The government's framework for vocational rehabilitation has not been widely welcomed, mainly because it doesn't go far enough. Helen Groom reports

' The announcement last week of the government's framework for vocational rehabilitation met with mixed response.Government efforts to understand and provide a best practice guide to the provision of rehabilitation were welcomed as a move in the right direction. But the reaction from employers and from rehabilitation providers themselves was that the document did not go far enough.Launching the framework, Minister for Work Jane Kennedy said the document was an "important first step towards a new approach", and set out the reasons why the best practice guide could not yet be developed.The government's argument is that much of the current research on rehabilitation from the UK was from small-scale rehabilitation services, making it difficult to draw general conclusions from the results.And while there have been large scale studies on rehabilitation abroad, the government said the results could not necessarily be transferable to the UK with its unique insurance industry and the NHS.But this point has been fiercely contested by rehabilitation provider IPRS. Chief executive David Bingham said: "We are not the first people in the world to use rehabilitation, so why do we have to do more pilots to tell us what we already know?"Best practice can be taken from around the world."But moving on from reaction to the framework, what else is the government doing about rehabilitation and getting people back to work?At the same time as the rehabilitation framework was announced, the Heath & Safety Executive (HSE) produced a best practice guide for managing sickness absence at work. Six key principles were identified, including recording and analysing sickness absence, keeping in contact with the sick employee, and agreeing and reviewing a return to work plan.The Department for Work and Pensions is also to send out a second online distance learning module to GPs, covering health and work issues. And the HSE will produce a prototype sickness absence recording software tool, aimed primarily at small and medium sized enterprises to help them record, analyse and manage sickness absence.Kennedy said efforts are continuing across government to reduce sickness absence and claims costs, including looking at the recommendations of the Better Regulation Task Force, and setting up rehabilitation pilot schemes."We're moving down the route [towards a best practice guide], but we're not yet in the position to say 'this is the new structure that will work for the insurance industry'," said Kennedy.

What the framework actually says:

  • DWP will set up a vocational rehabilitation steering group to help stakeholders play an active part in the future development of any new approach to vocational rehabilitation, and to help manage the delivery of the framework
  • A research working group will be set up to identify, and agree action to deliver, research priorities
  • The vocational rehabilitation steering group will be asked to set up a standards and accreditation working group to consider how best to increase standards and to consider the case for the accreditation of vocational rehabilitation providers.
  • What is vocational rehabilitation?Following the initial consultation, the Department for Work and Pensions (DWP) came up with the following definition:Vocational rehabilitation is a process to overcome the barriers an individual faces when accessing, remaining or returning to work following injury, illness or impairment. This process includes the procedures in place to support the individual and/or employer or others (such as family and carers), including help to access vocational rehabilitation and to practically manage the delivery of vocational rehabilitation.In addition, vocational rehabilitation includes the wide range of interventions to help individuals with a health condition and/or impairment overcome barriers to work and so remain in, return to or access employment. These interventions include; an assessment of needs; re-training and capacity building; return to work management by employers; reasonable adjustments and control measures; disability awareness; condition management; and medical treatment.