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About the P&I Team Briefings Home | Responses | PFI Index | Policy Guide
Rehabilitation and Retention Briefing 42


September 2002
The TUC published a report in July 2002 "rehabilitation and retention: what works is what matters". This follows extensive research by the Labour Research Department into the issue of rehabilitation and UK employers' approach to retaining their staff in work following sickness or injury.

Workers in Britain today have less chance than their counterparts in the USA and Europe of remaining at work in the event of them becoming sick or sustaining an injury at work. According to the Health & Safety Executive, 27,000 people a year leave work permanently in such circumstances, facing poverty and disability instead of jobs, health and wages.

At the same time, research by the HSE has found that only 3% of companies provide comprehensive occupational health support for their employees. In addition, only 30% of workers have access to any form of occupational health, compared with 50% in 1990.


Labour Research started their research in 2001 by surveying approximately 2000 safety representatives throughout the UK. This provided a snapshot of how employers treated rehabilitation and sickness absence.

The survey was followed by a series of interviews carried out with managers, occupational health staff, union reps and employees at nine companies and organisations, including Scottish Power, Scottish Courts Service, Sheffield City Council, Newham NHS Healthcare Trust, Moseley & District Churches Housing Association, along with four private sector companies.

In depth case studies were also carried out and formed a separate part of the report.

What is rehabilitation?

Sixty years ago, when planning the Welfare State, William Beveridge stated that access to rehabilitation was one of the three pillars of the welfare state. He defined it as "a continuous process by which disabled persons should be transferred from the state of being incapable under full medical care to the state of being producers and earners. Rehabilitation must be continued from the medical through the post-medical stage till the maximum of earning capacity is restored."

For the purposes of the research, LRD defined rehabilitation as "any method by which people with a condition resulting from sickness or injury which interferes with their ability to work can be returned to work".


The study came to the conclusion that Britain is one of the safest places in the world to work, due to the work of unions and HSE inspectors.

However, there are still too many accidents in the workplace and every year 27,000 people leave employment permanently due to work-related illness and injuries. Many more have long periods of sickness absence and do not get the support they need to get back to work. Even in unionised workplaces with a good network of safety stewards, there is very little evidence of access to rehabilitation.

The case studies carried out showed that employment practices aimed at rehabilitating staff provided many benefits to businesses by:

  • improved attendance and retention
  • reduced costs from absence and medical retirement
  • compliance with the DDA
  • demonstrating good practice on health & safety
  • promotion of a health "culture"


The case studies showed that employees suffering from a wide range of problems, ranging from injury, chronic pain, severe depression, ME, have been assisted in returning to and remaining in work often after years of sickness absence.

Their successful rehabilitation has been achieved through:

  • adaptations to work and working practices , including tools and equipment
  • changes in duties or change of post with same employer
  • phased returns to work
  • alterations to working hours
  • provide additional vocational training

Occupational health is one of the most important issues to aid retention in work and it is concerning that these services are being cut back. Employers need to be made to see OH as a benefit rather than a cost and will need to work out the figures to prove it.

Back pain and musculo-skeletal disorder (MSD) which includes RSI count for almost 60% of all health-related absenteeism at a huge cost to both employers and the NHS. Studies have shown the early intervention and management of the absence can have a remarkable reduction on the number of days through such illness.

The use of occupational therapists and physiotherapists by some employers has been very successful in helping people back to work and assessing jobs to see what steps will achieve the best outcomes.

The aim is for everyone to receive the same standard of rehabilitation as David Beckham did, prior to the World Cup in June 2002, when he broke a bone in his foot.


The research concluded that formal rehabilitation policies were essential to bring about the changes necessary.

Branches should therefore:

  • establish clear formal rehabilitation and retention policies or consider amendments to existing policies, such as Health & Safety, Disability, Equal Opportunities or Management of Sickness Absence procedures to include rehabilitation and retention measures.
  • place on Health & Safety Committee Agenda
  • ensure that Rehabilitation policies are separated from the Disciplinary Procedure.

  • Involve all levels of management as effective management is seen as a key to successful rehabilitation policies.
  • involve the trade unions in managing the process.
  • monitor sickness absence records and be aware of the potential for occupational causes
  • negotiate access to good occupational health facilities.
  • ensure that interventions are started as early as possible (within a month of the illness occurring)
  • keep in touch with members of staff who are off sick.
  • ensure that employers carry out risk assessments and investigate any work related health problems


Rehabilitation and Retention

Occupational Health: Back in Business 06 Aug 02

Rehabilitation an LRD Guide Aug 2002

Health Framework Health & Safety at Work September 2002 Edition.

Helped Back into Work Labour Research September 2002 Edition.



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