In a nutshell: NHS paediatric OT is free but heavily rationed — 12-18 month waits in Kent, often a single assessment followed by discharge after 6-12 sessions, and limited sensory integration work. Private OT is £70-£130 per session (£200-£450 for initial assessment) but offers weekly therapy, parent coaching, sensory integration, and the detailed reports you need for an EHCP. Many families end up using a hybrid of both.
Quick Comparison
|
NHS OT |
Private OT |
| Cost | Free | £200–£450 assessment, £70–£130/session |
| Wait time (Kent) | 12–18 months typical | Days to a few weeks |
| Who does it | HCPC-registered OT, often high caseload | HCPC-registered OT you choose, often with extra training |
| Session duration | 30–45 minutes, often in school | 45–60 minutes, clinic/home/school |
| Typical course | Assessment + 6–12 sessions, then discharge | Ongoing — weekly or fortnightly as needed |
| Sensory integration | Rarely available | Available with ASI-trained OTs |
| Family involvement | Limited parent contact | Parent coaching is central |
| EHCP-ready report | Basic, sometimes not provided | Detailed, quantified, tribunal-ready |
What NHS Paediatric OT Actually Offers
NHS children's OT in Kent is delivered through Kent Community Health NHS Foundation Trust. Once your referral is accepted — usually from a GP, paediatrician, health visitor, or school SENCO — you'll typically go through the following steps:
- Triage — a phone call or short questionnaire to decide whether your child meets the service's criteria
- Assessment — a single appointment, often 45-60 minutes, sometimes at a clinic and sometimes in school
- A short course of therapy — commonly 6-12 weekly or fortnightly sessions, though some services offer only a programme of home activities with no direct therapy
- Discharge — most NHS services discharge once goals are partially met or progress plateaus. You're unlikely to stay "on the books" indefinitely
NHS OT tends to focus on functional, concrete goals — handwriting, dressing, cutlery, sitting at a desk. Many NHS services are explicit that they do not offer sensory integration therapy. If sensory processing is your child's main difficulty, NHS OT may feel thin.
None of this is criticism of the individual therapists. NHS paediatric OTs are qualified, registered, and often excellent. The constraint is caseload. With hundreds of children waiting, services have to ration time.
NHS wait times in Kent — what to expect
Wait times across Kent have lengthened significantly since 2020. Figures reported by families and SENCOs through 2025 and into 2026 suggest:
- 12-18 months is a typical wait from referral to initial assessment
- Up to 24 months in some parts of Kent, especially rural and coastal areas
- Further wait after assessment before therapy begins, if direct therapy is offered at all
- Shorter waits for children flagged as urgent — typically those with complex medical needs, safeguarding concerns, or imminent transitions like starting school
If your child was referred more than six months ago and you've heard nothing, chase the service. Check the referral was accepted, ask where you are in the queue, and keep a written record. Kent SENDIASS can help you escalate if a referral has been lost.
When NHS Is Enough, and When Private Makes Sense
NHS may be enough if…
- Your child's difficulties are mild to moderate and you can wait
- The main concern is a specific motor skill (handwriting, scissor skills) rather than sensory processing
- You don't need a detailed written report for an EHCP application or tribunal
- Your school SENCO is experienced and can implement OT strategies well from a basic report
- Your child is already getting good support at school and you mostly need confirmation of what to do at home
Private is usually worth it if…
- Your child has significant sensory processing difficulties — especially if you're looking at Ayres Sensory Integration therapy
- You're applying for an EHCP or preparing for tribunal and need quantified, professional evidence
- Your child needs more than a handful of sessions — ongoing weekly therapy through a developmental stage
- The NHS wait would mean your child doesn't get support during a critical window (starting school, transition to secondary, after a new diagnosis)
- You want the OT to coach you as well — a private OT will typically spend time with parents each session
- You want school visits, detailed adjustment recommendations, and follow-up with the SENCO
It isn't an either/or. Many Kent families use both — NHS for assessment and a short course, then private to fill the gaps the NHS can't cover.
