Vocational Rehabilitation

This information is aimed at professionals supporting people with vocational rehabilitation.

Vocational rehabilitation is a process whereby those disadvantaged by illness or disability can be enabled to access, maintain or return to employment or other useful occupation. The Royal College of Physicians National Clinical Guideline for Stroke (2016) recommends:

  • People with stroke should be asked about their pre-stroke work and leisure activities
  • People who wish to return to work after stroke (paid or unpaid employment) should:
    • have their work requirements established with their employer
    • be assessed cognitively, linguistically and practically to establish their potential for return
    • be advised on the most suitable time and way to return to work, if return is feasible
    • be referred through the job centre to a specialist in employment for people with disability if extra support or advice is needed
    • be referred to a specialist vocational rehabilitation team if the job centre specialist is unable to provide the necessary rehabilitation.
  • Vocational rehabilitation programmes for people after stroke should include:
    • assessment of potential problems in returning to work, based on the work role and demands from both the employee’s and employer’s perspectives
    • an action plan for how problems may be overcome
    • interventions specifically designed for the individual which may include: vocational counselling and coaching, emotional support, adaptation of the working environment, strategies to compensate for functional limitations in mobility and arm function, and
      fatigue management
    • clear communication between primary and secondary care teams and including the person with stroke, to aid benefit claims or to support a return to work
  • People with stroke who wish to return to or take up a leisure activity should have their cognitive and practical skills assessed, and receive support to pursue their activity

Learn more about the journey back to work:

Returning to work after a stroke – Lucy’s story

Returning to work after a brain injury – Gavin’s story


Improving support in Greater Manchester

We have been working closely with the Greater Manchester Neuro-Rehabilitation Network to improve our support for vocational rehabilitation. An audit of clinical teams in 2017 highlighted a number of issues including:

  • Professionals would welcome further training to improve their knowledge and understanding
  • No standard pathway or assessment tools across the region
  • Teams are unable to always provide effective support due to resource limitations, with time restrictions of the service also a factor
  • No funding for services provided by the voluntary sector who often support people following discharge from NHS teams

The networks therefore aim to:

  1. Upskill local healthcare professionals in supporting people with neurological conditions in vocational rehabilitation
  2. Develop a pathway of best practice, with access to specialist vocational rehabilitation support
  3. Encourage better links and working with other agencies including the voluntary sector and job centres


Training of staff

In 2016, the networks commissioned the University of Salford to develop and run a 2 day training programme for Greater Manchester healthcare professionals supporting people with neurological conditions. The training is now being cascaded within teams and can be purchased for delivery outside of the region.


Greater Manchester pathway

We have developed a model and are working to secure funding for specialist support for complex cases or those who need help in the much longer term.


Working with job centres

We have been working with job centre staff to help them understand how they can better support people with neurological conditions in returning to work. We are encouraging our community teams to establish links and provide teaching to local job centres and have developed an online training package, plus other resources:

One hour teaching session slides for job centre staff

Resource pack for job centre staff


Other useful resources

Stroke Association – getting back to work