Sustainable return-to-work, with help from Vocational Rehabilitation

By Kay Needle, Early Intervention and Rehabilitation Expert at Generali UK Employee Benefits

For employees with long-term and chronic health conditions, returning to work – or even staying in work – is rarely black and white. It’s not always a case of being fully at work, or not. Or being fully fit, or not. There must be a middle ground. Traditional Occupational Health approaches haven’t always afforded that middle ground. And that’s where Vocational Rehabilitation comes in, says Robin Pickard, Managing Director of Form Health, one of our valued early intervention and rehabilitation partners.

Vocational Rehabilitation (VR) is a multidisciplinary approach, that complements Occupational Health (OH). OH is about managing and mitigating risk; preventing work-related illness and injuries. Whereas VR is about intervening early in an absence and providing the support required to improve wellbeing and move towards a sustainable return to work, wherever appropriate.

VR focuses on the whole person – their psychological, physical and social needs. It’s about helping employees receive access to proactive support very early in an absence. And, consequently, it’s about helping employers retain their people and improve engagement.

Generali UK’s Group Income Protection proposition has VR support embedded within it. This valuable support might be available with or without an associated claim on the insurance. So, in the case of any employee who has been absent from work for four weeks, or is expected to be absent for at least four weeks, it’s worth getting in touch with us to assess whether this is an appropriate case for VR.

We recently hosted a webinar in partnership with Form Health, including guest speakers Robin and his colleague Helen Appleby, Vocational Rehabilitation Services Manager. Helen demonstrated the advantages of VR in practice though various real-life case studies. In this article, we summarise one of those case studies. To find out more, contact us for a link to the full recording.*

A case of Long Covid: The value of VR in action

A male employee, a field worker in the environment industry, contracted Covid-19 in 2020. Various symptoms persisted beyond 12-weeks of that initial infection, and he was subsequently diagnosed with Long Covid. He’d been fortunate enough to work from home throughout this period, but, despite this, he became increasingly fatigued, which affected his capacity to engage fully in his normal duties.

He was stressed, the fatigue increased, and he was signed off by his GP. At this point, his symptoms exacerbated. On top of that, he felt a sense of guilt because he was taking time off. He didn’t know who to speak with or what to do.

When Form Health received the referral, there was no active OH support or NHS treatment in place. And, as we have all learnt with Long Covid, symptoms can and do change all of the time. Plus, access to the NHS’ specialist assessment service can take anything from up to six weeks to 14+ weeks depending on where in England you live. In short, the employee didn’t know whether he was going to get better.

So, Form Health’s first meeting with him focused on his symptoms at that time, how they were impacting his day-to-day life and what his job demands were. They examined together whether he could work at all and, if so, what that would look like. It became clear that he wanted to look at some way of getting back into work, which was a positive.

He wasn’t driving at that time. And he was worried that this would prevent him from carrying out his job. He had been offered a reasonable adjustment by his employer, in the shape of returning to work for just 20 hours a week instead of full time. Although great to hear that his employer was being supportive, he didn’t know if he could sustain that.

So, as part of Form Health’s assessment, they explored his perceived barriers and his motivation for returning to work. They explained to him the benefit of engaging with his employer to coordinate a realistic and achievable pathway back to his own occupation, in the longer-term. In addition, Form Health talked about the shorter-term steps, including work-focussed treatment, that could be undertaken to achieve the longer-term goal.

Form Health put in place support in the shape of physiotherapy and also a specialist fatigue rehabilitation programme, both of which had a work focus. This helped him to understand the ‘boom and bust’ cycle of Long Covid, how to manage his fatigue, when to take breaks and how to gradually increase his stamina.

Form Health were involved for around 4.5 months, during which time his fatigue improved and he was able to return to driving, which was a massive confidence booster for him. Through a graduated return-to-work programme, he was able to return to work full time within 6 months. This represented an amazing result considering, at the initial point of referral, he wasn’t sure if he would ever go back to work.

Helen adds: “Traditional practitioner medical assessments – such as Fit Notes, where perhaps the GP doesn’t even meet with the individual – would provide an opinion. They might even make recommendations for treatment. But they wouldn’t necessarily look at the job demands in enough detail to provide opinion or advice about how a person could achieve a sustained return to their normal occupation. If this employee had only gone down that route, there is a likelihood that his sickness absence would have continued to be extended.

“Chronic health condition management should be about supporting people with their decision to return, because for the most part, work is good for wellbeing. It should be about early and ongoing support, to achieve the best – and most sustainable – outcome for both the employee and the employer.”

*To access a free recording of the full 30-min webinar, please email [email protected]

All information contained herein represents the views and opinions of the author as of the date of writing and is provided for general information only. Nothing herein constitutes or is intended to constitute financial or other form of advice and no individual should rely upon the information provided in making a specific investment decision without first seeking independent professional advice.