Rapid organisational change potentially affects new practitioners' time for reflection and learning, reducing their chances for the repetition, experience and trial and error process so crucial to their clinical reasoning, as well as limiting their access to more experienced peers (Barnitt and Salmond 2000). Recent policies, phased in since 2003 as part of governmental Agenda for Change initiatives, have the potential to improve junior allied health practitioners' lot in the above areas (DH 2005). Alongside fundamental changes to NHS workers' pay and terms and conditions of employment, Agenda for Change establishes a formal system of preceptorship support for newly qualified NHS practitioners (Harbottle 2006). This term refers to a specific teaching and learning approach that enables newly qualified individuals (preceptees) to experience day-today practice with senior colleagues as role models and resources (preceptors) (Chickerella and Lutz 1981, cited in Allen and Simpson 2000). Such a programme requires preceptors and preceptees to engage in several sessions of observed practice and joint reflection. Preceptorship links directly to the NHS Knowledge and Skills Framework (DH 2004), having an impact on newly qualified practitioners' early pay progression. The NHS Terms and Conditions Handbook (DH 2005) states: Staff joining Band 5 as new entrants will have accelerated progression through the first two points (of the salary scale) in six monthly steps, providing those responsible for the relevant standards are satisfied with their standard of practice (Pay Section 2, Para. 1.8).

The primary aim of this study was to examine changes in clients' occupational performance and satisfaction with their performance within a community trust setting, using the Canadian Occupational Performance Measure (COPM). Given the rapid throughput of clients and the pressure of limited resources, the authors postulated that occupational therapy interventions were focusing on clients' self-care needs as a matter of priority for clients to be independent at home. Therefore, at a time when services are seeking to be increasingly client-focused, the authors' secondary aim was to explore whether self-care needs were also the clients' highest priorities. Fourteen occupational therapists and 62 clients took part in the study. The therapists used the COPM to assess the client; the clients completed the COPM at initial interview and at the end of the intervention. Inferential statistics were then used to ascertain any change over the intervention period. The findings showed a statistically significant change in clients' occupational performance and satisfaction with their performance, in all settings, following occupational therapy. There were notable differences in occupational performance goals between men and women, in that a higher percentage of self-care goals were identified by the men. Self-care goals were the most frequently cited goals in all of the settings.

This article explores the results of a small quantitative study conducted with 54 occupational therapy students. The data, gathered using a purpose-designed questionnaire, were based on respondents' reports of the 662 activities seen during their fieldwork education. These were categorised using headings from the Canadian Occupational Performance Measure (Law et al 1994). The findings showed that client-related leisure activities were the most frequently seen in all practice settings (physical disability, mental health and learning disability). The activities seen most often consisted of those in thè quiet recreation' category. Activities aimed at productivity, and particularly at household management, were also widely spread. Such activities formed a smaller but consistent percentage of those seen in all fields of practice. Self-care, and in particular personal care, activities were most prevalent in physical disability settings, but formed a lower percentage of the activities seen elsewhere. This article discusses these findings in relation to previous research in the field and considers the continuing place of activity in occupational therapy and in undergraduate occupational therapy education.

Nationwide Note: Enquiry data were initially categorised by COTSS-IP into 20 geographical regions in order to facilitate its members' travel to see clients. The boundaries derived were not coterminous with the then-existing COT Regional boundaries because the latter regions were seen to be too large. For the purposes of this article, the original COTSS-IP regions have been amalgamated into larger regions, as noted above.