By Lisa Westhorpe, Occupational Therapist & National Lead, Sport for Confidence
This report outlines a workforce development initiative focused on embedding physical activity within occupational therapy (OT) practice, specifically through a collaboration with Teesside University and community partners in the Tees Valley area of North East England. The initiative began in early 2024 with the goal of embedding physical activity within a pre-registration occupational therapy degree course, using a spiral curriculum approach. This was facilitated by Teesside University's course revalidation process, providing an opportune time to modify the curriculum content and mentor staff on the value of physical activity in OT practice.
The spiral curriculum work was purposefully extended beyond the academic setting to connect local community services with the university. The aim was to ensure that graduating students' knowledge of physical activity was recognised and supported within the wider healthcare system, preventing a disconnect where occupational therapists might be discouraged from promoting health through activity in community settings. We acknowledged that by focusing only on the academic course content, there was a risk that when students graduated out into the workforce, their employer may tell them that physical activity ‘wasn’t something we do here as part of occupational therapy practice’. Key partners in the spiral curriculum work to embed physical activity in the pre-registration occupational therapy degree course included the local Sport England funded active partnership (Tees Valley Sport), the leisure provider Tees Active, and various VCSE, NHS and adult social care services.
A significant component of this workforce planning development arose from accepting a student placement at short notice. An apprenticeship student from Teesside University required a placement and was interested to explore physical activity as part of occupational therapy practice, with a leisure centre in Darlington offering to host her under the long arm supervision of an occupational therapist. The placement was eight weeks in duration, primarily conducted virtually with some on-site leisure centre visits.
During her placement, the student undertook several key projects, including:
Producing an accessibility video for the leisure centre to help new users feel more confident entering the environment.
Analysing the local Joint Strategic Needs Assessment (JSNA), which identified a proportionally high number of individuals with learning disabilities in the Darlington area, alongside significant health inequalities and poor health of the local population.
Researching provision for adults with learning disabilities at the leisure centre; no services were being provided for adults, with only a weekly Special Educational Needs (SEN) session for children.
In response to these findings, the student identified Boccia as an accessible sport for individuals with learning disabilities and complex needs. She planned, promoted, and delivered a pilot Boccia group session, connecting with various community groups including learning disability care homes and social groups to invite participants. The pilot session was successful, attracting between 10 and 15 participants from diverse services.
Following her placement, the student presented her work to the leisure centre manager and other system stakeholders. The success of the Boccia pilot informed a funding application to Sport England's Movement Fund, submitted in collaboration with the leisure centre manager. Approximately six months later, we were informed that this application was successful, securing funding for staff training, Boccia court markings in the sports hall, equipment including Boccia sets, and a variety of sensory fidgets and seating options to support participation by individuals with learning disabilities.
A second occupational therapy apprenticeship student subsequently undertook a placement at the same leisure centre following the successful grant application. This student's on-site supervisor ran the local Move More provision and had extensive knowledge of community physical activity provision, funding sources, and training opportunities. The second student built upon the first student's work by purchasing required equipment and further tailoring the Boccia group using JSNA data to match population demographic needs. She coordinated with various services to ensure session timings accommodated participants' care arrangements and leisure centre staff availability.
The Boccia group, piloted by the first occupational therapy student and established by the second student, has proven highly successful and continues to operate weekly as of January 2026. The Movement Fund also provided training opportunities through Boccia England, enabling care staff and other interested parties including allied health professional students, volunteers, and leisure centre staff to learn about delivering Boccia sessions. Efforts were made to engage adult social care services to support the session, though this proved challenging initially; although there are many positives from this workforce development, there were aspects that did not go as planned, and it’s as important for us to share these as well as the successes.
The onsite supervisor for the second student, in addition to running the local Move More physical activity provision, also leads Sport England's Place Expansion programme for Darlington, a system-wide approach targeting areas with reduced physical activity levels and greater health inequalities. The supervisor confirmed that the students' work directly informed one of three themes within this Place Expansion initiative, specifically focusing on people with learning disabilities. Without this occupational therapy-driven work, it is less likely that provision for people with learning disabilities would have been prioritised in Darlington's leisure centre or within the broader system approach. Occupational therapists and OT students successfully advocated for system-wide change, orientating funding and provision towards those who were underserved and furthest away from physical activity opportunities.
This initiative demonstrates significant system-level impact driven by occupational therapy students and their practice. The Boccia group provision continues to address health inequalities experienced by people with learning disabilities in Darlington. The work has informed wider Sport England Place Expansion activities and will influence future developments through additional funding opportunities focused on training and system-wide approaches to include populations experiencing inequalities in physical activity provision.
Key lessons from this workforce development include:
The importance of saying yes to opportunities, in this case supervising a student, even when long term outcomes are uncertain.
Recognising that service development can be driven by students or colleagues rather than requiring direct personal involvement. Occupational therapists can be involved in innovation at any level; from identifying and communicating a need, to setting up a whole new service provision. Making links with your local university is a good place to start, as they are always looking for innovative placement ideas.
Leveraging occupational therapy skills as system connectors across different sectors and services. We are great connectors of people and services, which is valuable at a systems level. As well as connecting with traditional health and social care services, looking outside of this to connect with partners from sport (such as local Active Partnerships), leisure (e.g. leisure , VCSE and community sectors can increase learning across organisations and support better outcomes for clients.
Utilising entrepreneurial and creative occupational therapy skills beyond one-to-one interventions to address community-level needs.
Understanding occupational therapists as having knowledge of population health, capable of identifying unmet community needs that may not be visible through traditional service referral pathways – who are we not seeing in our services, and why?
This work continues to have ongoing ripple effects across Sport England Place Expansion initiatives, demonstrating how occupational therapy students can powerfully demonstrate community needs and how occupational therapists can play important roles in identifying and addressing population-level health requirements.
Many thanks to:
Occupational therapy apprentice students (and now qualified occupational therapists) Felicity Kyte and Emma Brown to their hard work, vision and tenacity during their physical activity-focused occupational therapy placements.
Staff from the Dolphin Centre in Darlington and Move More Darlington, for their time, insights and knowledge, which allowed occupational therapy students to link the health and physical activity sectors with their supervision.
Teesside University occupational therapy lecturing staff for sharing their expertise, and for their openness in welcoming Sport for Confidence to collaborate on their curriculum.
OT Student Felicity submitted her placement experience on RCOT Communities’ Improvement database, which can be found here.
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