Focus on Fairness Observatory

An arm’s length project of the Elizabeth Casson Trust exploring diversity, inclusion and equity within the profession.


On World Occupational Therapy Day, 2021, with it’s theme of ‘Opportunity + Choice = Justice‘, the Elizabeth Casson Trust was proud to launch its Focus on Fairness Observatory.

Development of the Observatory acknowledged a year-long journey by the Trust to examine our beliefs and our actions with regard to equality, diversity and inclusion. Read more about our journey here.

Our Observatory



The purpose and philosophy of the Observatory is built on appreciative enquiry and understanding to drive evidence-informed and solution-focused debates and initiatives across the occupational therapy sector.

We will achieve this by inviting leadership representation from across the occupational therapy sector and from outside the sector, to participate in fora examining issues which impact on individuals from diverse groups and communities through their professional journeys. 

Our method will be to…

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(a) Use appreciative enquiry with affected individuals to develop an understanding and identification of factors creating inequality and exclusion of minority groups in, and from, the profession

(b) Generate evidence-informed, meaningful insights and provide grants to commission work that will lead to impact and change

(c) Translate the work into actionable recommendations for change to support diversity, equity and inclusion in occupational therapy

(d) Facilitate and support the implementation of recommendations

(e) Share good practice across the profession, with other allied health professionals and with policy makers

The Focus on Fairness Observatory is an arms-length project, led by Professor Jane Melton. We have shaped our governance this way so that the Observatory can have the freedom for wide-ranging and independent conversations to thoroughly explore issues affecting the profession.

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Our first event: A Focus on…Education

The first forum in theFocus onseries was a Focus on…Education held on 18 January 2022.

32 participants from across health and social care, research and education, occupational therapy professional bodies (Royal College of Occupational Therapists (RCOT), Council of Occupational Therapists for the European Countries (COTEC), World Federation of Occupational Therapists (WFOT)), our regulatory body Health and Care Professions Council (HCPC), NHS England / Improvement and other allied health professions met to discuss diversity and equity in occupational therapy pre-registration programmes. It was a full room!



The meeting was held under Chatham House rule* and led to ‘deep conversations from a wide range of voices’ in a ‘positive learning environment’ (participant feedback). Baroness Hilary Armstrong co-chaired the event alongside Prof Jane Melton.

* the identities of the attendees cannot be disclosed, nor their affiliations, outside of the meeting

What did we discuss?

The focus was on education with particular emphasis on occupational therapy education for people from diverse backgrounds, including ethnicity, gender, (dis)ability, sexuality and religion, with discussions taking place in small groups. Each group focussed on one of the following four themes:

  1. Recruitment and admission
  2. Experience and inclusion
  3. Assessment and outcome
  4. Cultural humility and self-awareness





Each group identified actions which they believed had the potential to make a positive impact for supporting diversity and equity in occupational therapy education. By the end of the afternoon, several key priorities  had been proposed and agreed. These were themes or areas of focus agreed to either have the most importance or quickest need at this time. Three small focus groups followed to take these ideas and consider them in more detail, giving them better shape for the projects and outcomes desired.

What happened next?

The Observatory core team, led by Prof Jane Melton, presented a paper to trustees at the April 2022 board meeting of the Elizabeth Casson Trust. Funding for three streams of work were approved and calls for proposals were issued in the summer.


The projects shown to the right have been commissioned and are underway:



i/ Development of a pocket guide for occupational therapists and occupational therapy students. Similar to our newly-qualified occupational therapist pocket guides, this is intended for individuals to engage with in a quiet moment, adopting a reflective approach towards self-awareness and the consideration of our personal impact on individuals, our environment and the profession, and on the services we deliver. The guide is available below

ii/ Support of Equity Champions through a series of ‘reflective co-learning spaces’. The opportunity to participate will be offered to representatives from Higher Education Institutions (HEIs) that deliver occupational therapy programmes. The reflective space allows for ideas and proposed actions to be shared, witnessed and supported. The programme is based on the Solution-focused Approach, a structured method that focuses on what works – in the present, in the past and in the imagined future. The Equity Champions series will feature four spaces over seven weeks and will be hosted by Anita Volkert (Glasgow Caledonian University) and Rayya Ghul (University of Edinburgh) commencing in February 2023.

iii/ A research project to explore minoritised occupational therapy students’ experiences at the University of Bradford: Participatory action research developing student-led actions to address inequities and promote inclusion. Dissemination products will support the sharing  of actions with HEIs. The study will commence in October 2022.

