignment of community care to these individuals is critical in resolving the current model which is unsustainable.

*Adam Ferry, OT and Director of The Occupational Therapy Service, undertaking proportionate care reviews for county councils*

By delivering occupational therapy-led proportionate care reviews, TOTS is ensuring thousands of frontline care hours are appropriately assigned, hospital discharges are expedited, financial savings are implemented and ultimately, local authority resources are more effectively channelled within already stretched budgets.

Proven results from The Occupational Therapy Service have delivered significant improvements to local authority services. TOTS recently completed a proportionate care review for a city council which produced the following results:

Adam Ferry, Director and OT for TOTS comments: “Aside from the financial savings we deliver, our approach is first and foremost person-centred. It promotes a strengths-based, High Impact Change model that maximises dignity and independence. By ensuring care is proportionate to need, often through the introduction of the right equipment and handling techniques, we ensure residents can live successfully with lower risk. This not only delivers significant system efficiencies but also increases the quality of care delivered and often the length of each care call, helping the person and their carer to build strong, trusting relationships.”

Adam continues: “By expertly reviewing existing care packages, we consistently deliver significant savings that can be reinvested into other priority areas. This approach has a track record of success across the UK. For example, in one project, 60% of relevant cases were safely converted from double-handed to single-handed care, dramatically increasing capacity. In another confidential council partnership, a single complex package review we designed and implemented has created 50 extra care hours per week within the system.

In conclusion Adam says: ” The Occupational Therapy Service will continue to unlock a sustainable future for adult health and social care through a targeted focus on proportionate care. Our work always aligns with core principles of the Care Act, ensuring resources deliver more wellbeing, choice and interdependence for vulnerable individuals – an outcome we are proud to facilitate.”

The 9^th February marks the start of WFOT Congress 2026 and it’s no secret that this particular event has more relevance to The Occupational Therapy Service than others have done in the past, for two reasons.

The Congress is our Director Samantha Shann’s last event as WFOT President and we could not be prouder of what she has achieved. Her passion, care, compassion and drive has ensured that despite one of the most challenging tenures due to geopolitics in modern history, she has driven and inspired change across the globe.

*WFOT President and TOTS Director Samantha Shann*

The theme for WFOT Congress 2026 is ‘Inspiring Change, Innovating Futures’ and this strongly resonates with The Occupational Therapy Service (TOTS).

In his WFOT Congress welcome, Ritchard Ledgerd states that the theme “signifies our (WFOT) commitment to embracing new opportunities in our profession and exploring innovative strategies that lead us forward.”

TOTS values directly align with this commitment, with a focus on ensuring our interventions are robustly evidence informed, innovative, person – led, ultimately enabling interdependence. Indeed, our tag line is ‘inspiring meaningful change’, further highlighting the synergy.

*The 2026 WFOT Congress lanyard featuring sponsors The Occupational Therapy Service*. Made from recycled materials supporting sustainability in line with WFOT and TOTS values.

It is for this reason that TOTS made the decision to provide sponsorship to WFOT Congress 2026 for the first time, and therefore all delegates will be wearing a collaborative WFOT and TOTS lanyard during the event. Selecting the lanyards as sponsorship ensures that not only is the brand visible, but poignant in that all delegates will wear the logos of the two organisations into which Samantha has invested so much of her time.

In addition, TOTS chose to provide lanyards made from recycled materials proving their commitment to sustainability in line with WFOT values

We are proud to be associated with WFOT and it’s values, wishing all a successful and safe congress.

Leading UK company The Occupational Therapy Service, sponsored by Clos-o-Mat, has delivered engaging education to student OTs at The University of the West of England.

As part of its multi-faceted portfolio, The Occupational Therapy Service provides comprehensive training solutions that cater for diverse audiences. From practising professionals requiring CPD to apprentices seeking fundamental learning, it has the capabilities to deliver quality education.

