“Bolt-on” – How can an Occupational Therapist lead a portfolio career?



The working world is always evolving, but it certainly feels over the last few months this has accelerated significantly. As OTs we are simply not working how we were 6 months ago and this will have longer lasting impacts on us as Occupational Therapists. It seems then a good time to discuss more openly these changes and what this means for our future careers.

When we talk of portfolio careers, what do we mean? Well, by definition a portfolio career refers to multiple part-time jobs. Many also see it as simply having diversity in working or multiple income streams, but ultimately portfolio working allows control, preference and flexibility over who you work with and the influence you can have. Many Occupational Therapists work in a portfolio way already and this includes all of our Occupational Therapist Team at Jacqueline Webb. We spoke with a number of them about their clinical practice, the benefit of portfolio working to their clients and how it changed them as an OT. So, by sharing their experiences we hope it encourages more OTs to reflect on this way of working and evolve their clinical practice.

Diversity of work stream

Every OT we spoke to came across portfolio working in a different way. But all noted the diversity of work available to them that they hadn’t appreciated was there.  This professional diversification allows reflection on the skills you have developed, what is important for you as an OT and how you can have the biggest impact on the client group you desire to work with. Often with one source of employment naturally leading you to another.

Elaine Miller spent much of her early career working in NHS acute and community settings. But sought out portfolio working, beginning with contract work with the CQC. For Elaine the focus was on unrestricting her skill set.

 I felt that my skills were not being fully utilised in the NHS and I was restricted in the service I could provide; I wanted to have a new challenge and learn new skills to be at the forefront of showcasing how diverse and important Occupational Therapists are in different work sectors. I was able to maintain my role with CQC and working in orthopaedics in an in-patient setting while starting out as an expert witness.  Following this I made a move into Case Management for Unite Professionals which seemed like a very natural transition and left my NHS role.”

Similarly, Caroline Wright began her OT career in acute hospital settings progressing to a more senior Team Leader post in Social Care. She found time to incorporate her statutory services work with a gradual increase in portfolio working, before diversifying fully in 2008. This way of working has allowed Caroline to hone her skills in areas she enjoyed and create a diverse working week. The work she has combined would not be feasible to resource, unless put together in a portfolio style of work.

 “I eventually left Adult Social Care in 2008 and set up South Coast Occupational Therapy Ltd. My current portfolio of work comprises expert witness work for Jacqueline Webb & Co and alongside this I undertake case management, insurance assessments for three large insurance companies, and occupational therapy projects such as major adaptation works, and advice on equipment and rehabilitation programmes.”

Work with those in other professions

The OTs we spoke with all reported that through mixing more directly with other professionals, often in other industries, significantly benefitted their ongoing clinical practice. The emphasis being that choosing who you work with generates greater knowledge sharing and learning. Becoming stagnant in learning is easily done and often without realisation. It is often a complaint of many in standard, employed roles that they are not being pushed professionally. But, by working with different individuals and in more diverse MDTs, with more specific client groups you can exponentially enhance the tool kit at your disposal.

Carol Kendall has a portfolio of 5 work streams, so works with a wide variety of other professionals. having the opportunity to work with lots of different clients, clinicians and MDTs means I am always learning something new, picking up different skills and techniques and not getting ‘stuck in a rut.’”

Angela Ariu added to this further by stating that she was more connected to her profession because of the choice she has in who she works with. “I am much more connected to other professionals and enjoy being an OT ambassador and spreading the word about OT, this constantly reminds me of what is so great about Occupational Therapy”.

In addition, your enhanced toolkit can greatly benefit your colleagues. Angela Jamieson commented that by varying who she works with in her portfolio she is better positioned to manage her team in her statutory job I am more enthusiastic and better able to motivate the team in statutory services”.

Delivering better support

As described, working this way benefits your working practices and pushes you professionally, but how does this help your patients and clients. Well, put simply, portfolio working delivers for both you and your clients and patients. As we can all attest to, we often initially see people at their lowest, crisis point and are often limited in what we can achieve because of various constraints, whether this be care or equipment provision. In many ways portfolio working allows you to free yourself from some of this restriction and think more creatively for the client or patient. Through the points already discussed you can ultimately influence the outcomes of individuals more effectively.

By working in across disciplines Elaine commented on how individuals have been able to move forwards more effectively in their rehab. “I have been able to assist people who have been at a very low, vulnerable point in their lives with significant injuries and my assessments/reports help them to start to recover and move forward which is really important to me.”

By diversifying her work Caroline has seen and worked with more wide-ranging equipment and adaptations. “It allows me to be creative and flexible with my recommendations, and offers me great options to develop my knowledge of new equipment and adaptations which would normally be out of reach for clients within the statutory sector.”

 By choosing to work in the third sector Carol can use more personal experience to drive change. “I chose to work for Canine Partners because I have personal experience of how life changing assistance dogs can be, and I wanted to use my skills and experience to give something back.”

 Has it made me a stronger OT?

“My knowledge has grown considerably and I am able to recommend items of equipment that I didn’t even know existed when working within the statutory sector.” CW

 “I firmly believe that I would not have stayed within the profession had I not strayed out of my comfort zone and the routine of the statutory posts that were becoming restrictive and creating conflict with what I really believed I could do.” AA

 These quotes above highlight great personal advancement since considering this style of working, but perhaps most importantly you can put yourself in positions to increase the overall value of OT to all. Angela Jamieson, who works in the NHS but also as an Expert Witness, commented that “I value being treated as an Expert whose evidence and opinion is essential to the outcome of a case. I command as much respect as a Professor of Surgery in this area of work!”.  Clear presentation of the idea that as a collective of portfolio workers you can make a difference beyond your own gains.

The top tips for working this way!

So, what does this mean now for you as an OT with an interest in working this way. We asked our OT Team to name the single piece of advice they would give another OT starting their portfolio working journey. It was clear from the anecdotes that working with reputable, established businesses was key as it gave our OTs security in both ongoing work and income. Also, it is vital not to jump in with both feet, and keep something familiar so as not to overwhelm yourself with new learning. With the recent, significant rise in working from home this is a key skill to master in a disciplined and organised way; mastering this will give you greater options in where you can obtain work and ultimately who you can support clinically. Finally, consider your current clinical experience and be sure in your clinical confidence, as much of what you do may be independent of others and therefore open to scrutiny.

“Consider working for a larger firm, as they will find plenty of work for you, and keep you very busy.” Caroline Wright

“I think you should always keep a little of the old and new while you establish yourself and give yourself some breathing space to check it is for you.” Elaine Miller

“There is a certain level of risk involved if you need a steady income so make sure you have that covered but do not limit yourself to ‘traditional’ OT roles.” Angela Ariu

“Having the ability to organise yourself and your time is vital, along with the discipline to work from home and not be distracted.” Carol Kendall

Want to learn a bit more

To supplement the evidence provided in this article, we are providing an additional, virtual learning opportunity for those interested in this work. Watch the video above to review a recent workshop discussing this topic.