Occupational therapy assistant

Occupational therapy assistants help people manage daily life after illness, injury or disability, working under the direction of a registered occupational therapist. In the NHS most posts are on Agenda for Change band 3, with more experienced assistant practitioner posts at band 4, which from 1 April 2026 means £25,760 to £31,157 a year in England. Councils employ OT assistants too, mainly in adult social care, where the work centres on equipment and home adaptations.

In the NHS

Hospital OT assistants work on wards and in therapy departments. You help patients practise washing, dressing, cooking and getting on and off a bed or toilet, run therapy groups, and assess and fit small items of equipment that a patient needs to go home safely. Much of the work is discharge: checking that a person can manage at home, arranging equipment delivery and sometimes doing an access visit to the home with the therapist.

Community and mental health services shift the focus. Community OT assistants visit people at home to support rehabilitation, while mental health OT assistants run activity groups, help people build routines and support them back into work, education or volunteering. Paediatric posts work with children in clinics and schools.

In council social care

Councils use titles such as OT assistant, community care officer or occupational therapy support officer. The core work is assessing for and arranging equipment and minor adaptations so people can stay independent at home. Typical items are grab rails, raised toilet seats, bath lifts, perching stools, mobility aids and hoists, often supplied through a community equipment service run jointly with the NHS. Many councils train assistants as trusted assessors for straightforward cases, with an occupational therapist handling complex ones and major adaptations such as level-access showers or stairlifts funded through grants.

Council posts are paid on the NJC pay spine. Say a post is graded at SCP 9 to 14: that would pay £28,153 to £30,515 a year full-time. These posts come with Local Government Pension Scheme membership, where the 2026/27 member rate is 5.8% if your pay is £18,401 to £29,000 and 6.5% if it is £29,001 to £47,300.

NHS pay

The Agenda for Change pay scales for England from 1 April 2026, after the 3.3% award:

Band	Entry	Top
3	£25,760	£27,476 (after 2 years)
4	£28,392	£31,157 (after 3 years)

Band 3 is the usual grade for OT support workers. Band 4 is used for assistant practitioners, who often hold a foundation degree or Level 5 qualification and work with more independence. Posts in London get a high cost area supplement on top. Scotland pays on its own scales: band 3 is £29,061 to £31,364 and band 4 is £31,492 to £34,254 for 2026/27. Our guides to NHS band 3 and NHS band 4 cover the detail and the kinds of role at each band.

NHS Pension Scheme members on band 3 pay 6.5% of pensionable pay in 2026/27, because the rate for pay from £13,260 to £28,854 is 6.5%. Once pensionable pay reaches £28,855, as it can at band 4, the rate on the whole of it becomes 8.3%. Full-time NHS staff start with 27 days’ annual leave plus 8 public holidays.

Skills and qualifications

Most employers ask for good literacy and numeracy, often GCSEs in English and maths or equivalent, and experience of caring for people in a paid or unpaid role. Healthcare assistant, care worker or support worker experience counts strongly. For band 4 posts, employers usually want a Level 3 qualification in health and social care or similar, or a foundation degree.

New NHS support staff complete the Care Certificate in their first months. You should be comfortable with manual handling, patient with progress that can be slow, and good at explaining equipment to people who are anxious or in pain. Community and council posts need a driving licence.

Routes up

The obvious next step is qualifying as an occupational therapist. The degree apprenticeship lets you stay employed while studying, with the employer covering tuition, and some employers fund it for staff who have shown they can do the academic work. Our guide to NHS apprenticeships explains how those posts are advertised. Other routes include assistant practitioner posts at band 4, and specialist work in moving and handling or equipment services.

Vacancies are on NHS Jobs and Trac for health posts and on council jobs sites for social care. The allied health jobs hub brings current NHS listings together.