At its latest training session, The Occupational Therapy Service was invited to teach student OTs at The University of the West of England, Bristol. The two days of lectures covered housing related topics such as bathroom occupations, anthropometrics and economics as well as legislation and guidance.

Lucy Leonard, OT and Director of The Occupational Therapy Service, presenting at The University of the West of England.

Lucy Leonard, occupational therapist and company director, delivered the educational module leveraging her 26 years of experience in the field. Her insightful teaching combined theory and real-life examples, with the students having the opportunity to evaluate their own homes and campus for accessibility, risks and hazards.

On completion of the two days, Lucy summarised by saying: “It was a rewarding experience teaching students at UWE as they were fully engaged throughout. We received excellent interaction and feedback. Many students said they found my content thought provoking in terms of how OT makes a difference in today’s challenging community situations. They left enthused and with vocational knowledge vital for future career development. We thank the University for facilitating the opportunity and appreciate sponsorship from Clos-o-Mat, the specialist toilet manufacturer and one of our commercial clients, who made the lectures possible.”

The Occupational Therapy Service, a leading independent practice, experienced its most productive year ever in 2025 with associate therapists delivering more meaningful change than ever before.

Led by the three directors and eminent occupational therapists, Samantha Shann, Lucy Leonard and Adam Ferry, The Occupational Therapy Service continues to deliver exceptional service across several disciplines. As plans roll out in 2026, reflecting on the successes of 2025 is helping shape future strategies for The Occupational Therapy Service – ultimately ensuring clients receive the most value, whether clinically or commercially.

In terms of highlights from last year, Samantha says: “Maintaining OCN London accreditation was a key success for us and our clients in 2025. This commitment to quality educational services has been epitomised by the stronger partnership we have forged with Foundations. As the national body for HIAs, we have supported this organisation by consistently delivering highly popular Level 4 Trusted Assessors courses that leverage our expertise in home adaptations. Internationally, my role as President of the World Federation of Occupational Therapists has involved promotion and development of the profession with local occupational therapists and governments. This work continues to offer remarkable insights into global practises and how these can be used to improve service delivery back here in the UK.”

Adam adds to these achievements by continuing: “2025 was our strongest year in terms of commercial client work. We delivered CPD to over 1,500 therapists through our relationships with manufacturer and distributor partners. Plus, our team reaffirmed its commitment to The OT Show as educational partner and conference developers. From a local authority point of view, our associates delivered ROI on multiple levels such as our proportionate care reviews. With one council, we have saved the organisation £1.4m per annum and put back 60,000+ hours of care back into the system. These types of results are always how we measure success – it is not about us; it is about our clients.”

Lucy agrees with her co-directors that 2025 produced the most prolific number of results ever for clients of The Occupational Therapy Service. She concludes by saying: “Reflecting on the past is always crucial for the future. As we begin 2026 this review exercise has highlighted our core strengths and underlined our reputation for occupational therapy excellence. From delivering National Independent Advisory Services to shaping Housing and Design Policies, our ever-expanding network of associates has proven its worth. Partnerships have been strengthened across health, social care and the voluntary sector with the latter providing great emotional reward personally. Equally satisfying has been our hosting of educational webinars and seminars with a focus on evidence-informed practice. This content has gone even further with contributions to national Government research – once again showcasing the trust significant organisations place in us.”

The Occupational Therapy Service, a respected independent practice, is delighted to announce its associate Sarah Jane Rowlands will now be fulfilling a new role as Project Lead Occupational Therapist, for proportionate care and service development projects.

Sarah Jane is a highly experienced occupational therapist who has worked extensively in housing. She excels in supporting people to adapt their homes and environments to enable them to live positively. Her work spans environmental adaptations, assisted equipment provision and complex housing related decision making, with a strong focus on enabling meaningful occupation.

Alongside this, Sarah Jane has developed extensive expertise in manual handling and single handed/proportionate care. Her work in this field has been recognised nationally, including receiving an innovation award for practise that has helped shape safer, more proportionate approaches to care delivery. She has spoken at a national level on this subject, contributing to improved standards of occupational therapy practise beyond her own services.

