Development of the UK Rheumatology Occupational Therapy Capabilities Framework: a national consensus initiative

Abstract Objectives To describe the development and national consensus process underpinning the Rheumatology Occupational Therapy Capabilities Framework. This work addresses the absence of a structured framework defining the knowledge, skills and professional behaviours required of the occupational therapy workforce working within rheumatology services managing rheumatic and musculoskeletal diseases, and the need for a consistent national reference to support practice, workforce planning and professional development. Methods A five-stage mixed-methods process was adopted between May 2023 and September 2025, beginning with a design of a UK-wide scoping survey of rheumatology occupational therapists. Subsequent stages included expert consultation, alignment with national and international standards, stakeholder review, and endorsement by professional bodies. Results The process achieved national consensus across rheumatology occupational therapists from all four UK nations and resulted in a four-domain, five-level capability framework mapped to NHS Agenda for Change bands, and allied health professions practice levels. Conclusion This study describes a structured national consensus process used to develop and endorse a specialist capability framework for occupational therapy in rheumatology. The five-stage approach achieved formal endorsement from the Royal College of Occupational Therapists and the British Society for Rheumatology and offers a transparent, transferable model for specialist capability framework development across allied health professions.