Mapping Vocational Rehabilitation Services for People with Long Term Neurological Conditions

Work contributes to adult identity, confers financial benefits and status and can improve quality of life and reduce ill health. There are 6.8 million disabled people of working age in Britain; 1 in 5 of the total working age population but only 51 per cent of disabled people are in work. Recent government initiatives have aimed at supporting people with disabilities to return to work, yet it is unclear if these initiatives will help people with long term neurological conditions (LTNC). Although there is a growing consensus and evidence base about the interventions provided by and the benefits of vocational rehabilitation (VR) services, there is increasing concern that such services are not accessible for people with LTNC many of whom fall into 'hard to reach' groups.

Lead Investigators

Dr. Kate Radford (School of Health, University of Central Lancashire)
Dr. Diane Playford (University College London)


Dr. Chris Burton (Bangor University)
Professor Caroline Watkins (School of Health, University of Central Lancashire)
Julie Phillips (University of Nottingham)
Jo Sweetland (University College London)

Collaborators and their Institutional affiliation

Dr. Andy Tyerman (Community Head Injury Service, Bucks PCT)
Professor Anne Chamberlain (University of Leeds)
Dr. Andrew Frank (Vocational Rehabilitation Association)
Gail Townsend (Bucks PCT)
Emma Linley (Spinal Cord Injury Centre, Royal National Orthopaedic Hospital)
Jain Holmes (The Workplace Health Partnership Ltd)
Dr. Prabal K Datta (Mid Yorkshire NHS Hospitals)
Dr. Mick Meehan (Jobcentre Plus)
Dr. Bob Grove (Sainsbury Centre for Mental Health)
Dr. Margaret Phillips (University of Nottingham)
Dr. Fiona Ford (East Lancs PCT / University of Central Lancashire)
Judith Williamson (Service User Representative)
Sarah Joiner (Service User Representative)
Richard Parnell (Research and Policy Consultant)
Jonathan Franchi (Service User Representative)
Christa Wright (Independent Occupational Therapist)
Deborah Pipe (Service User Representative)
Henry Collier (Service User Representative)

Funding source

Research Initiative for Long Term Neurological Conditions

Project funding

(£): £191,690

Project Duration (months)

Start: 1 March 2009
Duration: 24 months


Plan of Investigation

The study will employ a combination of quantitative and qualitative methodology and will take place in three distinct stages.

The first two phases will include developing and using a questionnaire that will:

  • Identify VR services for people with LTNC.
  • Explore current practice, identifying well established and emerging services.
  • Identify differences between general and specialist VR services.
  • Probe perceptions about resources, barriers and facilitators.

The final phase will:

  • Elicit, through qualitative interviews, barriers and facilitators to developing specialist vocational rehabilitation services within the NHS.
  • Identify from the mapping exemplars of good practice and report these.
  • Use the information gained to develop communities of practice so that explicit ‘insider knowledge’ about what makes VR services effective and why can be shared and teams who might work synergistically can contact each other.


The study will result in:

  • A guide to English vocational rehabilitation services to include:
    • A map of all services identified.
    • A guide to establishing vocational rehabilitation services for both commissioners and providers.
    • Exemplars of good practice.
  • Support for partnership development with the potential to set up communities of vocational rehabilitation providers.
  • Baseline account of current vocational rehabilitation services and questionnaire that can be used to monitor development of VR services., for example to identify where changes in policy or practice have made an impact.

Public Outputs


  • Playford ED, Radford K, Burton C, Gibson A, Jellie B, Sweetland J, Watkins C. Mapping Vocational Rehabilitation Services for people with Long term neurological conditions: Summary report. Department of Health. March 2011.

Abstracts (including abstracts presented as posters or oral presentations)

  • Radford KA, Grant MI, Terry J, Marr L, Brain N. Developing Stroke Specific Vocational Rehabilitation: Mapping Current Service Provision. International Journal of Stroke. (in press). [Oral presentation at 6th UK Stroke Forum Conference, 29 November-1 December 2011, Glasgow, UK].
  • Gibson AM, Radford KA, Playford DE, Burton C, Sweetland J, Phillips J, Watkins CL. Mapping Vocational Rehabilitation Services for people with Long Term Neurological Conditions: A Questionnaire Survey. Clinical Rehabilitation (in press). [Oral presentation at SRR 2010 Summer Conference, 7-8 July 2010, Sheffield, UK].

Posters (no abstract) / Presentations / Invited talks

  • Radford KA. Informing the development of stroke specialist vocational rehabilitation: an interview and observational study. Community Therapists Network, Royal Derby Hospitals NHS Trust, 11 October 2011, UK. [Oral presentation].
  • Radford KA. Changing practice by design: researching vocational rehabilitation: an OT perspective. College of Occupational Therapists Specialist Section Work, 16 September 2011 Jury’s Inn, Sheffield, UK. [Keynote Lecture].
  • Radford KA. Vocational Rehabilitation. Welsh Stroke Conference, 17 June 2011, Wales, UK. [Oral presentation].
  • Radford K. Return to work after stroke. NIHR CLAHRC- NDL Conference, Trent Vineyard, 21 September 2010. [Oral presentation].

Website links / Publications

  • Dyck I. Hidden geographies: the changing lifeworlds of women with multiple sclerosis. Soc Sci Med 1995; 40(3):307-320.
  • Catanzaro M, Weinert C. Economic status of families living with multiple sclerosis. Int J Rehabil Res 1992; 15(3):209-218.
  • Aronson KJ. Quality of life among persons with multiple sclerosis and their caregivers. Neurology 1997; 48(1):74-80.
  • Waddell G, Burton A. Is Work Good for Your Health and Well-Being? 2006. Department of Work and Pensions.