Sarah Jane also brings a wealth of experience in reablement. She takes pride in delivering occupation-focused and graded approaches that prioritise individuals’ goals and holistic recovery. She has led multidisciplinary reablement teams since 2019 and now mentors and supports clinicians across a range of settings – bringing her accomplished leadership style to complex services.

Known for her attention to detail, strong clinical reasoning and high-quality reporting, Sarah Jane is a valued contributor to rehabilitation and transformation projects. Lucy Leonard, Director for The Occupational Therapy Service, concludes by saying: “Sarah Jane’s appointment as Project Lead Occupational Therapist reflects the experience, consistency and credibility required to support proportionate care initiatives at scale. She has always been a valued asset to our business, and we are delighted to continue working closely with her as we move forward with more proportionate care and service development projects.”

Sarah Jane is delighted to be taking up the new position of

Project Lead Occupational Therapist at The Occupational Therapy Service.

At the OT Show this year it was responsible for supporting a wide range of delegates and exhibitors through its multi-faceted service. In addition, it was once again the event organiser’s chosen partner for orchestrating the OT Show CPD programme, highlighted the company’s continued commitment to education. Pivotal to its activities on the show floor, from seminar presentations to engaging with fellow professionals, was the showcasing of its business values. These five pillars of OT excellence were regularly reflected upon whether discussing current business projects or offering advice to OTs seeking to enhance their career.

Lucy Leonard, OT and one of three co-Directors at The Occupational Therapy Service, commented: “I’m delighted that our show proposition has been so warmly received this year. Alongside our commercial and educational work, our team was busier than ever on both days with an increased number and diversity of delegate enquiries. From local authority and ICB representatives looking to implement cost effective proportionate care, through to OTs and Case Managers seeking better client outcomes, the variety of our conversations was rewarding and insightful. We look forward to continuing these discussions into the new year as our practice continues to expand and evolve at the forefront of OT thinking.”

The Occupational Therapy Service business values that underpinned its show activities were:

1. Person-led occupation
2. Evidence-informed practice
3. Enabling interdependence
4. Ethical and accountable 5. Inclusive environments

Watch Lucy Leonard outlining these values in a video at the show here.

Lean more about evidence-informed practice here with Adam Ferry, OT and Director, talking about how The Occupational Therapy Service is helping Derby City Council deliver proportionate care.

The Occupational Therapy Service directors to champion their business values at The OT Show

The Occupational Therapy Service Directors (central) and their associates

The Occupational Therapy Show, stand D27, NEC, 26–27 November

The Directors of The Occupational Therapy Service, a clinically-led OT company, will be showcasing why their values can enhance everyday practice for delegates attending The OT Show 2025.

As a respected independent practice, The Occupational Therapy Service collaborates with case managers, healthcare teams, local authorities, and industry partners to raise standards, improve systems, and deliver person-led change. Its three directors, President of the World Federation of Occupational Therapists, Samantha Shann; Adam Ferry, specialist in neurological rehabilitation and proportionate care; and Lucy Leonard, with 25+ years’ experience in complex rehabilitation and consultancy, will be leading their team of associates at the show. Together they will be available to talk about clinical practice, service innovation, training, and collaboration across health, social care, and industry.

As proud event partners, they have helped shape this year’s event CPD programme, reflecting the values of modern occupational therapy. These values drive how and why The Occupational Therapy Service do what they do and during the event, the three directors will be available to explore how these principles can enhance everyday practice and inspire meaningful change.

The Occupational Therapy Service values that will be explored are:

1. Person-led occupation

We work alongside people to identify what truly matters in their daily lives, using occupation as the foundation for every intervention.

Why it matters: Because meaningful activity is what gives life purpose, and it’s where change really happens.

2. Evidence-informed practice

Our recommendations are shaped by clinical expertise, research, and professional standards, ensuring interventions are safe, effective, and goal-oriented.