Several ideas were also generated at the Observatory event that are beyond the Trust’s sphere of activity, for example some ideas were recognised as belonging to the professional body of occupational therapy. These ideas were shared with our colleagues at the Royal College of Occupational Therapists (RCOT), who have taken the baton and work is underway. An update will be added to this page when appropriate. These ideas concern the educational standards for pre-registration programmes, including equity statements and requirements, considering the recruitment of accreditors with expertise (lived or acquired) in diversity and equity, and learner participation and partnership in programme design. It was also suggested that fine tuning the annual monitoring reports completed by universities could provide an excellent opportunity to facilitate the monitoring of change.

Our second event: A Focus on…Starting your Career

The second in our Focus on… series was a Focus on…Starting your Career held on 11 January 2023.

Participants came from a range of organisations, including universities and therapy services, and a range of professional backgrounds, including Human Resources. Many brought their own personal experiences of being minoritised and a newly qualified occupational therapist. Together the group considered the experiences of minoritised occupational therapists as they transition from University to starting their career and the first two years in practice.

The event was co-chaired by Lord Victor Adebowale and Prof Jane Melton and generated ‘valued contributions from colleagues [both experts and newly qualified OTs] through rich conversation’ leading to ‘tangible outcomes’ (participant feedback).


To add more information to the event, the Trust engaged with NQOTs at The OT Show in November to hear about their experiences. The mentimeter, above, shares some of their thoughts on belonging.

What did we discuss?


For this event, the themes we discussed were:

  1. Opportunities for Higher Education Institutions
  2. Approaches to recruitment 
  3. Support mechanisms
  4. Belonging and retention

 Small group discussions concluded with each group identifying two potential projects that they believed would positively change experiences for minoritised NQOTs. All participants then voted to select their priority projects.

The top four are:

  1. Co-produced research about what helps OTs to feel supported in transitioning from learner to OT
  2. Reviewing and redesigning recruitment processes from outreach to employment and creating an accessible guide to support teams
  3. Helping managers to understand their roles and responsibilities regarding active allyship
  4. Identifying mechanisms to bring together the support from higher education institutes and employer – what’s on the flaky bridge?

What will we do next?

Similar to last year, the Observatory team will begin to explore how to commission projects that will address these priorities, and will request funding for these projects from the Elizabeth Casson Trust. Watch this space!


An important Post Script

The Focus on Fairness Observatory team extends their deepest gratitude to those who have participated in the January events and following focus groups, without whom this work could not be taken forward in the form it is.

Observatory Steering Group: Prof Jane Melton MBE, Steve Ford, Malabika Ghosh, Edward Vera-Cruz, Caroline Waters OBE, Pam Anderson, Laura Rossiter

Our journey

Our journey started with developing a deeper understanding of who we are, of who Elizabeth Casson was, and of our core purpose to ‘further the profession of occupational therapy to the benefit of those who use our services’.

Our first change was to articulate clearly to our stakeholders our values, which can be read here. This includes out commitments on how our values at translated into actions.


This work led naturally to refreshing our strategic intentions and our operational framework which will ensure our projects and activities remain within our charitable Articles and Objects.

With this foundation laid, our next step was to recruit new trustees who could bring different perspectives and experiences to the Board. Two lay trustees (Edward and Caroline) and one occupational therapist trustee (Malabika) were appointed in July 2021.

In parallel, the trustees worked with Article Consulting to consider how the Trust could influence diversity, inclusion and equity in the profession. Development of the Focus on Fairness Observatory is the outcome of the work.


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The Elizabeth Casson Trust’s ‘Focus on Fairness Observatory’ – and their series of ‘Focus on…’ events – will be exploring factors that create exclusion and inequality for diverse groups in the profession and acting to influence these. WFOT welcomes this, today, on World Occupational Therapy Day as an example of an initiative driving positive impact for the profession.” World Federation of Occupational Therapists

The Royal College of Occupational Therapists welcomes this project that will ‘Focus on Fairness’ for occupational therapists and the profession. I’m also excited to have been invited as a member of the Observatory Steering Group that will help guide the direction of this important workSteve Ford, CEO Royal College of Occupational Therapists

COTEC (Council of Occupational Therapists for the European Countries) wholeheartedly endorses this work which should support and enhance practice, not only in the UK, but across Europe too. This is a key time for all of us to examine our practice at an individual, service, community and country level and strive for better – for our members and those they work with. We look forward to hearing what the Observatory finds.” Anu Söderström, President COTEC


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