What Private OT Actually Gives You
Beyond the obvious (shorter waits, longer sessions), here's what you're paying for:
Weekly or twice-weekly sessions
Regular therapy at a cadence that actually moves the dial. OT research suggests that for skills like handwriting or sensory integration, progress comes from consistent practice over weeks and months, not one-off sessions. Private OTs can deliver that rhythm.
Sensory integration (often ASI)
If your child is autistic or has sensory processing differences, this is often the single biggest reason to go private. Ayres Sensory Integration requires a sensory gym — swings, crash mats, climbing equipment, weighted tools — and postgraduate training through Sensory Integration Education (SIE). NHS services rarely have either.
Parent coaching
A good private OT teaches you. Expect to spend the last 10-15 minutes of each session going through what happened, what to practise at home, and what to ask school to do. Over time, you become fluent in your child's sensory profile and can advocate better in meetings.
Detailed, EHCP-ready reports
Private OT reports run to 10-20 pages and include standardised assessment scores, observation notes, quantified recommendations, and specific Section F-ready wording. This level of evidence is hard to get from the NHS and is often the difference between an EHCP being issued and being refused.
Longer-term commitment
A private OT can stay with your child through transitions — starting school, moving to secondary, exams, puberty. That continuity is valuable because your OT knows your child's history and can spot regressions quickly.
What Does Private OT Actually Cost?
Initial assessment: £200-£450
A full assessment usually lasts 90-120 minutes, plus report writing. Expect standardised tests (BOT-2, Beery VMI, Sensory Processing Measure), parent interview, observation, and functional tasks. Written report typically arrives within 2-4 weeks. More complex assessments with a full sensory integration profile sit at the higher end of that range.
Follow-up sessions: £70-£130
Session length is usually 45-60 minutes. Rates vary by location (Tunbridge Wells, Sevenoaks, and clinic-based practices tend to charge more) and by therapist experience. Many OTs offer block-booking discounts — for example, pay for 10 sessions upfront and get a 5-10% reduction.
Ayres Sensory Integration: £100-£150
ASI sessions are typically at the higher end of the range because of the training required and the cost of running a sensory gym. If ASI is what you need, this is the going rate and worth paying the difference.
Extras to budget for
- Travel fees — £30-£60 per visit for home or school visits, depending on distance
- School visits — often a flat fee of £100-£200 per visit, which usually includes a meeting with staff
- Report writing — standalone reports (for EHCP evidence without ongoing therapy) typically cost £400-£700
- Equipment — sensory tools, specialist pencil grips, weighted items, sloped boards. Your OT will recommend what's worth buying
For the full breakdown of session costs, extras, and how to budget, see our OT cost guide.
The Hybrid Approach — NHS Plus Occasional Private
Many Kent families end up running both systems in parallel:
- Keep the NHS referral active — it's free, and even if the wait is long, an NHS report has weight with some local authorities
- Commission a private assessment now — so you have something in hand for school, EHCP, or just to know what's going on
- Use private for the core therapy during the wait, especially for sensory work
- Drop to occasional private sessions once your child is established in a good school with OT provision in their EHCP
This is what most families we hear from do. It isn't cheap, but it's the realistic answer to "NHS isn't giving us what we need and we can't afford full-time private forever."
How an EHCP Can Fund OT
Section F of an Education, Health and Care Plan specifies the educational provision the local authority must deliver. If OT is written into Section F in specific, quantified terms, the local authority has a legal duty to deliver it — and they can meet that duty by commissioning a private OT if NHS OT can't provide what's specified.
Good Section F wording for OT looks like this:
"One hour of direct occupational therapy per week, delivered during term time by an HCPC-registered occupational therapist with postgraduate training in Ayres Sensory Integration. Plus six hours per term of indirect provision, including setting targets, training school staff, and reviewing progress. Plus one OT-led training session per year for all staff working with [child]."
Vague wording like "access to OT as appropriate" is not enforceable. If you see wording like that in a draft EHCP, challenge it. For the full step-by-step on getting OT into Section F, see our EHCP application guide.