Why it matters: People deserve the best of our profession, not guesswork or trends.

3. Enabling interdependence

We support people to engage in meaningful activities by fostering skills, confidence, and supportive environments, recognising that wellbeing is often built through connection with others.

Why it matters: Because thriving isn’t about doing everything alone, it’s about having the right balance of autonomy, support, and belonging.

4. Ethical and accountable

We act with professional integrity, making transparent decisions that respect rights, needs, and the principles of proportionate care.

Why it matters: Trust is earned when our decisions are honest, fair, and clearly explained

5. Inclusive environments

We design and recommend solutions that remove barriers, promote accessibility, and allow people to thrive in their chosen occupations.

Why it matters: Everyone should have the opportunity to take part in the activities that matter to them.

Director Adam Ferry concludes by saying:

“We’re excited to be attending The OT Show this year. What sets us apart is that we’re led by practising occupational therapists. Every decision we make is grounded in clinical insight, professional standards, and a deep understanding of the environments people live and work in – values we will aways uphold in the name of effective OT.”

The Occupational Therapy Service leads Armed Forces care with NHS Veterans Aware accreditation

The Occupational Therapy Service (TOTS), a leading and well-respected independent occupational therapy company, has been awarded NHS Veteran Aware accreditation in recognition of its training to support the Armed Forces community.

Delivered by the Veterans Covenant Healthcare Alliance, NHS Veteran Aware is an accreditation programme designed to help healthcare providers understand and meet the needs of serving personnel, reservists, veterans, and their families in the UK. TOTS identified this initiative as aligning with its values so applied for training to enhance its intervention for military charities, case management companies, the NHS and local authorities. This accreditation proves that the service it provides meets national standards and has proven competency in terms of social value, intervention and inclusion.

Lucy Leonard, occupational therapist and Director of The Occupational Therapy Service, commented: “For me, the visit was a proud moment but also a challenge. Pride that our team has done the work to reach this point; challenge because it reminds us to keep learning and adapting. It’s not about a plaque on the wall, it’s about how we approach every assessment, every recommendation, and every conversation so that veterans and their families get the right support and opportunities to live full, independent lives.”

Serving for over 40 years in the British Army, retired Lieutenant Colonel Guy Benson was invited to the TOTS headquarters to unveil a plaque which illustrates the new TOTS accreditation. Guy is the National Programme Director and Team Leader of the NHS VCHA and National Training and Education Programme. One of the most moving moments was sharing a painting given to our Director Samantha Shann, by a Ukrainian veteran she met earlier this year.

Retired Lieutenant Colonel Guy Benson unveils the Veterans Aware plaque with the accredited team from The Occupational Therapy Service

Guy added: “The Occupational Therapy Service, who recently joined the Veterans Covenant Healthcare Alliance (VCHA), are absolutely brilliant. This is a well led, professional and compassionate organisation who are making a real difference and playing their part in ensuring that the Armed Forces community do not face inequalities, unwarranted variation or disadvantage in the provision of healthcare. These are ordinary people, delivering the extra-ordinary and as such are playing their part in making the UK the best place in the world to be a veteran.”

Lucy sums up Guys visit by saying: “From a personal point of view, it was inspirational to meet Guy and hear about his past military experiences and commitment to improving care for fellow veterans. He was very humble and a real leader We’re grateful to Guy for giving his time, for sharing his experience so generously, and for encouraging us to keep going.”

The Occupational Therapy Service
Established in 2014, the Occupational Therapy Service is the UK’s foremost independent occupational therapy company providing international support for case managers, solicitors, insurers, retailers, equipment manufacturers and individuals in the community. It is led by three OT directors with expertise that is unsurpassed, namely RCOT Fellow and WFOT president Samantha Shann; award-winning Adam Ferry and Lucy Leonard. Together, these respected healthcare professionals head up a 100+ strong team of associates who deliver clinical, consultancy and training disciplines. 100% committed to leveraging the power of OT for positive outcomes, the Occupational Therapy Service has an outstanding track record and reputation.

