RCOT Professional Standards for OT Practice Conduct and Ethics v3 (1)
RCOT Professional Standards for OT Practice Conduct and Ethics v3 (1)
Version 2/2021
Professional standards for
occupational therapy practice,
conduct and ethics
Published in 2021
by the Royal College of Occupational Therapists
106–114 Borough High Street
London SE1 1LB
rcot.co.uk
This publication supersedes all previous editions of the Professional standards for occupational
therapy practice and the Code of ethics and professional conduct
The Royal College of Occupational Therapists rebranded in 2022. This publication was reprinted
in January 2022 to reflect the new branding but all other content remains unchanged
Copyright © Royal College of Occupational Therapists 2021
ISBN 978-1-913496-02-9
Contents
Terminology and language 1
Section 1: Introduction 2
1.1 The professional standards for occupational therapy practice,
conduct and ethics 3
1.2 Occupational therapy in practice 4
1.3 Legislation, guidance, policy and procedures 5
Contents iii
Section 6: Principles and standards – capability and fitness to practise 35
6.1 Fitness to practise 36
6.2 Your professional competence 36
6.3 Maintaining and expanding your capability 36
6.4 Changing roles and responsibilities 37
6.5 Delegation 38
6.6 The capability of colleagues 38
6.7 Occupational therapy pre-registration practice-based learning 39
6.8 Your health and fitness to practise 39
References52
Bibliography56
● The term ‘practitioner’ has been used to identify you as the active individual, wherever you work
and whatever your scope and level of practice. It includes occupational therapists, support
workers and occupational therapy learners, both students and apprentices. It is applicable to
practitioners in all roles, including those who are in management and leadership, education,
research, consultancy and advisory roles, and working in industry.
● he term ‘occupational therapy workforce’ has been used as a collective term for all practitioners
T
as defined in the paragraph above.
● The work you do for and with individuals/groups has been termed ‘intervention’, which includes
providing services such as care and support, information, assessment, recommendations or
advice, direction, supervision and education.
● he term ‘people (or those) who access the service’ has been used for those to whom you
T
provide intervention. These may be individuals, families and carers, groups or communities.
● Within the context of this document, the term ‘service’ usually refers to the overall occupational
therapy input that you provide, rather than referring to an occupational therapy department or
facility.
●
Although not specified in the individual standards, the person’s carers and/or family are actively
involved where appropriate and with the individual’s agreement.
1.1.1 The Royal College of Occupational Therapists, as the sole professional body
for the profession in the United Kingdom (UK), supports, develops and protects
the UK domain knowledge. These Professional standards for occupational
therapy practice, conduct and ethics are an element of that knowledge and
define an agreed set of professional standards that guide the work of the
occupational therapy workforce. These standards are reflected in the skills,
ways of thinking, behaviours, practice and experiences of RCOT members, and
in published literature.
1.1.3 For the first time, the Professional standards for occupational therapy practice
and the Code of ethics and professional conduct have been merged into one
document, organised as a combination of ethical principles and standard
statements. Together they underpin and define the requirements for
professional practice and conduct. This document describes a level of
practice and a way of thinking that RCOT expects its members to abide by
and believes all members of the occupational therapy workforce should
adopt.
1.1.4 These Standards are universal and applicable, with some interpretation, to
all practitioners. Wherever you work and whatever your scope and level of
practice, you should be able to apply the underpinning principles of these
Standards to the work you do.
1.1.5 RCOT sets the professional and educational standards for the occupational
therapy profession in the UK. These Professional standards for occupational
therapy practice, conduct and ethics (herein referred to as the ‘Standards’) are
produced in consultation and collaboration with RCOT members. The
completion, revision and updating of the Standards is the delegated
responsibility of the RCOT Professional Practice Department. They are revised
every five years, or earlier if necessary.
1.1.6 This is a public document, so may be used by others outside the profession to
determine the measure of professional practice and conduct expected of
members of the occupational therapy workforce. RCOT encourages recognition
of these Standards by other individuals, organisations and institutions who/
which are involved with the profession, including employers, commissioners
and those who access occupational therapy services.
1.1.7 Membership of RCOT provides benefits to support safe, effective and ethical
working practice and continuing professional development. It is advantageous
to both practitioners and employers, but it is voluntary and cannot be a
Section 1 Introduction 3
requirement for practice or a criterion for employment (Great Britain.
Parliament 1992). RCOT members sign up to abide by these Standards, but
they will be relevant and useful to all within the occupational therapy
workforce across the UK, whether they are members of the organisation or
not.
1.2.4 As a support worker, you have an approach to your work that is based on an
understanding of the connection between the person, their environment and
occupation. You will understand that the purpose of the intervention you
provide is to maximise an individual’s occupational performance and
participation.
1.3.1 This document does not identify every piece of relevant legislation, recognising
that there are differences across the four UK nations and that legislation
changes periodically. You must be attentive to and comply with any current
legislation, statutory guidance, best practice standards, and policies and
procedures that are relevant to your location, scope and level of practice. The
key broad areas of legislation related to this publication are listed in Section 8.
