University of Huddersfield
Occupational Health Advice Sheet for Managers
Rehabilitation Programs – Returning to Work
“Work is generally good for physical and mental health and well-being and can be therapeutic for people with
common health problems.” Waddell & Burton (2006)
In compiling this advice we referred to the literature as well as interviewing employees, personnel officers
and managers to find out what had been successful within the university setting.
“Recovery from common health problems is generally to be expected. Epidemiological studies show that:


prevalence rates are high among people of working age
most episodes settle uneventfully with or without formal health care (at least enough to return to
most normal activities, even if with some persistent or recurrent symptoms)

most people remain at work, and the large majority of those who
do take sickness absence manage to return to work quite
quickly (even if still with some symptoms) and only about 1% go
on to long-term disability and incapacity.”
Extracted from Waddell & Burton (2004)
There is a wealth of evidence supporting early return to work as being beneficial to the employee in terms of
significantly reduced likelihood of withdrawal from work and eventual discontinuation of employment (Black &
Frost 2011).
There are a number of variations to rehabilitation or phased return to work (RTW) programs. There is no
right and wrong strategy. They are designed for each individual case and can be adapted to suit the
business needs of the university as well as the continuing medical rehabilitation needs of the individual.
An early return to work can often have multiple benefits for both the employee and the organisation. It will
contribute to employee overall sense of wellbeing due to personal job satisfaction and social aspects which
would be missing in continued absence from the workplace. As a manager you should benefit from the
presence of your team member in a productive capacity even if in a cut down version of their role and hours
for a short period.
The purpose of RTW plans is to return the employee to work safely minimising risk of relapse. It needs to be
made clear to the employee that the RTW plan is about returning to 100% of the role and contracted hours
within a defined timescale (normally 4 – 6 weeks). Employees returning to work after a prolonged absence
(ill health including significant mental or physical health issues, career breaks, parental / maternity leave all
detailed on the HR website) will not always have the same level of physical and mental stamina as they had
prior to their absence. They can build up that stamina by re-entering work.
The number of hours and days initially possible is usually determined by the physical and mental demands
required of the day e.g. an academic member of staff returning to work in May is unlikely to be expected to
undertake any teaching duties at this time of year however an increment from catching up with emails and
administration tasks to marking examinations could be a gentle way back in before resuming teaching duties
in the next term.
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Attendance on campus can also be an important part of a socialisation process following long absences. If
the role requires a daily presence in the main workplace we would recommend that the information on
Mobility / transport, further on in this advice sheet, is considered.
Any adaptations that you agree with your member of staff should result in an impact on the impairment that
they have.
Fit notes
When a GP completes this section of a Fit note
you are supplied with advice for consideration.
The Management of Sickness Absence Policy
Section 9 provides the University position on Fit
notes.
Please remember that Fit notes are advisory and for the purposes of Statutory Sick Pay. An employee can
return to work at any time.
The end date on a Fit note is not necessarily prescriptive and Personnel or
Occupational Health can advise you about this. If the person has mobility problems they can still attend work
provided you have devised a Personal Evacuation Plan under Fire risk assessment Form E.
It should also be pointed out that GPs do not always appreciate the rigours of the work role – statements
such as “light duties” in relation to roles that require moving and handling weights and loads may need
clarification preferably from Occupational Health who can make an assessment of the individual against the
work role and help interpret the advice provided.
If “restricted duties” are suggested by a General Practitioner do not have to implement what has been written
but it is this is an issue that you as the manager may wish to consider and seek advice on from the HR team
and / or from Occupational Health.
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It is also helpful to consider whether the restrictions being suggested by a GP are relevant to the job role
being undertaken by the employee. Again, you may wish to ask for advice on this.
Examples of GP Fit note comments:
1. “Indefinite period of alternate duties” This is unlikely to be realistic for any role and as a manager you
are recommended to take advice from the HR team about this. If there is an associated health
related issue you may then be advised to seek an Occupational Health assessment.
2. “6 months phased return would be ideal”. The university normally expects employees to rehabilitate
to work over a 4 – 6 week period. Occupational Health can assess whether an underlying medical
condition has relevance to this comment in relation to the Management of Sickness Absence Policy
3. “Light duties for the next 3 months” was issued several months after recovery from routine
abdominal surgery when the employee had been back at work for several weeks. Job involved
moving and handling of equipment routinely throughout the day. The employee was referred and
assessed by Occupational Health. In the absence of any clear contraindication to moving and
handling activities the manager was advised that the person concerned was fit to undertake such
work and to ensure that the department risk assessment and moving and handling training
applicable to all team members be reviewed.
4. “Reduce the intensity / volume of work for 3 weeks”. It is up to you as the manager to decide
whether guidance like this can be accommodated within the needs of your service or school.
5. New fit notes from GP during rehabilitation to work which recommend on-going long term / new
adaptations – see 1. Above.
Graded reintroduction to work
If the absence has been prolonged and the individual has a significant loss of self-confidence or self esteem
you can consider having a meeting with the employee either on or off campus initially and then start to visit
their work location for brief spells before the actual start back date.
It is also helpful to agree with individuals what information will be provided to colleagues in relation to their
absence and how they wish to be treated on return to work.
Some people prefer not to have any
acknowledgement of their situation by colleagues or to be asked “how are you?” Others may feel upset if
they feel that they are being ignored. The same can apply to people who have had domestic problems or
bereavements.
Reduced hours per day
Why consider shorter hours per day
An employee, who has been on long term absence or absent with a physically or mentally debilitating illness,
may lose a significant degree of the physical and mental stamina that they would normally have during a
working week.
In this instance, offering reduced working hours per day can often allow an employee to return to work early
because they have more confidence that the shorter day is an achievable goal.
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In some cases, there can be a need to reduce the exposure to particular work demands with a gradual reintroduction of full duties and expectations. For various reasons, during the first period of a return to work,
setting a shorter day and thus a reduced expectation of performance can be useful provided both parties are
aware that this is a short term support measure. We would recommend that you take measures to manage
the employee’s expectations about this process carefully.
In the case of academic staff the spacing of work commitments will depend to some extent on the amount of
departmental cover available or timetabling of lecturing and other student contact sessions.
It is advisable to schedule end of working week meetings with the employee in order to ascertain what has
been managed and to agree what will be undertaken in the next week.
Employees may request to undertake all of the agreed hours in one block or over fewer days however this is
often unadvisable as will not ensure rest breaks in which to recover. We would usually recommend that a
plan involves a smooth graded and planned return if the individual is not ready to return in a full time
capacity. This strategy helps to prevent the over-confident from extending themselves too early.
Example return to work programme for a full time employee
Days
Hours
Demands
Week 1
3 – 4 encouraged to
split the days initially if
possible. Provided this
is achieved move on to
Week 2
3–4
Routine catch up work
Week 2
3 – 4 with days off
between days worked
Increment by 1 – 2
hours
Increment work
demands
Week 3
4 – 5 days
Same hours as week 2
unless employee feels
able to tolerate more
Increment work
demands
Week 4 - 6
If not already managing full days, hours and duties continue to increment to
full workload and working hours
Mobility / transport problems
For some employees who are returning from leave following a physical illness, there may be concerns
around travelling on public transport during peak hour times. This is often associated with:

