Investigating the best method of service delivery, or the ‘need’ for a particular service is gaining increasing support as demands intensify across the health‐care system, often with reduced financial resources. Following a restructuring within the Occupational Therapy department at the Austin and Repatriation Medical Centre, a limited amount of time (0.2 EFT Grade II) became available to provide additional services within the hospital. Occupational therapy services to patients of the rheumatology outpatient clinics had ceased since funding cuts approximately 7 years before, yet there had been numerous requests for service. As part of quality assurance activities, a needs assessment was conducted, interviewing clients attending these outpatient clinics. The Health Assessment Questionnaire, a Visual Analogue Scale for Pain, and a non‐standardised questionnaire were used to assess the need for occupational therapy by this patient group. Thirty‐five people were interviewed over a period of 2 weeks. The results supported increased occupational therapy involvement with this client population within the rheumatology outpatient clinic specifically in the areas of improving functional performance, pain management and hand therapy. The study also highlighted a need for promotion of the occupational therapy role both with clients and the medical staff.