1.3.2 This version of the Professional standards for occupational therapy practice,
conduct and ethics (2021) supersedes all previous editions of the Code of
ethics and professional conduct and the Professional standards for
occupational therapy practice.
Section 1 Introduction 5
Section 2
The uses and purposes of this
document
This section describes how these Standards can be
useful and beneficial to you.
2.1 Informing your practice
2.1.1 This is a practical document. You need to understand its content and how to
apply it to your work. It is an information resource to direct you and a means by
which you can examine your practice. It may also be used as an aid to
discussions in the workplace, whether with your work colleagues or with those
who access the service. These Standards may help to guide strategic decisions
relating to occupational therapy. They can be used as a basis for dialogue and
negotiation with commissioners, funders, purchasers of services and in other
business settings. You can use the Standards to demonstrate the value and
uniqueness of your professional contribution.
2.1.2 These Standards describe the essential practice, behaviours and values that
you have a responsibility to abide by at all times. They may be taken as
appropriate standards of reasonable care, as defined by the professional body,
which may be referred to by the Health and Care Professions Council (HCPC),
your regulatory body.
2.1.4 This document should be your first point of reference if you have a query
related to professional practice, conduct or ethics. You should also refer and
adhere to local policy and/or standards. You may find that occasionally local
circumstances prevent you from meeting some part of these Standards. In
such circumstances, you need to be sure that you are meeting your legal
responsibilities, your duty of care to those who access the service, and all
HCPC requirements. If you are concerned that your local policy causes you to
fall short of your legal and professional duties, or puts the welfare of those
who access your service/s, yourself or your colleagues at risk, you must raise
this with your employer. You should keep a record of your concerns and
actions.
2.2.2 Education providers are required to ensure that the Standards are observed in
order to maintain their occupational therapy pre-registration programme’s
accredited status with RCOT.
For learners and educators, these Standards also complement the current version of RCOT’s
Learning and development standards for pre-registration education (RCOT 2019a).
2.3.1 The primary role of the HCPC is the protection of the public. It has overall
responsibility for ensuring that all relevant health professionals meet certain
given standards in order to be registered to practise in the UK. Anyone using
the title or practising as an ‘occupational therapist’ in the UK must be registered
with the HCPC. If a formal complaint is made about an occupational therapist,
the HCPC will consider whether its own standards have been met. You must
know and abide by the requirements of the HCPC.
2.3.2 A key function of RCOT is to inform, support and encourage you as members of
the profession. It is not RCOT’s role to judge a practitioner’s fitness to practise.
The Professional standards for occupational therapy practice, conduct and
ethics are developed in line with the HCPC standards (HCPC 2013, 2016). If
you use the RCOT professional standards as an informative and convenient
way to monitor and maintain your professional practice, they will help you to
meet the HCPC requirements. There are resources available on the RCOT
website to help you with this.
Your duty of care is your responsibility to act in a way that ensures that injury, loss or
damage will not be carelessly or intentionally inflicted on the individual or group to whom/
which the duty is owed as a result of your actions.
There is a general duty of care to one another, but as part of the occupational therapy
workforce you carry a specific duty of care to those who access the service, including their
families and carers, even if you are not directly responsible for their care.
In determining whether the duty of care was discharged, the standard against which your
work will be assessed is:
the standard of the ordinary skilled person exercising and professing to have that
specialist skill. A [person] need not possess the highest expert skill; it is well established
law that it is sufficient if [the person] exercises the ordinary skill of the ordinary
competent [person] exercising that particular art.
(Bolam v Friern Hospital Management Committee 1957 in Unison 2003)
In other words, you do not need to be the best there is, but you must be practising at the
standard of a reasonably competent practitioner. The standards to be expected are not
generally affected by any personal attributes, such as level of experience.
3.1.2 You discharge your duty of care by performing your professional duties to the
standard of a reasonably competent practitioner, in terms of your knowledge,
skills and abilities.
3.1.3 You may be in breach of your duty of care if it can be shown that you have failed
to perform your professional duties to the standard expected of a reasonably
competent occupational therapy practitioner.
3.1.4 If it is claimed that you have, in the performance of your duties, breached your
duty of care to the person who accesses the service, it is a good defence to
show that a responsible body of like practitioners would have acted in the same
way. This is the Bolam Principle (Bolam v Friern Hospital Management
Committee 1957).
3.1.5 The Bolam Principle will only be a good defence, however, if it can be shown
that the body of opinion relied on has a logical basis and is respectable,
responsible and reasonable in its own right. This is the Bolitho Principle (Bolitho
v City and Hackney Health Authority 1998).
3.1.6.4 You have and record a demonstrable professional rationale for the
decisions you make and occupational therapy intervention you
provide.
3.1.6.6 You ensure that all reasonable steps are taken to ensure the
health, safety and welfare of any person involved in any activity
for which you are responsible. This might be a person accessing
the service, a carer, another member of staff, a learner or a
member of the public (Great Britain. Parliament 1974).
3.1.6.7 You ensure that anyone to whom you delegate work is competent
to carry it out in a safe and appropriately skilled manner (see
Section 6, point 6.5).
