Stakeholder perceptions of supporting patients' return-to-work in primary care: a qualitative study.

Background: Over 2.6 million people in the UK are absent from work due to ill-health, yet, for many, accessing work-orientated vocational support to facilitate return-to-work (RTW) is challenging. The majority of fit notes are issued in primary care, making this an ideal setting to provide vocational support.

Aim: As part of the Work And Vocational advicE (WAVE) randomised controlled trial (RCT; registry number NCT04543097), we explored the delivery of vocational support by trained Vocational Support Workers (VSWs), from the perspectives of patients, VSWs, employers and general practitioners.

Design & Setting: In the WAVE RCT, patients from 10 UK general practices were randomised to the offer of usual care or usual care plus vocational support. This qualitative study explored stakeholder perspectives of the vocational support intervention.

Method: Semi-structured interviews with participants in the intervention arm (=10), employers, VSWs and GPs (=5). Interviews were audio-recorded, transcribed and analysed using thematic analysis. Public and Patient Involvement was embedded throughout.

Results: Taking a person-centred, individualised approach to vocational support enabled VSWs to identify and mitigate RTW obstacles and support participants' self-efficacy to proactively negotiate RTW. The perceived independence of the VSWs from employers and healthcare was considered important and facilitated more open discussions about capabilities and RTW planning.

Conclusion: Findings indicate that individualised and independent vocational support offered to patients referred from primary care was perceived by all stakeholders to be valuable to patients absent from work due to illness and supported their RTW planning. These insights can inform future models of vocational support.