Hillingdon is implementing a recovery plan to address a backlog in occupational therapy (OT) services for children with Special Educational Needs and Disabilities (SEND). The issue was brought to the attention of the Hillingdon Health and Wellbeing Board at their meeting on 2 December 2025, due to the potential risk to children if the service is unable to meet current demand.

The Occupational Therapy Service Update report highlights that pressures on the service have been evident through a reduced workforce due to maternity leave, recruitment challenges and other factors, which has reduced OT capacity for a prolonged period, despite efforts to recruit to appropriate staffing levels. The report also notes that the matter is being brought to the Board's attention because of the potential risk if the service is unable to meet the current demand.

In the academic year 2024/25, approximately 400 children and young people did not receive their full allocation of OT contacts as outlined in their Education, Health, and Care Plans (EHCPs). While more than half of all contacts were delivered as expected, the board was notified because of the potential risk if the service is unable to meet the current demand.

The Central and North West London NHS Foundation Trust (CNWL), which is jointly commissioned to deliver these therapeutic interventions, is implementing a recovery plan that includes:

  • Plans to recover any missed contacts through separate commissioning arrangements in conjunction with families. The Occupational Therapy Service Update report notes: Where a child or young person has been identified for not receiving any contacts, plans have been put in place to recover these through separate commissioning arrangements in conjunction with families, and some of these have been delivered already.
  • Assessment of the therapy needs of all affected children. According to the Occupational Therapy Service Update, The therapy needs of all the other affected children are being assessed, and plans are being developed to ensure their individual needs are met appropriately. This will include input from children, families, therapists, and schools. Once these assessments are complete, appropriate therapy will be provided as agreed.
  • Commissioning additional capacity from the independent therapy market.

The report noted that there is a national shortage of OTs, which has impacted service delivery across many regions, and CNWL has not been immune to the recruitment and retention challenges in the country. It is expected that the appropriate OT provision will have been delivered by the end of the Spring term at the end of March for the children impacted during the 2024 / 25 academic year. The Occupational Therapy Service Update also states: Reassuringly, all the scheduled OT statutory contacts are forecast to be delivered by the end of the Autumn term at the end of December as planned, showing a marked improvement due to additional capacity.

At the Health and Wellbeing Board meeting, members expressed disappointment that neither the children services lead nor the author of the Occupational Therapy Service Update were present to present the report. The chair expressed disappointment, and the item was deferred to the next meeting. The reason for their absence is not stated.