3.1.6.8 When you consider that wellbeing, safety and care standards are
not being met, you raise your concerns with an appropriate
person.
● ensure that they are aware of any possible risks arising from
their choice;
● take reasonable action to ensure their safety;
● refer the individual to or provide information about an
alternative agency, if appropriate;
● inform relevant others, with consent if possible, especially if
there is an element of risk remaining;
● arrange for a follow-up, if required and consented to;
● comply with all necessary local discharge procedures;
● record this in the relevant documentation, together with any
assessment of mental capacity if required.
12 12
Professional standards for occupational therapy practice, conduct and ethics
3.2 Welfare
3.2.1 Under the Universal Declaration of Human Rights (United Nations General
Assembly 1948) everyone has economic, social and cultural rights. These
include the right to social protection, an adequate standard of living, and
physical and mental wellbeing.
You seek to act in the best interests of all those who access the service and
those with whom you work, at all times, to ensure their welfare, optimising
their health, wellbeing and safety.
3.2.1.1 You always recognise a person’s human rights and act in their best
interests, without discrimination of any kind.
3.2.1.6 You support those who access the service if they want to raise a
concern or a complaint about the care or service they have
received. You communicate honestly, openly and in a professional
manner, receiving feedback and addressing concerns
co-operatively should they arise. Advice is sought when required
and local policy followed.
3.2.1.9 You know, and act on, your responsibility to protect and safeguard
the interests of vulnerable people with whom you have contact in
your work role.
3.2.1.12 You raise a concern with the relevant registration body if the
practice, behaviour or health of a practitioner appears to be a risk
to the safety of those who access the service, colleagues or the
public.
3.3.1 Your approach is always to protect the rights of individuals and to advance
equality of opportunity for all. You work in a way that is equally fair and just,
inclusive and without discrimination of any kind. You always act in accordance
with human rights, legislation and in the individual’s best interests.
3.3.1.1 You offer equal access to the service and fulfil your role without
bias or prejudice.
3.3.1.2 You treat all people, irrespective of their needs, with dignity and
respect as equal members of society, entitled to enjoy the same
choices, rights, privileges and access to services.
3.3.1.3 You reflect on and are sensitive to how diversity affects people’s
needs and choices, incorporating this into any service planning,
individual assessment and/or intervention where possible.
3.3.1.4 You recognise that each person has their own philosophy of life,
and the potential significance of personal, spiritual, religious and
cultural beliefs.
3.3.1.5 You are attentive to and seek to meet personal, spiritual, religious
and cultural needs or choices within the intervention that you
provide, following local policy.
3.3.1.8 You report in writing to your employer, at the earliest date in your
employment, any personal circumstances, religious and/or cultural
beliefs that would influence how you carry out your duties. You
explore ways in which you can avoid placing an unreasonable
burden on colleagues in these circumstances. This does not affect
your general duties as set out in law or these Standards.
3.4.1.2 You uphold the right of individuals and groups to make choices over
the plans that they wish to make and the intervention that you
provide.
3.4.1.4 You seek to act in the best interests of people to ensure their
optimum health, wellbeing and safety. If the choices of an individual
with mental capacity are considered unwise, they are still accepted
as the individual’s choice.
3.5.3 For consent to be valid, it must be given voluntarily by the individual. They must
be provided with all the information that is relevant to their decision and must
have the mental capacity to understand and consent to the particular
intervention or decision.
3.5.3.5 People have the right to refuse or withdraw consent for any
intervention at any time in the occupational therapy process. You
respect a person’s choices where possible, even when they
conflict with professional opinion (see Section 3, point 3.4).
3.5.3.6 You respect the choices of a child under the age of 16 who is of
sufficient maturity to be capable of making up their own mind on
the matter requiring decision (Gillick competence).
3.5.3.9 If the person does not have the mental capacity to give consent,
you cannot provide intervention unless:
3.6.1.1 You embrace and engage with risk, assessing and managing it
in partnership with those who access the service.
3.6.1.2 You enable people to take the risks that they choose and to achieve
their chosen goals, as safely as reasonably possible.
3.6.1.4 You take reasonable care of your own health and safety and that of
others who may be affected by what you do, or do not do (Great
Britain. Parliament 1974, section 7). The principles remain the
same whether the potential harm is to people, organisations or the
environment.
3.6.1.6 You notify a line manager, or other designated person, when you
identify a risk that is not within your control.
3.6.1.7 You monitor, review and, where necessary, revise any situation
that entails risk.
3.6.1.8 When a person lacks the mental capacity to make certain choices,
risk does not necessarily limit best interests decisions, especially
when these take into account the individual’s stated preferences
and wishes. A risk assessment and a ‘best interests’ decision are
both required.
3.6.1.10 You ensure that you remain up to date in all your statutory training
to ensure safe practice, including risk management, health and
safety, safeguarding, moving and handling techniques and data
protection.
3.6.1.11 Where appropriate, you ensure that you and those for whom you
are responsible are trained, competent and safe in the selection
and use of relevant equipment, being attentive to local
procedures.
You are advised to read RCOT’s current guidance on risk management (RCOT 2018a).