Right to Choose for Children's OT
Right to Choose gives NHS patients the legal right to choose their provider for most NHS services. For children's mental health services, this has been a route to faster access via providers like Problem Shared or ProblemShared NHS. For children's occupational therapy, the picture is patchier.
- A small number of private providers hold NHS contracts for children's OT, but coverage varies by ICB (Integrated Care Board) area
- In Kent, Right to Choose for paediatric OT is rarely a realistic route as of 2026
- Even where it exists, the provider list is limited and wait times are not always shorter than the local NHS service
- Right to Choose referrals still need to come through your GP
It's worth asking your GP, but don't pin your hopes on it. Most families who go private pay directly or get OT funded via an EHCP.
Red Flags with Private Practitioners
The paediatric OT world is small and well-regulated, but there are still practitioners you should walk away from. Watch for:
- No HCPC registration — this is a legal requirement. If someone calling themselves an OT isn't on the HCPC register, they are operating illegally. Always check at hcpc-uk.org
- Claims that aren't evidence-based — auditory integration training (AIT), the Listening Programme, and some brain-training packages are not supported by current evidence. An OT who sells these as their main intervention is a red flag
- Promises of a "cure" for autism — OT is about helping your child access the world with the sensory profile they have. Anyone promising to make autism go away is not somebody you want
- Very large packages paid upfront — "sign up for a year of weekly sessions at £5,000" with no refund policy is a warning sign. Block booking for 6-10 sessions with a clear cancellation policy is normal
- No written report after assessment — you should always get a written report, and you shouldn't have to pay extra on top of a £400 assessment fee to get one
- No DBS check or insurance — ask and expect to see proof. Any reputable OT will have both
- Pushing specific equipment purchases — an OT recommending a £300 therapy ball because "it's the only one that works" is more salesperson than clinician
- No willingness to liaise with school — if your child is in school, OT that doesn't feed into the classroom is much less effective. A good private OT wants to talk to the SENCO
How to Find a Good Private OT
Look for the following stack of credentials:
- HCPC registration — legal requirement, non-negotiable
- RCOT membership (Royal College of Occupational Therapists) — not compulsory but shows professional standards
- SIE registration (Sensory Integration Education) — for sensory integration work. Tiers range from "Foundation" to "Advanced Practitioner in Ayres Sensory Integration." Ask which tier
- Paediatric experience — ideally a therapist who works mainly or only with children
- Experience with your child's needs — autism, ADHD, dyspraxia, visual impairment, whatever is relevant
- DBS check and professional indemnity insurance
Good places to start your search:
Questions to Ask Before You Book
- What's your HCPC registration number and SIE tier (if relevant)?
- How much experience do you have with children like mine? (autism, ADHD, sensory processing, etc.)
- What does an initial assessment include, and when will I get the report?
- Do you offer Ayres Sensory Integration, or the basic sensory approaches?
- Will you liaise with my child's school, and is that included or extra?
- Can you write EHCP-ready reports with quantified Section F wording?
- What's your cancellation policy?
- Do you offer home, school, or clinic sessions — and what works best for my child's needs?
- What happens if my child doesn't get on with you? Can we pause or switch therapists?
Key Takeaways
- NHS waits in Kent are 12-18 months for initial assessment, and NHS services often discharge after 6-12 sessions
- Private OT costs £200-£450 for assessment and £70-£130 per session (£100-£150 for ASI)
- Private is usually worth it for significant sensory difficulties, EHCP evidence, or when your child can't wait
- The hybrid approach works — keep the NHS referral, use private to fill gaps
- An EHCP with specific Section F wording can fund private OT via the local authority
- Right to Choose for children's OT is limited in Kent — don't rely on it
- Always check HCPC registration, and for sensory work, look for SIE registration too
- A detailed private OT report is often the best evidence you'll have for EHCP and tribunal
Useful Resources
This is not medical advice. This guide is for general information only. Every child is different, and every family's circumstances are different. Always consult a qualified occupational therapist or your GP for advice about your child's specific needs.
Read our full disclaimer.