Developing vocational rehabilitation services for people with long-term neurological conditions : identifying facilitators and barriers to service provision

Purpose: This study aimed to understand existing vocational rehabilitation (VR) service provision in one locality in London (population 3.74 million), identify any gaps and explore reasons for this, to support service development. Method: Using Soft Systems Methodology to guide the research process, semi - structured interviews were completed with nine participants, who were clinicians and managers providing VR within NHS services. Data were analysed thematically to build a ‘rich picture’ and develop a conceptual model of VR service delivery. Findings were then ratified with participants at an engagement event. Results: The findings indicate a spectrum of VR service provision for long - term neurological conditions with differing levels of funding in place. VR often takes place ‘under the radar’ and therefore the true VR needs of this population, and the extent of service provision is not known. There is inconsistency of understanding across the services as to what constitutes VR and outcomes are not routinely measured. Conclusion: For VR services to develop they require appropriate funding, driven by Government policy to commissioners. Clear definitions of VR, collecting and sharing outcome data and effective communication across services are needed at a local level. This is expressed in a conceptual model of VR service delivery