The University of Nottingham

A pilot project being led by researchers at The University of Nottingham is aiming to assist more stroke survivors to return to work.

Academics in the University’s Division of Rehabilitation and Ageing have teamed up with NHS community healthcare provider Nottingham Citycare Partnership to offer stroke survivors in the city access to specialist vocation-focused rehabilitation.

They hope to increase the number of stroke patients returning to employment — where possible with their existing employer.

Dr Kate Radford, who will evaluate the success of the one-year project, said: “Although it is an illness most often associated with older people, around one-quarter of all people who suffer a stroke every year are actually of working age. Currently, less than half of stroke survivors — just 44 per cent — return to employment.”

“With the age at which you can claim a state pension going up, this may have an impact on the number of people who are in a position to take early retirement. For financial reasons many people who have suffered a stroke need to return to work.”

Under the new project, being led by Nottingham Citycare Partnership stroke specialist Jane Terry, an occupational therapist (OT) will start working with patients as soon as possible after their stroke. The OT will carry out detailed assessments of the person, their job and their workplace and deliver specialist rehabilitation tailored to the patient’s specific needs.

The OT will act as a case coordinator to provide support, education and advice to patients, their family and a range of other stakeholders such as employers, NHS professionals, specialist stroke rehabilitation services, social services, and Jobcentre Plus staff including Disability Employment Advisors (DEA).

Patients will be seen initially in hospital but most of the interventions will take place in the home, workplace or out in the community as often as is required.

The specialist rehabilitation will include finding practical strategies to lessen the impact of stroke, for example using memory aids or pacing techniques to manage tiredness and fatigue and supporting patients’ reintegration into the community such as training in the use of public transport.

The OT will also offer assistance with preparing for work, for example helping patients to establish structured routines with gradually increased activity levels and the opportunity to practice skills integral to their job such as concentrating on a computer screen for extended periods.

The therapist will also liaise with employers, tutors or employment advisers to advise about the effects of stroke and to plan and monitor a phased return to work in the same role or more suitable role depending on the needs and capabilities of the stroke survivor.

The intervention was developed and tested in a Return to Work After Stroke feasibility study run by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care covering Nottinghamshire, Derbyshire and Lincolnshire (CLAHRC-NDL). The CLAHRC is a partnership between The University of Nottingham and a number of NHS organisations across the three counties.

The Return to Work After Stroke study, which recruited 46 patients from Derbyshire, looked at gaps in existing services for stroke survivors in supporting them back into work and then developed the specialist intervention to assess whether it could improve outcomes for those stroke survivors wishing to return to employment

Although only a small feasibility study – which set out to determine whether the intervention could be delivered and measured, it gave an early indication on its potential success, showing that with the OT’s support more stroke survivors returned to work than those patients who only accessed current NHS services.

The new pilot study in Nottingham has been welcomed by Marita Jenkinson, who suffered a stroke in her 30s and who struggled to return to her job as a beauty therapist.

She said: “It’s encouraging how through this programme stroke survivors can receive a thorough, caring and beneficial rehabilitation specific to their needs. I’m glad to see the inclusion of information and education for stroke survivors, family and employers, as it is important that the employer has an understanding of what they might expect to see from their stroke survivor employee. Similarly the participant needs to know what symptoms are normal post stroke.

“It is also important to have psychological support throughout the period of intervention for family and participants as over time stroke symptoms change and some problems disappear, while others arise.”