Rehabilitation after COVID-19: supporting those in employment back to work

Editor – I welcome, very much, the approach taken by Prof Wade.¹ It recognises clearly that medical practice should conclude only when the individual with COVID-19 has returned to as normal a life as is possible; and that this should include employment when applicable.

The importance of understanding employment as part of medical practice has been highlighted by consensus statements firstly in 2008 and recently in 2019 signed by many health professional bodies including the Royal College of Physicians.^2,3 In order to avoid unnecessary job loss for those with long-term consequences of COVID-19, the acute team needs to ascertain whether their patient is in employment and if so they should be advised either personally or through the family:

• to remain in contact with their employer as not all employers have effective absence management^4,5

• that there are many ways to assist disadvantaged individuals (DIs) back into work, even if this seems unlikely when viewed during the initial stages of illness.

Much of modern rehabilitation practice has been largely adopted by industry either through adopting disability aware processes (eg Business Disability Forum; https://businessdisabilityforum.org.uk/contact-us) or through their practices in addition to the advice given by rehabilitation professionals.⁶ Such practices include:

• facilitating a return to work (RTW) before the DI has fully recovered

• part-time working; possibly only a few hours per week initially

• phased (graded) RTW

• working from home

• adjusting work tasks and responsibilities

• allowing time off work for health-related activities eg appointments and rehabilitation

• utilising the Access to Work Scheme or other advice from the Department for Work & Pensions.

The technical aspects of how this is achieved by vocational rehabilitation professionals has been described elsewhere.⁷

The acute teams can, by these simple means, reduce unnecessary worry about future job prospects. Facilitating a successful RTW helps not only the DI and their family but also their employer and the government by converting ‘benefit recipients’ into ‘tax payers’.