Title: FRESH - Facilitating Return to work through Early Specialist Health-based interventions
Funder: Department of Health (England)

Abstract: Vocational Rehabilitation is defined as ‘whatever helps someone with a health problem return to or remain in work’. It involves helping people find work; helping people who are in work but having difficulties; and supporting career progression in spite of illness or disability. Health based services supporting people with traumatic brain injury in returning to work are rare in the UK.This 3-year research project is a feasibility randomised control trial with a nested qualitative process evaluation across 3 NHS traumatic brain injury referral centres.The purpose of the study is to develop a treatment manual training package and mentoring model based on the Nottingham model of Early Specialist Traumatic Brain Injury Vocational Rehabilitation and to test the feasibility of delivering it and measuring its effects and costs in three new NHS sites in a multi-centre feasibility randomised control trial.The primary objectives of the feasibility study are:a)To determine whether an Early Specialist Traumatic Brain Injury vocational rehabilitation package (manual training and mentoring model) based on an existing NHS service in Nottingham can be developed and implemented in 3 different NHS regional traumatic brain injury referral centres with differing service configurations.b)To determine whether we can test the feasibility of delivering early specialist traumatic brain injury vocational rehabilitation (ESTVR) in these referral centres and of measuring its impact and cost effectiveness (compared to usual NHS care) on return to work (finding new work for those unable to return to an existing job) and job retention (return to work with an existing employer) in a multi-centre feasibility randomised control trial.c)To determine whether early specialist traumatic brain injury vocational rehabilitation can be delivered in a way that is acceptable to traumatic brain injury patients staff and employers when compared to usual NHS rehabilitation.d)To determine whether we can identify primary outcomes of an NHS early specialist traumatic brain injury vocational rehabilitation service important to service users NHS service providers and professionals. 102 participants across 3 NHS centres with a new traumatic brain injury admitted to hospital for = 48 hours over 16 years of age and working or in full time education at time of injury. Participants will be randomly allocated to intervention group or control group.Intervention group: early specialist vocational rehabilitation targeted at preventing job loss (up to 6 sessions) delivered by an occupational therapist supported by a traumatic brain injury case manager (up to 5 sessions) in addition to usual NHS careControl Group: usual NHS care onlyThe duration of treatment will be 12 months for both groups with questionnaires completed at baseline 3 months 6 months and 12 months.A nested qualitative study (interviews and focus groups) will investigate participants’ (service users and employers) and service providers’ (staff) beliefs about important outcomes following vocational rehabilitation their views of the acceptability and usefulness of the early specialist traumatic brain injury vocational rehabilitation package (manual package and mentoring system) and of the intervention. It will explore implementation barriers and perceived changes in practice resulting from training and the anticipated and actual effects (including costs) of implementation on supporting services.Findings will be used to inform a definitive multi-centre randomised control trial.


Research activity codes: 6.7 PHYSICAL
Health categories: INJURIES AND ACCIDENTS