4.1.1.2 You understand the relationship between the person, the occupation
and the environment and how one may affect, or be affected by, the
other.
4.2.1 Your actions are based on a set of logical professional reasons, which are
themselves informed by professional knowledge, skills and experience, and
published resources.
4.2.1.1 You are able to explain, and you record, your professional rationale
for anything you do for/with or in relation to those who access the
service.
4.2.1.2 You use national guidelines, current policy, research and best
available evidence to underpin and inform your reasoning, rationale
and practice.
4.3.2 Access is offered equally without bias or prejudice, in keeping with clearly
documented procedures and criteria for your service/s (see Section 3, point 3.3).
4.3.4 Where occupational needs are not present, or where there are needs that
cannot be met by you/your service, you refer or direct individuals to alternative
services, information and advice, where available.
4.3.5 There are certain circumstances where you can refuse to provide, or choose to
withdraw, intervention. These include where there is fear of violence; where
there is harassment; where there is a lack of appropriate and safe equipment;
where you do not have the knowledge and skills; where there is a conscientious
objection; where you know the person accessing the service personally; where
you are asked to do something illegal; where you believe the intervention would
be harmful to the person; where it is not clinically justified; or where you
consider there has been a change in circumstances such that the intervention is
no longer covered by valid and informed consent.
4.3.6 You have the right to refuse to provide any intervention that you believe would
be harmful to a person accessing the service or that would not be clinically
justified, even if requested by another professional. The guidance given by the
Court of Appeal in the case of R (Burke) v. General Medical Council Official
Solicitor and others intervening (2005) is that if a form of treatment is not
clinically indicated, a practitioner is under no legal obligation to provide it,
although they should seek a second opinion. Similarly, a doctor who is
responsible for a service user may instruct a therapist not to carry out certain
forms of treatment if they believe them to be harmful to the service user
(Department of Health 1977).
4.4.1 Following receipt and/or acceptance of a referral or a request for assistance, the
service to which the case is allocated takes the legal responsibility and liability
for any assessment and possible intervention provided (see also Section 3, point
3.1).
4.4.2 If you have accepted someone onto a waiting list, you have a degree of
responsibility. If your service carries a waiting list or another reason causes a
significant delay before you take any action, you contact the individual and the
referrer, informing them of the situation.
4.4.3 Through interview, observation and/or specific assessment, you identify and
evaluate the occupational performance and participation needs of those who
access the service.
4.4.4 You use assessment techniques, tools and/or equipment that are relevant and
appropriate to those who access the service, their occupational needs and their
circumstances.
4.4.5 Your analysis of the assessment outcomes shows how the current situation or
conditions of those who access the service affect their occupational
performance and ability to participate.
4.4.7 If further assessments or investigations are indicated, you initiate these or refer
to other services.
4.5.1 You work in partnership with those who access the service, agreeing their
objectives, priorities and timescales for intervention.
4.5.3 You intervene as early as possible, to optimise outcomes and to reduce, delay or
prevent future needs where possible.
4.5.5 You empower people to maintain their own health and wellbeing and to manage
their own occupational needs, wherever possible.
4.5.6 With the individual’s agreement, you actively involve their carers and/or family,
keeping them informed and included in decision making, as appropriate.
4.5.7 In order to enable carers and/or family to be involved, their requirements and
needs are incorporated into the interventions/recommendations, where
necessary.
4.5.8 If indicated and with consent, you refer any carer for an assessment of their
own needs.
4.5.9 You consider how the assets and strengths of the individual, their carers/family
and their communities can be used to maximise their occupational performance
and participation.
4.5.10 You review and modify your plans and interventions regularly in partnership
with those who access the service.
4.5.11 Any decision to cease intervention is informed by your evaluation and the
choices of the person who is accessing your service (see Section 3, point 3.1.6).
4.6.1 You evaluate the value and benefit of your intervention for those who access the
service in terms of their occupational performance, participation and wellbeing.
4.6.2 You use outcome measures to monitor, review and demonstrate the ongoing
effectiveness of your intervention.
22 Professional standards for occupational therapy practice, conduct and ethics
4.6.3 You include the views and experiences of individuals or communities when
evaluating your practice.
4.6.4 Your evaluation takes account of information gathered from other relevant
sources, such as carers and/or family, or other professionals.
4.6.6 You collect and collate outcome data to meet the requirements of
commissioners/funders of services.
4.6.7 Where possible, you collect and use data to demonstrate the value for money of
the service/s you provide.
4.6.8 You use the information you collect, with other national, local and professional
guidance and research evidence, to improve the quality, value and effectiveness
of the service/s you provide.
4.7.1 You take every opportunity to engage with research, proportionate to your
scope and level of practice.
4.7.2 You reflect on the value and importance of research as the foundation of the
profession’s evidence base.
4.7.3 You access, understand and critically evaluate research and its outcomes,
incorporating it into your practice where appropriate to provide evidence-
informed interventions.
4.7.4 You incorporate evidence-based outcome measures and research activity into
your practice, to demonstrate the effectiveness of intervention and services.
