Private vs NHS Occupational Therapy for Children UK (2026)

Quick Comparison

What NHS Paediatric OT Actually Offers

Kent Community Health NHS Foundation Trust provides children's OT services in Kent. Referral sources, acceptance criteria and the pathway used depend on the service and the child's needs; check the current KCHFT referral guidance rather than assuming one route.

• Referral and triage — the service checks its current criteria and the information supplied
• Assessment — the setting, format and people involved depend on the pathway
• Plan — recommendations may include direct work, advice, equipment, environmental changes or support for family and school
• Review or discharge — ask at the outset how goals, progress, review and re-referral are handled

Occupational therapy focuses on participation in everyday activities. Ask the service which functional goals and interventions fall within its current remit, what it does not provide, and what support is available while waiting.

NHS wait times in Kent — how to check

KCHFT does not publish one waiting-time figure that applies to every children's OT pathway. Timescales depend on the child's functional needs, the referral route and local capacity, so parent reports should not be presented as an official Kent-wide estimate.

• Confirm that the referral has been accepted and which pathway it entered
• Ask for the service's current expected timescale for that pathway
• Ask what support or online resources can be used while waiting
• Contact the service again if your child's function deteriorates or circumstances change

If you have heard nothing after referral, contact the service to check it was received and keep a written record. Kent SENDIASS can help if communication breaks down or you need advice about support in education.

Questions to Compare Before Choosing a Route

The NHS route may meet the need if…

• The child is accepted and the proposed pathway addresses the functional goals you have identified
• The expected timescale is workable and interim support is available
• The service explains what assessment, written advice, family involvement and school liaison it will provide
• You understand how progress, review, discharge and re-referral will work

A private assessment may be worth considering if…

• A registered provider can offer a suitable assessment sooner and you understand the full cost
• You need a defined assessment or report scope that the provider has confirmed in writing
• Your child has a defined functional goal and the provider can explain how progress will be measured and reviewed
• You want optional family coaching or school liaison and have confirmed that it is included
• You have checked HCPC registration, relevant experience, complaints arrangements, insurance and cancellation terms

Using a private service does not cancel an NHS referral, but tell each clinician about other assessments or interventions so advice is coordinated. Paying privately does not guarantee an EHCP decision, tribunal outcome or NHS adoption of a treatment plan.

What Private OT Actually Gives You

Private scope varies. The written quote should explain what is included, what costs extra and what happens if the proposed work is not suitable.

Flexible session frequency

Private services can offer more flexible appointments, but more sessions are not automatically better. Frequency should follow the child's goals, baseline difficulties and response to intervention, with formal review points rather than an open-ended weekly commitment.

Sensory integration (often ASI)

Some private OTs offer Ayres Sensory Integration in an equipped clinic. Specialist training and facilities explain the higher price, but not necessarily better outcomes. The NIHR SenITA trial found no clinical benefit over usual care across its main outcomes and found the programme was not cost-effective. Ask what functional change is expected and how it will be measured.

Parent coaching

If coaching is one of your goals, ask how much parent or carer time is included, what written guidance you will receive and how advice will be coordinated with school.

Detailed, EHCP-ready reports

A private report may include standardised assessment results, observations and quantified recommendations if those are clinically appropriate and included in the agreed scope. Ask for a sample structure and delivery date. A report is evidence to be considered; it cannot guarantee an EHCP or tribunal outcome.

Longer-term commitment

Some private providers offer continuity through transitions. Ask about availability, handover, records, review points and what happens if the clinician leaves or the arrangement ends.

What Does Private OT Actually Cost?

Comprehensive assessment: £450-£1,000+

Published UK provider fees show a wide range. A brief consultation or screening can cost less, but a comprehensive assessment with standardised tests, observation and a detailed report commonly starts around £450 and may exceed £1,000. SEND tribunal assessments can cost more. Get the scope in writing before booking.

Follow-up sessions: £80-£150

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: commonly £100-£160

ASI sessions are often at the higher end because of the training required and the cost of running a sensory gym. Do not pay the premium on the assumption that specialist means proven: agree a short initial block, measurable goals and a review date.

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 special educational provision the local authority must secure. The authority may commission a suitable provider to deliver specified OT, but this does not automatically reimburse therapy a family arranges privately.

Good Section F wording for OT looks like this:

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

NHS patient-choice rights depend on the particular referral, service, contract and exclusions. Do not assume a generic paediatric OT entitlement or shorter wait. Ask the GP or referrer and the responsible NHS service whether a choice right applies, which providers are currently commissioned, and what each provider's scope and wait are.

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
• Large packages paid upfront — compare the total with pay-as-you-go and obtain the cancellation, refund, expiry and missed-session terms in writing before paying
• An unclear assessment quote — reports are not always included. Get written confirmation of assessment time, tests, observations, school liaison, feedback and report type before paying
• No measurable goals or review point — avoid open-ended weekly therapy where nobody can explain what improvement should look like or when progress will be reviewed
• 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:

• SENDPath Kent OT Directory — our curated list of paediatric OTs working in Kent
• RCOT Find an OT — the Royal College directory
• Sensory Integration Education — to find ASI-trained therapists
• Recommendations from local parent groups — word of mouth is often the fastest route to a therapist you'll trust

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

Useful Resources

• What Is Occupational Therapy for Children? — the full parent's guide to paediatric OT
• How Much Does Private OT Cost in the UK? — full cost breakdown
• Find an Occupational Therapist in Kent — our curated directory
• Sensory Processing Difficulties in Children
• EHCP Application Guide for Kent
• Royal College of Occupational Therapists (RCOT)
• Sensory Integration Education
• Kent SENDIASS — free, impartial advice for Kent families