DOTS Equipment & Adaptations Triage Model
Matching competence to complexity, risk and service need
Increasing complexity, risk and specialist input
TIER 1
STRAIGHTFORWARD NEEDS
Lower complexity | Lower risk | Higher volume
Typical characteristics
Stable needs
Clearly identified functional difficulty
Standard equipment or straightforward minor adaptations
No significant clinical red flags
Suitable for an agreed Trusted Assessor pathway
Appropriate workforce
Appropriately trained frontline staff
Trusted Assessors | Support Workers | Housing and Community Staff
TIER 2
ENHANCED / SPECIALIST NEEDS
Increasing complexity | Increased risk | More developed assessment
Typical characteristics
Several factors affecting function
More complex home environment
Increased risk or uncertainty
Specialist equipment or adaptations may be required
Greater assessment and decision-making responsibility
Appropriate workforce
Advanced practitioners and specialist support
Experienced Trusted Assessors | Advanced Practitioners | Occupational Therapy input where required
TIER 3
COMPLEX NEEDS
High complexity | High risk | Lower volume
Typical characteristics
Multiple interacting needs
Significant or changing clinical presentation
Complex rehabilitation requirements
Major adaptations or specialist equipment
High-risk or uncertain situations
Advanced clinical reasoning required
Appropriate workforce
Specialist professional assessment
Occupational Therapists | Specialist Practitioners | Multidisciplinary Teams
Higher service volume
Lower service volume
The right skills, at the right level, at the right time.
Straightforward needs can be managed within clearly defined Trusted Assessor pathways, while specialist Occupational Therapy expertise is protected for situations requiring complex clinical reasoning.
DOTS Workforce Development Pathway
OT-led training, clear professional boundaries and appropriate escalation
2
LEVEL 2 TRUSTED ASSESSOR TRAINING
Core assessment and safe equipment provision
3
LEVEL 3 TRUSTED ASSESSOR TRAINING
Developed assessment, risk awareness and decision making
4
LEVEL 4 DFG EQUIPMENT & ADAPTATION TRAINING
Home environments, adaptations and DFG-related practice
WHY THIS MATTERS IN PRACTICE
FASTER RESPONSES
Straightforward needs can be addressed without unnecessary delay.
APPROPRIATE ESCALATION
Staff recognise when complexity or risk requires specialist input.
PROTECTED OT CAPACITY
Occupational Therapists can focus on complex assessment, rehabilitation and major adaptations.
DEFENSIBLE DECISIONS
Clear assessment, boundaries and documentation support safer practice.
© DOTS Training & Consultancy 2026