4.8.1 Good practice in keeping records protects the welfare of those who access the
service. As such, it forms part of your duty of care. Your records are also your
evidence that you have fulfilled your duty of care in your practice.
4.8.1.6 You identify the evidence that informs your practice, where
available.
4.8.1.7 You include all your risk assessments, actions taken to manage
the risk and any outcomes.
4.8.1.8 Your records demonstrate how you meet your duty of care.
4.8.1.11 You explain your reason for recording and processing information
to those who access the service.
4.8.1.12 You comply with any legal requirements and local policy in
relation to confidentiality, the sharing of information and any
individual’s request to access their own records.
4.8.1.13 You keep your records securely, retaining and disposing of them
according to legal requirements and local policy.
You are advised to read RCOT’s current guidance on keeping records (RCOT 2018b)
for further information.
4.9.1 Confidentiality is an important legal and ethical duty, but it is not absolute.
There is a balance between the professional and legal responsibility to respect
and protect the confidentiality of those who access the service, and sharing
information for the wellbeing and protection of the individual or the wider
public.
You abide by the current versions of the UK General Data Protection Regulation
(UK GDPR) and the Data Protection Act 2018 (Great Britain. Parliament 2018)
in all your information/data processing.
4.9.1.4 You must have a valid, lawful basis for sharing or using a person’s
information. This must be recorded (Information Commissioner’s
Office 2019, p51).
4.9.1.5 You explain the reason and seek consent for sharing any relevant
information.
4.9.1.7 You share information in the best interests of those who access the
service within the framework of the Caldicott Principles 2013
(Department of Health 2013), i.e. the information necessary for the
purpose with those who have a clear ‘need to know’.
4.9.1.12 You obtain and record consent prior to using visual, oral, written
or digital material relating to individuals for wider purposes (such
as teaching). The person’s confidentiality and choice must be
observed in these circumstances.
4.10.1.1 You seek to ensure that your service meets the needs of those
who access it, now and in the future.
4.10.1.2 You seek to gain and provide value for money when acquiring or
providing goods and services.
4.10.1.3 You seek ‘to re-evaluate practice models and expand clinical
reasoning about occupational performance to include sustainable
practice’ (World Federation of Occupational Therapists 2012).
4.10.1.4 Where service resources are limited, any priorities that are
identified and choices made are compliant with legal
requirements, and national and/or local policy.
4.10.1.6 Where a person’s first choice cannot be met, you explain this and
offer an alternative where available. If this is not possible, or is
unacceptable:
4.10.1.8 You recognise the limits of your own capacity and do not extend
your workload or remit to the detriment of the quality or safety of
your practice or service.
4.10.1.9 You document, report and provide evidence (to the relevant
manager) on resource and service deficiencies that may endanger
the health and safety of those who access the service, carers,
yourself or your colleagues (Great Britain. Parliament 1998, section
43B, point (1)d). Local policy should be followed.
You are advised to read the World Federation of Occupational Therapists’ Sustainability
matters: guiding principles for sustainability in occupational therapy practice, education
and scholarship for further information (Shann et al 2018).
Your behaviour may be deemed unacceptable when it does not have the wellbeing of
those who access the service at its core, or when it undermines confidence in the service,
organisation or profession. This may be whilst in your work role, or outside of your work
role.
5.2.1 You must comply with the law and the requirements set out in The Equality
Act 2010 (Great Britain. Parliament 2010), and not discriminate against the
following protected characteristics: age, disability, gender reassignment,
marriage and civil partnership, pregnancy and maternity, race, religion or
belief, sex and sexual orientation.
5.2.2 You embrace and value the diversity of everyone equally, across all aspects of
life, and this is reflected in your practice.
5.2.3 You recognise your own internal biases and the role you play in addressing
continued systemic discrimination within your own practice and wider
systems.
5.3.1 You are accountable for your actions and behaviours, both inside and
away from the workplace.
● the impression and impact you make on others, conducting and presenting
yourself in a professional manner whilst in your work or study role;
● your conduct outside of your work or study role, in situations where your
behaviour and actions may be witnessed by, or have an impact on, your
colleagues, your employer, those who access the service and/or the public.
5.4.1 You reflect on and take responsibility for the way you use digital platforms.
5.4.2 Your conduct and content on digital platforms and social media do nothing to
undermine confidence in your professional practice or rationale, your employer
or your profession.
5.4.3 When using digital platforms and social media, you recognise that you are
presenting yourself, through words and images, to a wide group of people.
5.4.4 You consider the outcome that, if you are known to be or identified as a
practitioner or an employee, your words and images may be seen as
representative of or applicable to your profession and/or your employer.
5.5.3 You do not undertake any professional activities when under the influence of
alcohol, drugs or other intoxicating substances.
5.5.4 You inform HCPC and/or your employers if you are convicted of a criminal
offence, receive a conditional discharge for an offence or if you accept a
police caution.
5.5.5 If a registered occupational therapist, you inform HCPC if you have had any
restriction placed on your practice, or have been suspended or dismissed by
an employer or similar organisation, because of concerns about your
conduct or competence.
