NHS or Private Occupational Therapy? A Parent's Guide to Getting Help for Your Child

How the NHS route works

In England, children's occupational therapy is usually provided by your local NHS trust. For most Peterborough families, that means the community children's team run by Cambridgeshire Community Services or the North West Anglia Healthcare Foundation Trust, depending on your child's needs.

A referral can come from:

• Your GP, who passes your concerns to the right team
• Your child's school, often the SENDCo (Special Educational Needs and Disabilities Coordinator)
• A health visitor, for pre-school children
• A paediatrician, speech and language therapist or other NHS professional already involved with your child

Once the referral is accepted, your child is placed on a waiting list and assessed when a slot becomes available. You do not need to pay for NHS care, and you can ask your GP or school to make a referral at any time. It is always worth doing, whatever else you decide.

Realistic waiting times

This is the part most parents find hardest. Waiting lists for community children's occupational therapy vary enormously across the country, and in many areas families wait many months, sometimes over a year, between referral and first appointment. We cannot quote an exact figure for your area because it changes month to month, but it is completely reasonable to ring your GP surgery or the community team and ask how long the current wait is. Knowing the real number helps you plan.

What NHS occupational therapy usually offers

NHS OT services do valuable work, and for many children they are exactly the right fit. Typically you can expect:

• An assessment of your child's everyday functional skills
• A block of input, often a set number of sessions rather than open-ended support
• Advice and strategies shared with you and, with consent, your child's school
• Signposting to other services where appropriate

Because demand is so high, NHS services usually have to prioritise children with the most urgent functional difficulties, and there are referral criteria your child may or may not meet. Some parents are told their child is "not severe enough" for the service. This can feel crushing when you know your child is struggling every day. That is not a reflection on your child or your parenting; it is the reality of a stretched system.

When private occupational therapy makes sense

Private OT is not a replacement for the NHS. It is simply a faster, more flexible route to the same professional expertise. Families typically choose it when:

• The waiting list is too long and your child needs help now
• Your child did not meet the NHS referral criteria, but you can see they are struggling
• You need a written report for school, an EHCP application, or an Education, Health and Care Plan assessment
• You want a thorough assessment and a clear, jargon-free explanation of what is going on
• You want strategies and support built around your family's routine, not a fixed number of sessions

A good private OT will always tell you honestly whether an assessment is needed, and will never pressure you into booking one. If we do not think we can help, we will say so and point you somewhere that can.

Can you use both routes at once?

Yes, and for many families this is the best approach. You can ask your GP or school for an NHS referral today, and see a private OT in the meantime so your child is not left waiting without support. With your consent, reports and strategies from a private assessment can be shared with NHS teams and your child's school, so everyone works from the same picture. Nothing about going privately removes your child's place on an NHS waiting list.

Questions worth asking any occupational therapist

Whether you end up with the NHS or a private practice, these questions help you get the best from the service:

• What are your qualifications and are you registered with the HCPC?
• What will the assessment involve, and how long will it take?
• Will we receive a written report, and can we share it with school?
• How will the strategies be explained, and what support is there to put them in place?
• What will it cost, and are there any extra fees?

Any occupational therapist registered with the Health and Care Professions Council (HCPC) has met the same national standards. NHS or private, the clinical training is identical. What differs is the waiting time, the length and shape of support, and how the service is funded.