Quality requirement 6: Vocational rehabilitation

People with LTNCs are to have access to appropriate vocational assessment, rehabilitation and ongoing support to enable them to find, regain and remain in work and access other occupational and education opportunities.

Easy and equitable access to vocational rehabilitation


Service responsive to changing, ongoing needs



Indicators of progress

Playford (2011) found pockets of excellence where developments often resulted from the interests and vision of an individual worker and were evidence-based and strategically recognised.
Most of the services identified were for people with sudden onset conditions, such as traumatic brain injury and stroke, and provided support to help people return to an existing job or find a new one.

Fitzpatrick et al (2010) and Bernard et al (2010) found that where these services were available they were frequently condition-specific (e.g. head injury or stroke) and often provided by voluntary organisations.

Inhibitors of progress

Both Playford (2011) and Bernard et al (2010) both found that vocational rehabilitation services tended to be generic, rather than specific to people with neurological conditions, although Playford also identified that 40% were condition-specific. Carpenter (2009) found that rehabilitation models associated with conditions like stroke or head injury did not meet the needs of young men with DMD.

In addition, Playford (2011) found evidence that training for staff delivering vocational rehabilitation (VR) was inadequate. Not all of the people delivering this service received regular training in VR. 30% of service providers had never received any training.
While the majority of services stated that they offered long-term follow up, most of the services identified had waiting lists of between 2 and 4 months, suggesting they were working to capacity and were unlikely to be able to respond in a crisis.

Bernard et al (2010) found that some areas had limited funding to provide/support day opportunity services that might provide vocational rehabilitation.

In Abbott and Carpenter’s study less than a quarter (23%) of the sample of young men with DMD had been in paid employment. Only a minority had received any formal support from services to help them to stay in work, specifically receiving an assessment of how their neurological condition affects work (20% of those who had worked), and smaller proportions receiving support for work from an occupational therapist, or receiving specific guidance about staying in work or restarting work.


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