5.5.6 You co-operate with any investigation or formal inquiry into your own
professional conduct, the conduct of another worker or the treatment of a
person who accesses the service, where appropriate.
5.6 Communication
5.6.1 Your language and communication style and manner are always professional,
whether towards your colleagues or those who access the service.
5.6.2 You are able to articulate the purpose of occupational therapy and the reason
for any intervention being undertaken, so enabling fully informed consent and
promoting understanding of the profession.
5.6.6 Discussions related to those who access the service are held in a way that
maintains their dignity and privacy.
5.6.7 You clearly and accurately participate in formal and informal reporting.
5.7.1 You actively seek to build and sustain positive professional relationships.
5.7.2 You respect the responsibilities, practices and roles of other people with whom
you work.
5.7.3 You respect and value the diversity of your colleagues, recognising the unique
assets they bring to the workplace.
5.7.4 You act with integrity towards your colleagues at all times, treating them fairly
and equally, without discrimination, bullying or harassment. Bullying and
discriminatory behaviour are unacceptable and unprofessional.
5.7.5 If you experience or witness bullying and/or discriminatory behaviour, you raise
your concerns with a line manager or other appropriate person and follow
statutory and local policy.
5.7.6 You work with others within your area of expertise to promote knowledge,
skills, and safe and effective practice.
5.7.7 You work collaboratively with or refer to your colleagues, utilising their skills to
maximise the outcomes of intervention when appropriate.
5.7.8 You consult with other service providers when additional knowledge, expertise
and/or support are required.
5.7.9 You refer a person who accesses the service to another appropriate colleague
if the task is outside of your level or scope of practice (see Section 6, point 6.2).
5.7.10 You recognise the need for interprofessional and multiagency collaboration to
ensure that well-co-ordinated, person-centred services are delivered in the
most effective ways.
5.7.11 You work and communicate with colleagues and representatives of other
organisations to ensure the safety and wellbeing of people accessing services.
5.7.13 You seek consent from those who access the service for their personal
information to be shared with colleagues or other services where necessary.
If concerns are raised about any relationship, sexual or otherwise, it will always
be your responsibility to demonstrate that you have not exploited the
vulnerability of an individual, regardless of when the relationship may have
started or ended, or however consensual it may have been.
5.8.1.3 You do not enter into relationships that would impair your
judgement and objectivity and/or that would give rise to the
advantageous or disadvantageous treatment of any individual or
group.
5.8.1.4 You do not enter into relationships that exploit individuals sexually,
physically, emotionally, financially, socially or in any other manner.
5.8.1.5 You do not exploit any professional relationship for any form of
personal gain or benefit.
5.9.1 Any reference you make to the quality of work or the integrity of a professional
colleague is expressed with due care.
5.9.2 You raise your concerns with a line manager or other appropriate person and
follow statutory and local policy if:
● you become aware that something has gone wrong or someone has
suffered harm as a result of a colleague’s actions or omissions;
● you become aware of any intentional malpractice, criminal conduct or
unprofessional activity, whether by occupational therapy personnel or other
staff; or
● you are aware of any kind of discrimination, bullying and/or harassment in
the workplace, whether towards colleagues or those who access the
service.
5.9.3 The information you provide is objective, relevant, evidence based where
possible and limited to the matter of concern.
5.10.1 You do not accept tokens such as favours, gifts or hospitality from those who
access the service, their families or commercial organisations when this might
be construed as seeking to obtain preferential treatment (Great Britain.
Parliament 1889, 1906, 1916). In respect of private practice, this principle still
prevails in terms of personal gain.
5.10.4 You put the interests of those who access the service first and do not let this
duty be influenced by any commercial or other interest that conflicts with this
duty: for example, in arrangements with commercial providers that may
influence contracting for the provision of equipment, or care and support.
5.11.1 Information and/or advertising (in any format or on any platform) in respect of
professional activities or work is accurate. It is not misleading, unfair or
sensational and complies with any relevant legislation.
5.11.3 You respect the intellectual property rights of others at all times. You do not
claim another person’s work or achievements as your own unless the claim can
be fully justified.
5.11.5 If you are aware that possible misrepresentation of the protected title
‘occupational therapist’ has occurred, you raise a concern with the HCPC.
The HCPC refer to a practitioner’s ‘fitness to practise’, which means you have the skills,
knowledge, experience, character and health to practise safely and effectively (HCPC 2017b,
p4). In order to remain competent, you need to keep your skills and knowledge up to date
and relevant to your level and scope of practice. You also need to be attentive to and look
after your own physical and mental health and wellbeing.
6.2.1 You only provide services and use techniques for which you are qualified by
your professional education, ongoing learning and/or experience. These
must be within your professional competence, appropriate to the needs of
those who access the service, and relate to your terms of employment.
6.2.2 You have sufficient knowledge, skills and experience to make reliable
professional judgements, suitable to your level of responsibility and scope of
practice.
6.2.3 You seek advice or refer to another professional when you do not have sufficient
knowledge and/or skills.
6.2.4 You are attentive to and abide by the current legislation, guidance and
standards that are relevant to your level and scope of practice and place of
work.