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Newham Launches Inclusive Housing Design Guide

The London Borough of Newham has taken an important step towards more inclusive housing with the launch of a new design guide, created to ensure future homes better meet the needs of people with learning disabilities and neurodivergence.

The guide was developed by occupational therapists and associates Dr Rachel Russell, Dr Jan Healey and Dr Marney Walker from The Occupational Therapy Service (TOTS). Working in partnership with residents, local planners and service providers, the team co-produced practical recommendations that place health, wellbeing and independence at the centre of housing design.

Newham faces some of the most pressing housing challenges in the country, with high levels of homelessness, overcrowding and a rapidly growing population. The borough’s Strategic Housing Needs Assessment (2022) highlighted more than 6,500 residents with learning disabilities and almost 3,000 with Autism Spectrum Disorder, with numbers expected to rise significantly by 2040. At the same time, more than 50,000 new homes are planned in the borough over the next 15 years.

This combination of urgent need and large-scale development made Newham the ideal place to explore how housing could be designed differently. The new guide responds directly to these challenges, offering practical tools for developers, housing associations and local authorities to ensure that future homes are not only accessible but truly supportive of day-to-day life.

The project has been recognised nationally, with a feature in the September edition of OT News Magazine. Its publication highlights the potential for this work to act as a model for other local authorities and housing providers, shaping more inclusive design across the UK. Read the full article here

AKW, the specialist accessible kitchen and bathroom manufacturer, is strengthening its service with clinical support from The Occupational Therapy Service.

AKW has partnered with The Occupational Therapy Service since 2015. By working closely together, this collaboration of industry leading companies has been able to enhance the AKW team’s clinical approach to product provision and service.

AKW is one of the UK’s market leaders in the design and manufacture of accessible kitchens and bathrooms, wet rooms and showers for people with disabilities. With over 28 years of experience in the industry, it is committed to enhancing independence and improving daily living through an extensive range of high-quality products. These solutions make bathrooms and kitchens safer, more convenient and easier to use for individuals with mobility challenges – all guided by The Occupational Therapy Service. This level of support has just been extended through the joint production of new media to advise professionals and consumers seeking the right designs for specific medical conditions.

Filming took place recently at the AKW centre in Middlewich, Cheshire. This location, which complements the AKW Droitwich showroom, provides unique simulated inclusive kitchens and bathrooms. These centres of excellence are also regularly used by healthcare professionals for meetings, CPD workshops and client assessments.

Videos featuring Adam Ferry, OT and Director at The Occupational Therapy Service, were shot within several of the AKW accessible environments to highlight considerations around aspects such as wheelchair accessibility and living with dementia. Visual impairment, arthritis and stroke were also explored in terms of what domestic spaces require for maximum safety and occupation.

Adam said: “This latest educational material aims to improve independence and dignity for end users whilst giving AKW a competitive edge. As a specialist provider, they have always taken pride in being thought leaders within their field. Our latest joint venture reaffirms this position and reinforces the value of our commercial relationship. This new material will be available soon so watch this space.”

Away from this latest specific project, The Occupational Therapy Service continues to deliver a range of other clinical services for AKW. Emma Taylor, OT for The Occupational Therapy Service, goes on to say: “We deliver on many levels for AKW. These include supporting R&D, offering general advice and managing focus groups. We also work with them when helping individual clients with disabilities. If a client come to them requiring an inclusive bathroom or kitchen, we help guide AKW so that their solution maximises occupation.”

In conclusion, Laura Walsh, AKW Business Development Manager, sums up by adding: “I think the collaboration between the two of us is so important. Having expertise from a different perspective is critical – we focus on product design but need to understand the clinical side as well. That’s where Emma and the rest of The Occupational Therapy Service team come in. So, we can continue to innovate whilst being able to meet individual client needs on a case-by-case basis. Our latest material will reflect this ethos.”

