Long Covid
All of the survey respondents who required workplace correspondence found that it positively influenced the return-to-work process . Respondents highlighted that formal correspondence had not only provided useful recommendations , but also commented on the important role of therapist advocacy and in the validation of symptoms .
One survey respondent suggested that there should be more communication between other stakeholders , such as occupational health and human resources , as they felt that the recommendations were not always fully implemented by their manager .
Another respondent said : ‘ The communication was so helpful . My manager was grateful of the advice too , as it helped her to understand and plan my return to work . The feeling of support was so important and reassuring to me .’
While another stated : ‘ The occupational therapist who supported me during the last year has been amazing . Without her advocating for me during ill health , I think I would have struggled to speak up for myself when needed .’
In total , 83 % of patients were known to have returned to work on their final occupational therapy review ; 31 % of survey respondents reported to still be on reduced duties ; and 38 % remained on reduced hours .
Most patients were therefore given a fourmonth open appointment and were encouraged to contact the department with any work-related needs .
One respondent suggested that the department should offer planned one-to-one reviews over an extended period , highlighting that they needed a ‘ nudge ’ to ask for help .
In addition , 67 % of survey respondents selfscored their work ability as moderate to excellent , compared to their lifetime best , and 33 % of respondents reported to have had at least one failed attempt at returning to work , which they attributed to persisting Long Covid symptoms .
Many patients described a continuation of symptoms long beyond their return to work : ‘ After returning to work , it still took a long while for me to return to full health . Brain fog was a long-term problem . However , I think I ’ ve recovered as well as I can and as close to normal as possible .’
Four rehab hubs have now been commissioned , which will provide rehabilitation to patients across Derbyshire , receiving referrals directly from the Long Covid Assessment Clinic .
The hubs will be led by an occupational therapist who specialises in vocational rehabilitation and who will case manage the care of each patient . The multidisciplinary team will include specialists in chronic fatigue , respiratory rehabilitation and psychology .
Referred into one hub , the case manager will co-ordinate care and will identify if a patient needs specialist input . Rather than experiencing the delays associated with onward specialist referral , the patient will have access to this input within the hub .
The evaluation has brought to light the importance of patient choice when deciding on the method of delivering care . It will still be important to offer remote care to those who face barriers in face-to-face attendance .
Debate remains on whether or not patients with energy limiting illness should be given exercise as a rehabilitation intervention . For many patients , office-based duties or lighter duties are not an option .
After returning to work , it still took a long while for me to return to full health .”
We have found that meaningfully prescribed work-simulated programmes are valued by patients as they endeavour to return to work . Any rehabilitation programme should therefore have the capacity to assess and treat patients on a face-toface basis .
All of the patients in this service evaluation found that workplace correspondence had a positive influence on their return to work .
Given the complex presentation of symptoms often associated with Long Covid and the lack of understanding outside of the healthcare community , it is essential that the rehabilitation therapist provides well-informed advice and acts as an advocate during sickness absence and phased return .
Generic return-to-work advice can be adequate for facilitating a safe and sustainable return-towork for many people . However , occupational therapists can offer people with Long Covid a more creative and individualised set of recommendations , which truly maximise their potential for success and gives them an opportunity to thrive in the workplace .
Words JASMINE YULE , Occupational Therapist , Group Rehab , University Hospitals of Derby and Burton NHS Foundation Trust
July 2022 OTnews 39