6.2.5 You make yourself aware of developments within the profession and current
research, relevant to your level and scope of practice, applying these where
appropriate and possible.
6.3.1 You continuously maintain high standards in your professional knowledge, skills
and conduct across the four Pillars of Practice: Professional Practice; Facilitation
of Learning; Leadership; and Evidence, Research and Development (RCOT 2021).
6.3.2 You reflect on and apply the Principles for continuing professional development
and lifelong learning in health and social care (Interprofessional CPD and
Lifelong Learning UK Working Group 2019). The five principles state that
continuing professional development (CPD) and lifelong learning should:
6.3.3 You remain up to date with any changes to legislation, guidance and
standards, both general and specific to your level and scope of practice.
6.3.4 You remain up to date with professional developments, guidance and research,
both general and specific to your level and scope of practice.
6.3.5 You participate in any statutory and mandatory training required for your work.
6.3.6 You seek to extend your capabilities, across all four Pillars of Practice, through
post-graduate study, which may or may not be award bearing.
6.3.7 You maintain a continuous, up-to-date and accurate record of your CPD
activities, according to the requirements of the Health and Care
Professions Council (HCPC 2017a, p5).
6.3.9 You support the learning and development of colleagues and the profession by
sharing your knowledge, skills and experience.
6.3.10 You keep up to date with digital skills, understanding the scope, benefits and
potential impact of emerging digital technologies to ensure that you can make
best use of what is available.
For further information about continuing professional development, please refer to the
Interprofessional CPD and Lifelong Learning UK Working Group (2019) Principles for
continuing professional development and lifelong learning in health and social care.
6.4.1 If you seek or are asked to work in areas within which you have less
experience, you ensure that you have adequate skills and knowledge for safe
and effective practice and that you have access to appropriate supervision and
support (see Section 6, point 6.2).
6.4.2 You assess any possible risks in taking on a different role or responsibilities, to
ensure that you provide a safe service.
6.4.3 If you are asked to act up or cover for an absent colleague, or if you are asked
to take on additional tasks, such duties are only undertaken after discussion,
considering additional planning, support, supervision, and/or learning and
development requirements.*
*
Circumstances may require you to be flexible in what you do. You need to use your professional judgement to remain
safe in your practice and always work in the best interests of those who access the service. It is the responsibility of the
organisations in which you work to ensure you are supported to do this (NHS England et al 2020)
6.4.5 You formally raise any concerns you may have about your capability to carry
out any additional tasks or responsibilities.
6.4.6 If you find that you cannot agree to such a request, you contact your local union
representative for advice and support where necessary.
6.5 Delegation
6.5.1 When you delegate interventions or other procedures, you ensure that the
person to whom you are delegating is competent to carry them out.
6.5.2 You provide appropriate supervision and support for the individual to whom you
have delegated the task/s.
6.6.1 Should you have reasonable grounds to believe that the conduct or professional
performance of a colleague may be deficient in standards of professional
capability, you notify their line manager or other appropriate person in strictest
confidence. This includes (but is not limited to) when:
6.6.2 In reporting any concerns to a line manager or other appropriate person, the
information is objective, relevant, substantiated where possible and limited to
the matter of concern.
6.6.3 If asked for a second opinion by a person who accesses the service and/or their
carer, it is confined to the case in question and not extended to the general
capability of any other practitioner.
6.7.2 You recognise the need for personal development and learning to fulfil the role
of the practice educator and, where possible, undertake appropriate study.
6.7.3 As practice educator, you provide an experience of practice for learners that
complies with the current version of the RCOT Learning and development
standards for pre-registration education (RCOT 2019a) and current
professional standards, and is compatible with the stage of the learner’s
education or training.
6.7.4 As practice educator, you have a clear understanding of the role and
responsibilities for yourself, the learner and the education provider.
More information is available from the current versions of the RCOT Learning and
development standards for pre-registration education (RCOT 2019a) and the Career
development framework (RCOT 2021).
6.8.1 You monitor and proactively look after your own physical and mental health
and wellbeing.
6.8.2 You seek help or advice at the earliest opportunity should your physical or
mental health become a concern.
6.8.3 You make changes to how you practise, or you stop practising, if your health
may affect your ability to perform your job capably and safely.
6.8.4 You inform your employer/appropriate authority and the HCPC about any
health or personal condition that you believe may affect your ability to practise
safely and effectively, if you are unable to adapt your work or if you need to
stop practising (HCPC 2017b, p6).
More information on informing the regulatory body is available from Guidance on health
and character (HCPC 2017b).
Best The best interests approach asks whether any proposed course of
action is the best one for the individual, taking into account their:
interests
• past and present wishes and feelings;
• b
eliefs and values that may have influenced the decision being
made, had the person had capacity; and
• other factors that the individual would be likely
to consider if they had capacity.
Candour ‘Telling patients openly and honestly that something has gone wrong
with their care is an essential part of a healthcare professional’s
(duty of) practice. The obligation to do so is known as the professional duty of
candour.’
(Professional Standards Authority for Health and Social Care
2019, Section 1.1)
Data ‘Data protection is the fair and proper use of information about people.
