Practice Pointer: Work and vocational rehabilitation for people living with long covid, 2024, O’Connor, Raynor et al.

SNT Gatchaman

SNT Gatchaman

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Work and vocational rehabilitation for people living with long covid
Rory J O’Connor; Amy Parkin; Ghazala Mir; Jordan Mullard; Sareeta Baley; Jenny Ceolta-Smith; Clare Rayner

What you need to know

• Support patients to assess their current abilities at work compared with what they could do previously; they don’t need to be 100% well to start the process of returning to work

• Going back to work too early after acute illness may be counterproductive; patients should not make hasty decisions around resignation or retirement in the early stages

• Use the fit note to help someone return to work, emphasising the need for flexibility to accommodate day-to-day fluctuations

Link | PDF (BMJ) [Open Access]
 
"Many people living with long covid are attempting to return to work, or stay in work, while learning to manage an emerging long term condition.2 These challenges may be compounded by workplace burnout, fuelled by labour shortages, the psychological effects of the pandemic, widening inequalities, and global economic insecurity."

Hmmm
 
I’ve never heard of anyone making a

hasty decision

about resigning or retirement due to ME and doubt it’s any different with LC.

More likely feeling pressure to return quickly due to financial situation needing to keep up with rent payments.

also pressure will come from managers. Many employers these days operate pretty strict absence management rules that line managers have very little discretion over especially for people in less well paid jobs. The employer can dismiss on grounds of ill health if the person can’t do the job. I believe if people have short contracts, agency work the protection is even more limited.

if going back too early is counterproductive in bullet 2 how does that fit with not needing to be 100% in bullet 1 - unhelpful mixed messages


Eta I didn’t decide to retire until 27 months after diagnosis all of that time I had been trying to work part time and still had a lot of sick absences. The last time I tried to go back after a couple of months off and only lasted 2 weeks. If I didn’t get ill health retirement approved I would have been dismissed. I will never know if taking the maximum permitted paid/part paid long term sick absence of 12 months in one block would have produced a better outcome because all HR policies and attitudes by medics is around getting back to work ASAP.
 
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I feel compelled every once in a while to restate obvious things that I’d become sick of repeating, to dust them off for another outing. So here goes…

WTF.
WTF.
WTF!?

A government doesn’t have to ensure that each member of the population catches COVID-19 once a month and eventually ends up with brain damage and heart failure or at least a small stroke or a few blood clots.

Nor to force these now sickly members of society to go back to work anyway. A government could just not do that.

Could try to keep people healthy instead, if only so that they are healthy enough to keep working and help out this ‘economy’ fellow I’ve been hearing so much about.
 
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The paper said:
"Many people living with long covid are attempting to return to work, or stay in work, while learning to manage an emerging long term condition.2 These challenges may be compounded by workplace burnout, fuelled by labour shortages, the psychological effects of the pandemic, widening inequalities, and global economic insecurity."

Hmmm
Click to expand...
Those sure are real problems. They just have nothing to do with this problem. Except labour shortages, which are in large part this problem, but they don't see it. It's actually kind of funny that they mix in unrelated problems with the clear wink-and-nod that they are similar (LC is basically burnout, wink, wink), but also include a consequence of the main problem being discussed, unaware that it's a consequence of it.

This was written with pwLC and it shows, but it adds up to a sort of compromise between the patients who get it, and the health care professionals who add, well, nothing. Other than the usual weird stuff that hints at psychological problems.

It's also largely ignorant of the reality of work. Not everyone can ask for accommodations from an employer. I was self-employed when I got ill, so all the clinic could do was sign me a work note, which I was, what, supposed to hand to myself? This basically takes an average of averages and simply ignores that there are common exceptions. There is discussion of this, but it really assumes that government schemes work, and of course it's fully UK-centric and simply fails in most of the world, which doesn't have any protections for disability at all.

As they recognize, most of the advice comes from the patient community. Professionals have really not added anything to it. This should not be acceptable.

In collaborations between patients with lived experience and HCPs, you usually find that the only useful contributions come from the patients. Here again.

Or maybe it's just the nature and perspective of how they're trained that makes a solid understanding come off otherwise, it wouldn't be the first time. So a problem with how the profession uses language that removes meaning and understanding.
 
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