OTSLPQualitativeClinical rehabilitation2021

A study of mapping usual care and unmet need for vocational rehabilitation and psychological support following major trauma in five health districts in the UK.

Jade Kettlewell, Stephen Timmons, Kay Bridger and 5 others

PMID 33222497

WHAT IT FOUND

Across the UK trauma networks studied, support after major trauma was uneven.

Many musculoskeletal and amputation survivors lacked vocational or psychological help, faced long waits, and fell between acute and community teams.

Key findings

01Common problems included inconsistent transition from acute to community services, postcode-based access, less expertise away from trauma centres, and gaps in vocational and psychological support, especially for musculoskeletal injuries.

02Most vocational rehabilitation teams across the five major trauma pathways only offered return-to-work support to individuals with acquired or traumatic brain injury.

03Waiting lists for community rehabilitation were long, in some areas up to 12 months, and few services provided vocational support.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs

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What it does not show

The study did not include commissioners or employers, so it cannot show how funding decisions or workplace support affect return-to-work. It interviewed only a small number of carers, so carer perspectives were limited. It covered five UK trauma networks, so findings may not transfer to other regions or health systems. It did not test an intervention, so it cannot show whether vocational or psychological support improves outcomes. Participants were recruited purposively and through known providers, so some stakeholder groups may be over-represented.

Declared interests

The study was funded by the National Institute for Health Research as part of a larger programme (Ref: RP-PG-0617-20001). No competing-interests statement is included in the supplied text.

The easy way to misread this

Do not read the service gaps as proof that vocational or psychological support improves return-to-work. This study mapped current care and did not test an intervention.

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