Remote Occupational Therapist - Home WorkingNHS

Job summary

To provide occupational therapy assessment and intervention for working-age adults whose health is affecting their ability to stay in or return to work, as part of the Enable service. The post is home-based, with consultations delivered by telephone and video.

• Carry out functional and work-focused assessments with patients from pilot GP practices who request a fit note.
• Issue and sign fit notes as the certifying healthcare professional.
• Complete workability assessments and plans with eligible patients, setting practical, occupation-focused goals to support a sustainable return to work.
• Work as part of a multidisciplinary team with the Advanced Nurse Practitioner, Occupational Health Nurses and admin team.
• Record activity and outcomes accurately so the pilot can supply data and learning to the Department for Work and Pensions (DWP).

Main duties of the job

Key responsibilities

Fit note certification

• Assess patients' fitness for work and issue and sign fit notes in your own name, as permitted for HCPC-registered occupational therapists under the Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2022.
• Assess the patient by video or telephone consultation, or by reviewing a written report from another healthcare professional, before issuing a fit note.
• Certify only within your own scope of practice and competence. Refer to the ANP or Clinical Lead when the presenting condition, complexity or risk falls outside it.
• Issue fit notes through EMIS, including correct dates, condition wording and review periods.
• Meet the service turnaround standard for fit note requests (currently 3 working days).
• Take part in audit of your fit notes for quality and consistency, and act on feedback from the Clinical Lead.

Job description

Fit note certification

• Assess patients' fitness for work and issue and sign fit notes in your own name, as permitted for HCPC-registered occupational therapists under the Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2022.
• Assess the patient by video or telephone consultation, or by reviewing a written report from another healthcare professional, before issuing a fit note.
• Certify only within your own scope of practice and competence. Refer to the ANP or Clinical Lead when the presenting condition, complexity or risk falls outside it.
• Issue fit notes through EMIS, including correct dates, condition wording and review periods.
• Meet the service turnaround standard for fit note requests (currently 3 working days).
• Take part in audit of your fit notes for quality and consistency, and act on feedback from the Clinical Lead.

Clinical assessment and workability plans

• Manage a defined caseload of working-age adults referred through the fit note pathway.
• Complete workability assessments and plans with eligible patients, assessing physical, cognitive, psychological and environmental factors affecting work through remote assessment.
• Where an in-person functional assessment is clinically necessary, arrange this through agreed pathways and record the rationale.
• Advise on graded return to work, activity pacing, fatigue and symptom management, and practical workplace adjustments.
• With the patient's explicit agreement, liaise with employers by telephone, video or in writing about reasonable adjustments and return-to-work arrangements.
• Signpost and refer to other services and community resources.
• Identify and act on risk, including mental health risk, escalating promptly to the Clinical Lead and Advanced Nurse Practitioner. At the start of each remote consultation, confirm the patient's identity, location and a contact number.
• Undertake comprehensive assessments of occupational performance, functional capability and the impact of physical, mental health and social factors on work participation.
• Assess an individual's ability to undertake the functional demands of their role and identify opportunities for reasonable workplace adjustments and support.
• Identify and respond appropriately to safeguarding concerns, deterioration in mental or physical health and risks which may impact patient safety or ability to work.
• Escalate concerns in accordance with organisational policies and agreed clinical pathways.

Communication and teamwork

• Communicate complex and sometimes sensitive information about health and work, adapting to each patient's needs and overcoming barriers to understanding, including those that arise in telephone and video consultations.
• Work as an active member of the Enable multidisciplinary team and attend virtual team meetings, case discussions and huddles.
• Build good working relationships with pilot GP practices, PCN teams and partner organisations.
• Contribute an occupational therapy perspective to the development of pathways, templates and patient information.

Records, data and evaluation

• Keep accurate, contemporaneous clinical records in EMIS to professional and MBPCC standards.
• Record activity and outcome data accurately and on time, as needed for DWP evaluation.
• Contribute to service evaluation, audit and quality improvement, including sharing learning from the pilot.

Professional development

• Take part in annual appraisal and agree a personal development plan.
• Maintain a CPD portfolio that meets HCPC requirements.
• Develop knowledge of vocational rehabilitation, occupational health and work and health policy.

Working arrangements

Contract and hours

• This is a fixed-term post funded through the national pilot. Continuation beyond the pilot period cannot be guaranteed and is subject to national decisions on the future of the model.
• Some flexibility over working hours may be needed to accommodate patients who are in work and employers who are only available outside core hours, such as Saturday working.
• The post holder will be expected to work in a rapidly evolving service where processes, systems and documentation change during the pilot period, and to lead others through that change.

This is a home-based post. MBPCC's Homeworking, Hybrid Working and Remote Learning Guidance applies in full, and the post holder remains subject to the same professional, contractual, governance and performance expectations as staff working from MBPCC premises.