It’s part of the fundamental right to privacy – but on a more practical
protection level, it’s really about building trust between people and organisations.’
(Information Commissioner’s Office 2019)
Diversity ‘The fact of many different types of things or people being included in
something; a range of different things or people.’
(Cambridge University Press 2020)
‘The concept of diversity encompasses acceptance and respect. It
means understanding that each individual is unique, and recognizing
our individual differences.’
(Queensborough Community College 2018)
Duty of care A responsibility to act in a way that ensures that injury, loss or damage
will not be carelessly or intentionally inflicted on the individual or body
to whom/which the duty is owed, as a result of the performance of
those actions.
A duty of care arises:
• When there is a sufficiently close relationship between two parties
(e.g. two individuals, or an individual and an organisation). Such a
relationship exists between a person who accesses the service and
the member of the occupational therapy workforce to whom they
have been referred, whilst the episode of care is ongoing.
• Where it is foreseeable that the actions of one party may cause
harm to the other.
• Where it is fair, just and reasonable in all the circumstances to
impose such a duty.
(Caparo Industries Plc v Dickman 1990)
Section 7
1 Introduction
Key terms 43
Environment The circumstances, objects or conditions that make up a person’s
surroundings, in which they live and that they experience. This might
include physical, social, societal, cultural or economic environments.
Ethics Principles and values that govern the reasoning, actions and
behaviours of a person or group, in this case within a profession. These
often relate to beliefs about what is morally right and wrong.
Generic role A generic role may involve combining tasks previously undertaken by
different professions. This might be a part or all of a role. For example,
or practice providing management support across a range of professional groups
or carrying out a range of health checks within the community.
Hand over To give away or entrust the responsibility for an individual to another.
The handover action is complete when the receiving person
acknowledges and accepts management and responsibility.
This is not to be confused with the role of the practitioner in a ward/
case handover, where they may report information to other staff but
still retain responsibility for the occupational therapy provided to the
individual.
Human rights ‘Human rights are the basic rights and freedoms that belong to every
person in the world, from birth until death. They apply regardless of
where you are from, what you believe or how you choose to live your
life. They can never be taken away, although they can sometimes be
restricted – for example if a person breaks the law, or in the interests of
national security.
‘These basic rights are based on shared values like dignity, fairness,
equality, respect and independence. These values are defined and
protected by law.
‘In Britain our human rights are protected by the Human Rights Act
1998.’
(Equality and Human Rights Commission 2019)
Section 7
1 Introduction
Key terms 45
Informed Informed consent is an ongoing agreement by a person to receive
treatment, undergo procedures or participate in research, after the
consent risks, benefits and alternatives have been adequately explained to
them. Informed consent is a continuing requirement. Therefore,
occupational therapy personnel must ensure that those who access
the service continue to understand the information with which they
have been provided, and any changes to that information, thereby
continuing to consent to the intervention or research in which they are
participating.
In order for informed consent to be considered valid, the individual
who accesses the service must have the capacity to understand the
information and use it to make an informed decision. The consent must
be given voluntarily and be free from undue influence.
Alternatively the consent may be given by a health and welfare deputy
or by a court.
Intervention The work you do for and with individuals/groups, which might include
providing services such as care and support, information,
recommendations or advice, direction, supervision and education.
‘The process and skilled actions taken by occupational therapy
practitioners ... to facilitate engagement in occupation.’
(O’Brien et al 2012, p180)
Occupational A person’s ability to carry out the activities and roles that they need,
want, or are expected to do in their daily life.
performance
People who The term ‘people (or those) who access the service’ has been used for
those to whom you provide intervention. This may be an individual,
access the families and carers, a group or a community.
service
Personal A relationship that exists for social or emotional reasons. This may be
with a colleague or may develop with a person who accesses the
relationship service.
Personalised A personalised approach to health and care ensures that people are in
control of and are given choices in the way their needs are addressed,
care planned and delivered. This approach is based on people’s strengths
and what matters to them. It ensures that individuals are active
participants, not just passive recipients, of the support they receive.
Practitioner For the purposes of this document, the term ‘practitioner’ has been
used to identify you as the active individual, wherever you work and
whatever your scope and level of practice within the occupational
therapy workforce.
Professional ‘The process used by practitioners to plan, direct, perform and reflect
on client care.’
(clinical)
(Schell et al 2014)
reasoning
Professional The basis for your course of action, based on your professional
reasoning.
rationale
Professional A formal relationship that exists for the purpose of carrying out your
role, with boundaries governed by policies, procedures and agreed
relationship ways of working.
Service Within the context of this document, the term ‘service’ usually refers to
the occupational therapy that you provide as an individual or group,
rather than referring to the occupational therapy department or facility.
Sustain/ ‘Sustainable health care combines three key factors: quality patient
care, fiscally responsible budgeting and minimizing environmental
Sustainable impact.’
(Jameton and McGuire 2002)
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Reviewed every five years, this publication provides a useful reference point for
members of the public, employing organisations and others who need to be aware of
the expectations of the professional body.
rcot.co.uk
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