FEATURE VOCATIONAL REHABILITATION
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As the rise in numbers of COVID-19 cases has slowed, all eyes are on
the nation’s economic recovery. What does that mean for people who
need help back into work?
The last few months have seen huge
numbers of people requiring acute support
from the health service, and attention is
now turning to what rehabilitation they will
now need.
There have been 300,000 confirmed cases of
COVID-19 in the UK so far, a huge number that is
likely dwarfed by the total number who have had it
but haven’t been tested. And while many of those will
be of retirement age, it includes thousands of people
still working. So what are the issues facing them in
returning to work?
COVID-19 is a complex condition, and its lingering
effects vary from person to person. Breathlessness is
common, as are the complex and variable symptoms
of fatigue and associated myalgia. There are reports
of post traumatic stress disorder-like symptoms
for those who have been intubated, and anxiety is
common, regardless of how serious the acute phase
of their symptoms had been. A cognitive fogginess
is also common yet seemingly underreported, and is
proving to be a symptom that doesn’t shift quickly.
Many people will be trying to manage these
symptoms against a backdrop of tremendous
uncertainty about their work. Some will be
furloughed or getting used to new ways of working,
perhaps at home or with altered schedules, and the
rising threat of redundancies will be leaving some
employees unsure of whether or not they should
seek support.
Among those working to support people back
into their jobs in this complex time is the vocational
rehabilitation service in the Royal Free London NHS
Foundation Trust’s community neurological conditions
management team.
In many ways, the team’s work continues in it’s
traditional vein; the work remains person centred and
highly individualised. ‘It has to be as everyone’s job is
so different,’ says Carina Knight from the team.
That means the team is looking at what their job
roles are, completing job demands analysis, providing
rehabilitation in line with the tasks they do, and
supporting them with a graded return to work plan and
other reasonable adjustments to build up their work
tolerance.
But there are some particular issues the team is
consistently encountering around COVID-19 patients.
They have been accepting patients with any high-level
cognitive changes and fatigue, and confusion is a big
issue they having to support people with.
‘They’re still breathless and experiencing cognitive
changes like confusion and changes to their memory,
so they are understandably anxious about how they are
going to go back to work and reintegrate,’ says Carina.
The cognitive effects of the virus do not yet seem to
have been widely documented but are proving central
to vocational rehabilitation work. The Royal Free team
is supporting a 75-year-old gentleman who spent three
weeks on an intensive care unit with severe respiratory
problems and kidney problems. He has been
32 OTnews July 2020