This activity is part of Healthy Working Life, a joint programme of the West Yorkshire Combined Authority and NHS West Yorkshire Integrated Care Board.
Overview
West Yorkshire is setting an example in how integrated rehabilitation can transform lives, reduce health inequalities and boost economic participation. Following the success of a pioneering Stroke Vocational Rehabilitation Service pilot, we are now scaling up our approach - embedding vocational rehab into stroke, cardiac and pulmonary pathways as part of the Healthy Working Life programme.
Why this matters?
Currently, 30% of people out of work across the country for health reasons have a heart or circulatory condition. People with heart disease are more likely to leave work than those with cancer or mental health conditions. Chronic obstructive pulmonary disease (COPD) alone has forced an estimated 420,000 people in the UK to stop working early. Stroke survivors face similar challenges - one in four are of working age, yet many can’t return to work as they can’t always access the rehab they need.
West Yorkshire is tackling this head on.
A groundbreaking stroke rehab pilot
Launched in April 2024, West Yorkshire Integrated Care Board colleagues working in Airedale, in collaboration with the Integrated Stroke Delivery Network, delivered the Stroke Vocational Rehabilitation Service across Airedale, Bradford, Craven and Wharfedale in partnership with SkillsHouse (Bradford Council). The service supported stroke and subarachnoid haemorrhage (SAH) survivors to return to, remain in or end work well - addressing challenges such as fatigue, cognitive impairment, communication difficulties and anxiety.
These symptoms were limiting access to work and daily life. The pilot offered a flexible, therapy-led model combining virtual delivery with in-person support.
Patients accessed:
- 1:1 and group-based rehab
- fatigue and cognitive management sessions
- allied health professions (AHP) reports and Statements of Fitness for Work - commonly known as the MED3 form or fit notes
- employer engagement and advocacy
- carer education and Personal Independence Payment (PIP) support
Real impact, real lives
The results were compelling:
- 76% of patients improved their work or job prospects
- 57% remained in their original job
- 26% returned to work after sick leave
- 7% started new employment or volunteering
- 12% were supported to end work well
Patients described the service as “life-changing,” with many crediting it for helping them rebuild confidence, manage symptoms and navigate difficult conversations with employers.
"The dedicated specialist support that I have got from rehabilitation team was not only instrumental, but critical in my return to work,” - stroke rehab patient
"I don't think I would be the same person I am today without the service. I am more upbeat, positive and assertive. The future looks better, I'm truly grateful physically and mentally," - stroke rehab patient
Pam’s story
Pam, 57, was working four days a week as an assistant accountant when she experienced a stroke. She was left with mild word-finding difficulties and fatigue. Although she could move around independently, she lacked confidence outdoors. Before her stroke, Pam had found her job stressful and wasn’t sure she wanted to return to work.
Pam joined a fatigue group and received one-to-one support focused on returning to work. She was given a personalised AHP report and a phased return-to-work plan, supported by a MED-3 fit note. With regular check-ins from the team, Pam returned to work over eight weeks.
When a difficult appraisal left her feeling unfairly treated, we helped her contact her union and request an occupational health review. She later reconnected with us through the patient initiated follow up (PIFU) system for short-term support in increasing her work duties and returning to driving.
Pam is now back to her previous hours and gradually taking on full responsibilities. She’s gained confidence in managing her symptoms and setting healthy boundaries at work.
Angela’s story
Angela, 49, was working as a GP and medical examiner when a serious accident left her with a bilateral subarachnoid haemorrhage and fractured skull. She experienced brain fog, slower thinking, fatigue, anxiety and low mood.
Determined to return to work, Angela joined a virtual fatigue group but found the format difficult to engage with and felt uncomfortable socialising online. Concerned about being recognised by patients and already familiar with much of the content, she chose to leave the course.
The team quickly adapted, offering a full cognitive assessment followed by a 1:1 session to create a personalised recovery plan. Together, they focused on pacing, cognitive exercises and managing fatigue. She received tailored worksheets and support throughout.
A phased return plan was developed for one role, which she resumed successfully. The team then created a second plan for her other role, checking in regularly to ensure progress. Angela’s demanding job meant she sometimes needed last-minute changes. The team stayed flexible, offering timely support and helping her manage stress while protecting her wellbeing at work.
Thanks to this personalised, responsive approach, Angela returned to both roles safely and confidently - avoiding burnout and gaining tools to advocate for her needs.
What’s next?
The focus will now be on cardiac, pulmonary and stroke rehab, where services already exist and can grow quickly. The goal is for a fairer, more joined-up rehab offer that helps more people recover, stay in work and live a healthy life.
Three key priorities are driving the scale-up:
1. A universal vocational rehab offer
We’re training cardiac, stroke and pulmonary teams in all five areas of West Yorkshire to provide basic level 1 vocational rehab. Patients will also have access to resources - videos, translated materials, British Sign Language (BSL) content and printed guides - to help them manage recovery and work.
2. Stronger, more consistent local rehab
We’re expanding local rehab services, rolling out more six-month stroke reviews and protecting vital support like speech and language therapy. This means fairer access for everyone, wherever they live.
3. Returning to work and staying in work
We’re building expertise in our workforce, focusing on prevention for working-age people and creating 
clear, supported return-to-work pathways within rehab services.
Rehabilitation Lead Jez Gee said: “This is about more than recovery. It’s about opportunity.
“By helping more people recover fully, we’re increasing healthy life years. Better access to rehab and peer support reduces isolation and mental strain. Local and digital delivery models cut travel and carbon impact. And crucially, keeping people in work boosts resilience and productivity.
“West Yorkshire is showing the country how rehabilitation can drive both better health and economic growth and proving that integrated rehab doesn’t just help people heal - it helps communities thrive.”
This project is part of Healthy Working Life - reducing the number of people in West Yorkshire who may become unable to work because of ill health. Find out more on our Healthy Working Life website pages.
You can also view the stroke rehab pilot drives transformation across West Yorkshire case study as a pdf file.