Occupational therapist jobs

Occupational therapists (OTs) help people manage everyday life after illness, injury or disability. They work in two quite different public sector settings: NHS trusts and council social care teams. Either way you need an HCPC-approved degree and registration with the Health and Care Professions Council. A newly qualified OT in the NHS in England starts on band 5, which is £32,073 to £39,043 from 1 April 2026. Council posts are paid on each council’s own grades, built on the national local government pay spine.

What occupational therapy involves

OTs look at what a person needs to do (get dressed, cook, use the toilet, go back to work, get to school) and what is stopping them. Then they work on it through rehabilitation and practice, by changing the way a task is done, by providing equipment, or by adapting the home.

In hospital, much of the work is getting people home safely. That means assessing someone on the ward, running kitchen or washing assessments, planning equipment and care, and sometimes visiting the home before discharge. In mental health services, OTs use activity and routine to support recovery. In children’s services, they work on fine motor skills, sensory needs and school participation.

NHS roles

NHS OTs work in acute hospitals, community rehabilitation teams, mental health and learning disability services, paediatrics, hand therapy, neurology and palliative care. As in physiotherapy, many newly qualified OTs start on a band 5 rotation through several clinical areas before specialising at band 6.

Band	Typical NHS role	Pay from 1 April 2026 (England)
5	Newly qualified or rotational OT	£32,073 to £39,043
6	Specialist OT	£39,959 to £48,117
7	Highly specialist OT or team lead	£49,387 to £56,515

NHS OTs pay into the NHS Pension Scheme: 8.3% on band 5 entry pay, 9.8% from band 6 entry. Scotland’s band 5 runs from £34,494 to £42,977.

Council roles

Councils employ OTs in adult social care and children’s disability teams. The work centres on people living in the community. You assess for equipment, recommend adaptations such as stairlifts, level-access showers and ramps (often funded through Disabled Facilities Grants), and advise carers on moving and handling. You carry a caseload, do home visits and write assessments that lead to funding decisions.

Council OTs are paid on the council’s own grading structure, which in England, Wales and Northern Ireland is built on the NJC pay spine. After the 2026/27 award of 3.3%, the spine runs from £25,614 at SCP 3 to £56,293 at SCP 43, and each council decides which points its OT grade covers. The NJC pay spine guide lists every point. Council staff join the Local Government Pension Scheme, where contribution rates are lower than in the NHS scheme at the same salary, for example 6.5% on pay from £29,001 to £47,300.

Councils set leave locally too. The national minimum is 23 days, rising to 26 after five years’ continuous service, plus eight public holidays and two extra days. NHS staff start at 27 days plus eight public holidays.

Qualifying as an OT

The standard route is a BSc (Hons) in occupational therapy, applied for through UCAS. Entry requirements vary. Many universities ask for A levels or an Access to HE diploma, and some prefer a science or social science subject. Graduates with a relevant degree can take a two-year pre-registration MSc. Some NHS trusts and councils offer occupational therapy degree apprenticeships, often to existing occupational therapy assistants. See occupational therapy assistant for that starting role.

After graduation you apply to the HCPC, pay the fee and keep your registration up to date. The HCPC registration guide covers the requirements. The fee qualifies for tax relief as a professional subscription.

Choosing between NHS and council work

The two settings suit different people. NHS hospital work is fast, with lots of short assessments and pressure to discharge. Council community work is slower per case but involves more paperwork, funding panels and liaison with housing and care providers. Council posts are often weekday hours only, while hospital OTs may cover weekends.

Pay and terms differ, so compare the full package: salary, pension, leave and sick pay. The take-home pay calculator can compare offers on different salaries and pension schemes.

Sick pay in both sectors

NHS and council sick pay schemes use the same scale, based on length of service. In the first year you get one month’s full pay and two months’ half pay (the half pay starting after four months’ service), rising to six months’ full pay and six months’ half pay after five years. If you move between the NHS and a council, your previous service may or may not count, depending on the employer’s policy, so ask before you accept. See sick pay for council staff and NHS sick pay.

Finding vacancies

NHS OT posts are on NHS Jobs and the national sites in Scotland and Northern Ireland. Council posts appear on council websites and regional local government job boards; see where councils advertise jobs. NHS allied health openings are listed under allied health jobs.