Ethics and professionalism CPD for occupational therapists

For many occupational therapists, the report is the intervention. A functional capacity assessment for the NDIS, a home modification recommendation, a driving assessment or a workplace capacity report decides what support, equipment or independence a person gets. When a report is overstated, understated, inaccurate or late, the harm is real, and it is often the report that brings an occupational therapist to Ahpra's attention.

The rest of the work raises equally distinctive questions. You often practise alone in people's homes, where the line between professional and personal is easy to blur. You recommend equipment that can either support a person's freedom or quietly restrict it. You serve several parties at once: the person, their family, a funder, an employer and sometimes a supplier your organisation has a stake in. And you are asked, again and again, to respect a capable person's right to make choices you would not make for them.

The profession is also growing fast. The Occupational Therapy Board's 2024/25 annual summary reports 34,423 registered occupational therapists, an increase of 7.4% in a single year, driven partly by the NDIS, aged care, mental health and private practice. That growth means more early-career practitioners and sole traders working where supervision is lighter and commercial pressure is stronger, which is exactly where clear ethical habits matter most.

In 2024/25, 165 notifications about 128 occupational therapists were lodged with Ahpra, and 268 notifications about 212 occupational therapists were received nationally once matters handled in New South Wales and Queensland were included. Most came from patients, relatives or members of the public.

The most common concerns were clinical care, documentation, communication, behaviour and boundary violations. Documentation, at almost one in five complaint types, stands out for occupational therapists compared with many other professions, reflecting how much of the work is written assessment and reporting for funders. Most notifications close without regulatory action, particularly when the practitioner engages constructively and shows insight.

The practical lesson is that the habits which prevent complaints are the same ones a regulator looks for if a complaint is made: clear consent, honest reports, documented reasoning, managed conflicts and safe boundaries.

NDIS practice places you under two regulatory systems at once. The Occupational Therapy Board regulates you as a registered practitioner, and the NDIS Quality and Safeguards Commission regulates providers and workers through the NDIS Code of Conduct. That code requires integrity, honesty and transparency, prompt action on safety concerns, reasonable steps to prevent abuse and sexual misconduct, and no unfair pricing of goods supplied or promoted to participants. Give a written estimate of fees before services begin, charge only for what you actually provided and never charge participants more than other clients for the same service.

Equipment and environmental recommendations deserve a specific check. A device used primarily for postural support or safe positioning is generally not a mechanical restraint; the same device used mainly to stop someone moving because of their behaviour may be. For every recommendation that limits movement or access, ask what its primary purpose is, what less restrictive alternatives exist, who has authorised it and how it will be reviewed. Aged care, hospitals and mental health services have their own legal frameworks.

Driving assessments are a specialised role that generally requires post-graduate driver assessment qualifications. Licensing authorities make the licensing decision, and reporting obligations on health professionals vary between jurisdictions, with a legal duty to report in some circumstances in South Australia and the Northern Territory. Where a person keeps driving against advice and you believe there is serious risk, seek advice from your supervisor or indemnity insurer and act in line with your jurisdiction's law.

The early years of practice, and the first move into private or NDIS work, are when supervision is often thinnest and commercial pressure strongest. If you are asked to take on clients outside your experience, it is a reason to say no, refer or arrange supervision first, and to record the plan in your CPD learning plan. Occupational therapy assistants and allied health assistants work under your delegation and supervision, must never be presented as occupational therapists, and you remain accountable for the decision to delegate.

Practice owners and team leaders shape the conditions that make ethical practice easy or hard: report templates, equipment supplier relationships, fee schedules and performance measures. Ahpra's interim guidance is explicit that employers should not set targets that push practitioners to put business interests ahead of client health. If you lead a team, consider team licences so everyone works from the same standards, and keep your own learning organised with the CPD portfolio. Your own health matters too: heavy caseloads, report deadlines, long drives and moral distress about funding decisions take a toll, and having your own general practitioner is part of safe practice.