Over her 25-year career in occupational therapy, TOTS director Lucy Leonard has discovered one truth: language matters. Be it in how we communicate, or how we shape understanding — this could be in supporting our clients’ in their chosen environments or indeed themselves . Occupational therapy focuses on meaning, engagement and identity, all themes which can be affected by the language we choose to use.

Lucy feels passionately about language having previously tackled this subject at The Occupational Therapy Show, and recently gave an interview with OT Today magazine in the hope of reaching a wider audience.

In the article Lucy explains,

“In occupational therapy, we pride ourselves on being holistic. We go beyond symptoms, beyond diagnosis, and into the meaningful fabric of daily life: what people do, want to do, or need to do. But how often do we stop to examine the language that underpins this work? The words in our assessments, the terms we use in care plans, the way we talk about progress or struggle – they all have an impact.”

The main topics of discussion centre around the use of words such as ‘resilience’, ‘independence’ and ‘safe’ and their meaning in an occupational therapy context. Lucy goes on to say,

“Occupational therapists are trained to notice the subtle nuances in daily life. Their language should honour that nuance, capturing the complexity of lived experience rather than reducing it to generic phrases or passive descriptors.”

Click here to read the full article in OT Today

Reflections from Unite Professional Case Management Conference 2025

Shirleyanne Kippax

Clinical Co-ordinator at The Occupational Therapy Service

The theme of this years’ Unite Professionals conference, ‘Readiness for Rehabilitation’, could not resonate more with The Occupational Therapy Service as we pride ourselves on providing fully client-centred occupational therapy. This means having a clear focus on the right intervention at the right time for our service users, with a main focus being on goal orientated rehabilitation.

Being invited as an exhibitor for this year’s event not only provided TOTS with an exciting opportunity to meet some of the wonderful case managers we regularly work with but also to have meaningful discussions with those new to using our service and, those who have yet to work with us. These conversations allowed us to showcase how The Occupational Therapy Service can support case managers UK-wide, in identifying rehabilitation needs and achieving rehabilitation goals for their often, complex clients.

To ensure TOTS made the most of this opportunity we were keen to ensure we took some learning away with us and the conference did not disappoint- with key speakers including a former veteran sharing insight into his rehabilitation journey, expert-led discussions from professionals including solicitors and insurers who shared the key priorities in the litigation process and a comprehensive presentation with focus on the case managers’ role in organising rehabilitation whilst juggling the litigation process, there was certainly a lot for us to consider and reflect on. For an occupational therapist working in to the case management industry understanding what case managers want is vital, one of the workshops provided centred around the referral process and response time, quality of reporting and outcome measures, MDT working and access to specialist rehab equipment and services. In the 2 weeks following the event, this learning is already being considered during our regular clinical meetings and discussed within our lead clinical team, ensuring we continue to expand our expertise in occupational therapy in-line with the clear demands of case management.

The Occupational Therapy Service are always grateful to attend fantastic events like these as we continually strive to ensure a gold standard service to case managers across the country. Every day is a learning day.

Many thanks to Unite Professionals

The Occupational Therapy Service reclaims budget capacity for local authorities

The Occupational Therapy Service Supporting WFOT Congress 2026

The Occupational Therapy Service successfully delivers academic guidance at UWE

2025: The Occupational Therapy Service achieves most successful outcomes ever.

The Occupational Therapy Service announces new Project Lead Occupational Therapist

The Occupational Therapy Service has highest ever delegate engagement at The OT Show

Championing our Business Values

The Occupational Therapy Show, stand D27, NEC, 26–27 November

1. Person-led occupation

2. Evidence-informed practice

3. Enabling interdependence

4. Ethical and accountable

5. Inclusive environments

NHS Veterans Aware Accreditation

Innovation in the Public Sector

The Occupational Therapy Service demonstrates continued clinical value to AKW

Lucy Leonard talks to OT Today about language

Learning with Unite Professionals