fears of re-injury from the push and shove on and off transport,

inability or difficulty with negotiation of steps

lack of seating which may be required during travel due to physical instability, pain, discomfort or
low stamina

increased journey time during peak travel

anxiety provocation
If an employee is recovering from a condition which has resulted in reduced mobility Occupational Health can in
some cases arrange for short term Non Ambulant Parking closer to the main place of work than normal. This
may mean that an individual can commence a phased return to work sooner than would otherwise be
contemplated.
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If an individual has longer term mobility problems they will need to make alternative arrangements by applying
for a blue badge.
Alternatively Access to Work may be approached to provide temporary assistance with transport to work when
an individual cannot use normal public transport for various health reasons.
Display Screen Equipment (DSE) workers
If a returning employee regularly works on a computer and you are aware of a current physical component
affecting their attendance e.g. back, arm, hand or shoulder pain or impairment it would be advisable to seek
the help of your DSE assessor and / or Occupational Health in determining any DSE adaptations that could
assist a return to work. More DSE information to assist you in your role as a manager is here
Occupational Health holds a small stock of equipment and seating that can be loaned and trialled for short
periods whilst working out what best suits an individual’s needs.
People with broken wrists or legs often manage to return to work before a Plaster of Paris cast is removed.
People with conditions such as tendonitis or carpal tunnel syndrome are also likely to benefit from an early
Occupational Health assessment and ergonomic advice.
Further advice
If after using this guide you have any unanswered questions please feel free to contact the Occupational
Health team to discuss further.
There is also a wealth of other up to date information on the Health@Work section of our website – this
includes support groups, charities and other organisations where advice can be sought.
Further reading
Waddell G, Burton A Kim (2004) Concepts of Rehabilitation for the Management of Common Health
Problems (London TSO)
Black C & Frost D (2011) Health at Work – an independent review of sickness absence (London Stationery
Office)
Waddell G, Burton A Kim (2006) Is work good for your health and wellbeing
Heather Bearpark
Occupational Health Manager
2013
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