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New trial to test ‘return to work’ rehab programme after traumatic injury

Friday, 24 May 2019

Trauma survivors are to play a major role in helping to develop and trial a new rehabilitation programme that will help people who have suffered a serious injury to return to work.

The six-year, £2.4 million project is being funded by the National Institute for Health Research (NIHR) and led by researchers at the University of Nottingham and clinicians at the East Midlands Major Trauma Centre at Nottingham University Hospitals NHS Trust.

Moderate or severe traumatic injuries - often caused by road accidents, falls, sporting injuries or assaults - can be life-threatening and life-changing. Thankfully, more patients who are affected by these common injuries are surviving, thanks to improved specialist care offered by hospital major trauma centres.

However, many will be left with long-term physical, psychological and financial problems and one year on from their initial injury up to one-third of patients will still not have returned to work.

The project is being led by Denise Kendrick, Professor of Primary Care Research in the university’s School of Medicine, and Dr Kate Radford, Associate Professor in the university’s Division of Rehabilitation, Ageing and Wellbeing.

We know that being in work is good for physical and psychological health but, despite the advances in care offered by major trauma centres, rehabilitation and help for injured people to return to work remains patchy and poorly developed.
Professor Denise Kendrick

The project will involve clinicians from the East Midlands Major Trauma Centre based at NUH’s Queen’s Medical Centre, which has among the highest survival rates in the country. It also brings together a multidisciplinary team from the Clinical Trials Research Unit at the University of Leeds, Nottingham Trent University, Queen Mary University London, and four other major trauma centres across England: Addenbrooke’s Hospital, Cambridge; Leeds General Infirmary; Southmead Hospital, Bristol and The Royal London Hospital.

The research team will be working with patients affected by traumatic injury, NHS service providers and clinical commissioners to develop a rehabilitation programme called ROWTATE that will meet the needs of patients and can be realistically supported and delivered by the NHS.

The personalised rehabilitation will be put through its paces by a small group of trauma survivors at two major trauma centres to troubleshoot any design issues and potential problems with delivery before being rolled out in a larger scale trial with around 700 patients at five major trauma centres across England.

The trial will measure how many injured people who receive ROWTATE have returned to work 12 months later and compare this to people who have not had access to the new rehabilitation.

The project will also assess the potential impact it has on patients’ physical, psychological and financial problems to find out whether the new programme could reduce the burden on the NHS and wider society and save more money than it costs to provide.

Personalised support through vocational rehabilitation can help patients with some conditions such as back pain, spinal cord or brain injuries and mental health problems, to stay in or return to work and we have already developed a successful programme for people with brain injuries. As trauma includes many different types of injuries which result in an array of work-related problems, our next step is to adapt that programme to cover these and test how well it works.
Professor Denise Kendrick

The study will take an innovative approach, involving a group of trauma survivors at every step of the research, from helping in its design and undertaking some aspects of the research to contributing to the analysis of the findings, writing reports for publications and advising on how the results are communicated to the public.

Trevor Jones sustained a serious brain injury in January 2004 after being involved in a collision with a car while out cycling. He was placed in an induced coma for two weeks and doctors believed he was fortunate to have survived. After coming out of hospital he was paralysed down his right side and he had to relearn many motor skills including walking, writing and typing. As a result, it took him almost a year to return to full-time work in his job as an accountant.

During this time he was fortunate enough to receive the support of a specialist return to work support service which was the original model for the programme to be tested in the ROWTATE study.

He believes that had he not received the specialist rehabilitation support he would have attempted to go back to work too early and since his retirement in 2009 he has become involved with patient public involvement (PPI), volunteering much of his time as a patient representative on research studies.

I was really helped by the return-to-work service and the occupational therapist who advised me and my employer on what was realistic, what kind of skills I would have to re-learn and making a phased return to work.
Trevor Jones, Trauma Survivor

The research team are hoping that the results of the study will help to inform policy makers, NHS providers and commissioners, employers, charities and patient organisations about the future development of rehabilitation programmes aimed at aiding trauma patients’ return to work.

I’m very conscious that I was fortunate the service was available in Nottingham but is not in many other parts of country. I am quite passionate that the service I benefitted from should be available for other injury types, no matter where you live. The ROWTATE study is designed to show that we can train people in other areas to offer that service and that it works, it helps people get back to work and I really think that’s very worthwhile.
Trevor Jones

Story credits

More information is available from Prof Denise Kendrick in the School of Medicine, University of Nottingham on +44 (0)115 846 6914, denise.kendrick@nottingham.ac.uk

Emma Thorne - Head of News
Email: emma.thorne@nottingham.ac.uk
Phone: 0115 748 4734
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