Location and in-person attendance

• Live in the UK and carry out all work from a UK address for the duration of employment. Working from outside the UK is not permitted.
• Deliver patient consultations remotely by telephone and video, using MBPCC-approved systems only.
• Travel to MBPCC head office at the start of employment to collect MBPCC equipment and to attend a face-to-face induction.
• Attend MBPCC head office when equipment needs to be collected, exchanged or returned, including at the end of employment.

Suitable home working environment

• Have a suitable, dedicated workspace that supports concentration, minimises distractions and enables professional communication.
• Ensure consultations and confidential conversations cannot be overheard, and that screens cannot be seen by family members, visitors or anyone else not authorised to view them.
• Have a suitable desk or workstation, appropriate seating, adequate lighting, ventilation and heating, and reliable internet access sufficient for video consultations and clinical systems.
• Use a headset whenever patient or confidential information is being discussed, and use the MBPCC background on video calls.
• Complete the MBPCC Homeworking Self-Assessment (including display screen equipment) and sign the Employee Homeworking Agreement before starting, and tell your manager of any significant change to your home working arrangements.
• Home working is not a replacement for childcare or dependant care arrangements. Where caring responsibilities affect your ability to work, discuss this with your manager.

Information governance and cyber security

• Use only MBPCC-issued devices, organisational accounts and approved systems and video conferencing platforms. Do not store confidential information on personal or unapproved systems.
• Lock screens when away from the workstation, keep passwords, smartcards and fingerprint access to yourself, and do not allow anyone else to use MBPCC devices or systems.
• Verify who is present before discussing confidential information, share only the minimum necessary, and keep patient-identifiable information out of chat functions unless clinically necessary and authorised.
• Do not record, screenshot or photograph consultations, meetings or training unless this has been authorised. Do not join patient-related calls from public places.
• Secure and dispose of any paper records using approved methods, and report any information governance or cyber security incident immediately.

Audit and monitoring

Because this post involves remote access to patient-identifiable clinical information, enhanced governance controls apply. The post holder will be subject to audit and monitoring, including:

• Periodic information governance audits and an annual information governance review.
• Verification that the home working environment is, and remains, secure and suitable.
• Asset and equipment audits, at least annually. MBPCC equipment remains organisational property and must be cared for, faults reported promptly and items returned when requested.
• Compliance monitoring of mandatory training, information governance and cyber security training.
• Monitoring of availability, activity and performance against service standards, through one-to-ones, work plans, activity schedules, supervision and clinical audit.
• Quarterly one-to-one and wellbeing reviews, and an annual review of the home working arrangement.

Failure to meet these requirements may be managed under MBPCC's disciplinary, information governance and data protection procedures.

Availability, communication and wellbeing

• Work contracted hours, be visible and contactable during agreed working times, keep your electronic calendar up to date and respond to communications promptly.
• Attend virtual team meetings, huddles, multidisciplinary discussions, supervision and training punctually and in full. Training during working hours is working time and must not be combined with caring or domestic tasks.
• Follow the MBPCC Lone Working Guidance and use agreed routes (Teams or telephone) to escalate clinical risk to the Clinical Lead or Advanced Nurse Practitioner without delay.
• Take regular screen breaks, raise wellbeing or workload concerns early, and report any accident that happens during work activities.
• If you become unwell while working, tell your manager at the earliest opportunity, stop work if you are unfit to continue and follow normal sickness reporting procedures.

Remote working, confidentiality and information governance

The successful candidate will be required to work remotely whilst maintaining the highest standards of confidentiality, information security and professional conduct. These essential requirements are also assessed through the person specification.

Essential requirements

• Ability to maintain a secure, private and professional remote working environment suitable for the handling of confidential and sensitive information.
• Ability to conduct telephone, video and online meetings in a location where conversations cannot be overheard by unauthorised individuals.
• Demonstrable understanding of confidentiality, information governance, cyber security and data protection responsibilities.
• Commitment to complying with all organisational policies relating to information governance, confidentiality, records management, acceptable use of IT systems and remote working.
• Ability to process, access, store, share and dispose of information securely and only for authorised business purposes.

About us

Enable is one of four national pilots funded by the Department for Work and Pensions (DWP) to test a better fit note process, and it is the most clinical of the four. MBPCC delivers it under an NHS contract across the Barrow and Mid Furness Primary Care Networks.

For participating practices, every fit note is issued by the multidisciplinary Enable service rather than the GP practice. There is no change to fit note legislation, so every patient still needs a valid, signed fit note. Working patients who agree to take part receive a workability assessment and a personalised workability plan that focuses on what they can do and how to stay in, or return to, work. Employers are contacted only with the patient's explicit agreement. The pilot generates data and learning for the DWP to shape future national policy.

The service uses EMIS, AccuRx, X-on Surgery Connect and Florey questionnaires. This post is home-based: consultations are delivered by telephone and video, and the post holder works with the Enable team through Microsoft Teams and the service's clinical systems.

The service expects to handle more than 20,000 fit note requests a year at full rollout.