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Research

How primary care can help survivors of transient ischaemic attack and stroke return to work: focus groups with stakeholders from a UK community

Chantal Balasooriya-Smeekens, Andrew Bateman, Jonathan Mant and Anna De Simoni
British Journal of General Practice 2020; 70 (693): e294-e302. DOI: https://doi.org/10.3399/bjgp20X708149
Chantal Balasooriya-Smeekens
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge.
Roles: Research associate
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Andrew Bateman
NIHR Research Design Service, School of Health and Social Care, University of Essex, Colchester, Essex.
Roles: Reader in rehabilitation; director
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Jonathan Mant
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge.
Roles: Professor of primary care research
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Anna De Simoni
Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London.
Roles: Clinical lecturer
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  • Collaboration and change to help return to work after cerebrovascular illness
    John CD. Gration
    Published on: 22 June 2020
  • Published on: (22 June 2020)
    Collaboration and change to help return to work after cerebrovascular illness
    • John CD. Gration, Occupational Physician and GP, Independent
    This commendable study discussed some vexing practical challenges. Its helpful suggestions for improvement included a patient-held shared-care plan at discharge from stroke wards, such assessment to form part of the patient electronic records, and a GP practice nurse whose role assists patient employment through local knowledge of community and neurorehabilitation services.
     
    Occupational health (OH) clinicians were not included in the study’s focus groups, which seemed a surprising omission given their role.1 This letter briefly offers additional points from that perspective on this important topic.
     
    Safe return home is a frequent rehabilitation goal of occupational therapists (OTs). Cerebrovascular conditions often impact on work capabilities, and must be taken into careful account at work, where OTs may rarely practise except in NHS settings. Reasonable adjustments need considering for disability, as the Equality Act requires. Access to Work is a helpful government agency whose Disability Employment Advisers (DEAs) can help with compliant good practice return.2
     
    Professional bodies, such as the College of Occupational Therapy, provide helpful guidance documents. I did not find one on the study topic, but their one on the prevention of falls was helpful, and is a condition with similar neurorehabilitation challenges. It advocated focus on the poten...
    Show More
    This commendable study discussed some vexing practical challenges. Its helpful suggestions for improvement included a patient-held shared-care plan at discharge from stroke wards, such assessment to form part of the patient electronic records, and a GP practice nurse whose role assists patient employment through local knowledge of community and neurorehabilitation services.
     
    Occupational health (OH) clinicians were not included in the study’s focus groups, which seemed a surprising omission given their role.1 This letter briefly offers additional points from that perspective on this important topic.
     
    Safe return home is a frequent rehabilitation goal of occupational therapists (OTs). Cerebrovascular conditions often impact on work capabilities, and must be taken into careful account at work, where OTs may rarely practise except in NHS settings. Reasonable adjustments need considering for disability, as the Equality Act requires. Access to Work is a helpful government agency whose Disability Employment Advisers (DEAs) can help with compliant good practice return.2
     
    Professional bodies, such as the College of Occupational Therapy, provide helpful guidance documents. I did not find one on the study topic, but their one on the prevention of falls was helpful, and is a condition with similar neurorehabilitation challenges. It advocated focus on the potential benefits to the individual of interventions to improve mobility, independence and active participation.3 Work can provide particularly helpful corresponding opportunities.
     
    Input and expertise from the wider neurorehabilitation team, such as speech and language therapy, neuropsychology and OT, can help to provide practical professional assessment and guidance information to assist with work rehabilitation. Clear and comprehensible information of this kind, particularly if patient-held, should help both employer and employee with rehabilitation risk assessment, work return planning, monitoring and review.
     
    GPs similarly have an important part to play in endorsing recovery and rehabilitation. Fit notes can indicate “may be fit for work”, by indicating suggested adjustments. Additional free text can help to promote successful return to work.1
     
    We all want to help, and pave the way for optimal recovery. Successful return to work after significant illness is often a major and affirming positive outcome for the patient.
     
    References
    1. Nicholson PJ, Gration JCD. What occupational medicine offers to primary care. Br J Gen Pract 2017; DOI: https://doi.org/10.3399/bjgp17X692213
    2. GOV.UK. Reasonable adjustments for workers with disabilities or health conditions. www.gov.uk/reasonable-adjustments-for-disabled-workers (accessed 22 June 2020)
    3. Royal College of Occupational Therapists.  Occupational therapy in the prevention and management of falls in adults Practice guideline (second edition). www.rcot.co.uk/node/396   (accessed 22 June 2020).
     
    Show Less
    Competing Interests: None declared.
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British Journal of General Practice: 70 (693)
British Journal of General Practice
Vol. 70, Issue 693
April 2020
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How primary care can help survivors of transient ischaemic attack and stroke return to work: focus groups with stakeholders from a UK community
Chantal Balasooriya-Smeekens, Andrew Bateman, Jonathan Mant, Anna De Simoni
British Journal of General Practice 2020; 70 (693): e294-e302. DOI: 10.3399/bjgp20X708149

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How primary care can help survivors of transient ischaemic attack and stroke return to work: focus groups with stakeholders from a UK community
Chantal Balasooriya-Smeekens, Andrew Bateman, Jonathan Mant, Anna De Simoni
British Journal of General Practice 2020; 70 (693): e294-e302. DOI: 10.3399/bjgp20X708149
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Keywords

  • employment
  • invisible impairments
  • primary health care
  • qualitative research
  • stroke

More in this TOC Section

  • The experience of implementing and delivering group consultations in UK general practice
  • A smoking cessation intervention in Australian General Practice: secondary analysis of a cluster randomised controlled trial
  • GPs’ and patients’ views on the value of diagnosing anxiety disorders in primary care: a qualitative interview study
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