This study set out to explore the experiences of adults receiving treatment in outpatient hand therapy and physiotherapy services in the United Kingdom (UK), specifically in relation to remaining in or returning to work. Motivation for the study included the 2022 UK legislative change that enabled occupational therapists and physiotherapists to issue formal sickness certification (Fit Notes).
Methods
Semi-structured 1:1 qualitative interviews were completed between 2022–2023 at two public hospitals with local ethics approval. Questions examined the impact of the injury/condition on work participation, advice received, and recommendations for supporting future patients. Interview transcripts were analysed using reflective thematic analysis.
Results
Twenty-three interviews were conducted (12 male, age range 24–72 years). Four themes were developed in relation to remaining in or returning to work: (1) individual experience; (2) workplace support; (3) healthcare support; and (4) provision of return-to-work advice and Fit Notes. Themes captured variation in needs depending on condition, employment type, and workplace support. There were strong expectations for therapists to provide work-related guidance.
Discussion
Being in employment was highly valued by participants for purpose and well-being. Participants placed high trust in therapists’ expertise and considered them well suited to provide return-to-work advice and Fit Notes. Clear, written, condition-specific guidance with realistic timeframes was strongly desired to aid communication with employers. Meeting these needs may improve patient confidence and facilitate sustained work participation.
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