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Scottish Society of Rehabilitation Autumn 2004 meeting
Vocational Rehabilitation
12th November 2004 Westpark Conference Centre, Dundee
Chair: John Ferguson-Smith, Occupational Physician
Dr Andrew Frank, well-known in the field of rehabilitation medicine, opened with his views on the political status of rehabilitation in contemporary Britain, and described two strands of Vocational Rehabilitation; return to previous work and the employment of longer-term disabled people. As unemployment has decreased over the last 20 years, the number of long-term Incapacity Benefit claimants has risen alarmingly. The Department of Work and Pensions framework addresses this, with Pathways to Work pilot schemes appearing to be successful. In Vocational Rehabilitation the abilities of the individual are enhanced by rehabilitation at the same time as the demands of the job are reduced. When these match, vocational rehabilitation will be successful. Both the Top-Down (government policy) and Bottom-Up (employers and health providers) approaches are necessary to make successful vocational rehabilitation happen.
Colin McHardy, Head of Healthy Working Lives branch of the Scottish Executive, described Scotland’s problem of poor health compared with the rest of UK and Europe. Part of the initiative to reverse this focuses on the workplace, going beyond statutory Health and Safety requirements to encourage and reward the adoption of health-related behaviours and attitudes in firms. The working group’s brief extends to employability (900 000 Scots are of working age but economically inactive) and fits in with the wider aims of the Scottish Exec on health, growth, equality etc. The benefits to employers of better work-force health were emphasised.
Dr Jane Wilford, occupational physician and medical director of Healthy Return Glasgow, described the Healthy Return randomised controlled trial which is currently under way. In 5 pilot areas, eligible people are assigned to a control group using existing services, and trial groups receiving health and/or workplace intervention. To date, results indicate that clients appreciate the coordinated approach, that occupational therapists are indispensable, and that the NHS is still making people wait too long with curable work-limiting conditions (equality for all meaning loss of employment for some). The study population is self-selected and not typical of the whole population claiming incapacity benefit.
After one of Westpark’s famous lunches and the SSR’s AGM, the afternnon session began with Norma Bennie MBE, NHS Project Director in Argyll and Clyde for the Incapacity Benefit Reform project. Pathways To Work gives 3 recommendations: access to advisors; removal of financial disincentives to work; and management of medical conditions alongside the NHS. In this project, conditions are managed on a “cognitive behavioural therapy” model, addressing altered thoughts, beliefs and behaviours as well as physical symptoms.
Dorothy Strachan, from Momentum (formerly Rehab Scotland), described their Pathways programme for return to work after traumatic brain injury. Pathways is based on a holistic person-centered model, is flexible, needs-led and collaborative. On average, programmes last 59 weeks of which most is spent out on work placement. They handle about 40 clients a year, with a growing workload due to people previously re-settled in employment requiring further advice when work conditions change.
Tim Dawson, chair of the National Vocational Rehabilitation Association, told us about the organisation, which is, like the SSR, multidisciplinary and aims to promote practice development for workers in VR, set and monitor standards, make political representation and develop the framework of qualifications and accreditation in vocational rehabilitation. One of the NVRA’s most notable achievements to date has been the HOST report, which highlighted the need for accredited training in Vocational Rehabilitation and a need for more research.
Joanne Pratt and Roana Dixon of the division of Occupational Therapy of Glasgow Caledonian University presented a paper on the experience of police officers returning after sickness. Through qualitative studies of narrative data, they recognised a series of four stages in the process of return to work, during which transitions take place in the dimensions of place, time-use, self-perception, response of others and beliefs (and related actions). This was illustrated with case histories.
Duncan Mitchell SSR Committee December 04
Page updated 31/03/05
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