Take Home Messages:

Returning people to work after they have been off work for significant periods poses major challenges and success is uncommon.

Approaches that positively engage the worker, deal with the worker in a respectful manner, avoid bureaucratic inefficiencies, and work in partnership are required to improve the chance of success.

Each of these is simple in its own right, but requires consistency of approach, time to spend with the worker, and an approach that supports timely actions.

Why the research matters:

Long term claims account for 80% of costs and result in substantial suffering.  The longer someone is off work the less likely they are to return to work.

What the research involved:

Canadian researchers sought to evaluate barriers to and facilitators of return to work for people with chronic conditions and disability.

We have divided our summary of this paper into two parts.  In Part 1 we summarised the section of the paper in which the researchers reviewed studies on this topics. In this article, Part 2, the researchers interview and obtain information from individuals with chronic disability and work absence.

Recognising an employee-centred approach is important to assist return to work, the researchers interviewed ten people with chronic disabilities who had been absent from work for at least two years.

Each of the ten was interviewed over an extended period.  They were asked about their experiences with  return to work, the barriers and facilitators to return to work, and what had activated and motivated them to stay in the process. They were asked about strategies that would improve the overall situation.

Research summary:

The authors pointed out there were three main issues employees needed to deal with. The first two were systems, the last was communication. 

Barriers in dealing with the health system included:

• A sense that they were or were not supported by their treating health practitioner;
• The sense that they received biased independent medical review;
• Healthcare professionals were not able to assist them with positive and coping strategies.

Barriers in dealing with the return to work system included:

• Lack of reliable and consistent procedures - eg the correct protocol was followed by the participant, but there was lack of follow through by the return to work system, or claimants indicated they would go to an assessment and recommendations were made, but not followed through;

• Lack of system accountability;
• Lack of system flexibility; and
• Lack of dignity and respect within the system;

Facilitators in both systems were:

Knowledgeable providers, who were approachable and would listen.
 

The third area was communication and knowledge transfer.  These long term claimants indicated they had issues with:

• Accessing and using knowledge—the felt there was a poor knowledge transfer between the return to work and health systems, and they could often become alienated in the process;
• Gaps in knowledge transfer occurred when the claimant did not receive specific information, or they felt they had to push to find out relevant information.  Further, they indicated that information was often confusing and they did not understand the information provided.
• The claimants indicated that framing and exchanging knowledge in user-friendly formats would assist, and client-friendly communication is important for people to make informed decisions.

Original research:

Left behind in the return-to-work journey:  Consumer insights for policy change and practice strategies
Monica Korzycki, Martha Korzycki and Lynn Shaw. 

Work 30 (2008) 277–287 277

Link to PubMed Abstract