Implementing vocational rehabilitation for people with multiple sclerosis in the UK National Health Service: a mixed-methods feasibility study

To implement a job retention vocational rehabilitation (VR) intervention (MSVR) for people with multiple sclerosis (MS) and their employers in the UK National Health Service (NHS). Multicentre, single-arm feasibility study with post-intervention interviews. MSVR was delivered by an occupational therapist (OT). Feasibility was assessed by recruitment rates, compliance, and practicality of delivery. Acceptability was assessed with post-intervention interviews. A survey assessed change in eight vocational outcomes (e.g., vocational goals, work instability) immediately post-intervention and at 3-month follow-up. Recruitment and training an OT was challenging. Twenty participants with MS, three employers, and three healthcare professionals were recruited. All participants but one completed the intervention. Factors affecting intervention adherence included annual leave and family responsibilities. MSVR was associated with improved vocational goal attainment post-intervention (<i>t</i>(18) = 7.41, <i>p = &lt;</i>0.001) and at follow-up (<i>t</i>(17) = 6.01, <i>p = &lt;</i>0.001). There was no change to the remaining outcomes. Interviews identified six themes: intervention impact, accessibility of support, the OT’s role, readiness for support, workplace supportiveness, and barriers to NHS delivery. Challenges with recruitment, identifying newly diagnosed MS participants, and understanding the OT’s training needs to deliver the intervention were identified. The intervention demonstrated acceptability, but participants wanted it to continue for longer to address further needs. Successful implementation of vocational rehabilitation services for people with multiple sclerosis within healthcare services requires multiple environmental and pragmatic changes.Healthcare professionals should record employment status from diagnosis to monitor changes in employment over the disease course, highlighting changes in working hours, occupation type, and employment rates.Vocational rehabilitation has the potential to improve the confidence of people with MS around symptom management and feeling supported and empowered at work. Successful implementation of vocational rehabilitation services for people with multiple sclerosis within healthcare services requires multiple environmental and pragmatic changes. Healthcare professionals should record employment status from diagnosis to monitor changes in employment over the disease course, highlighting changes in working hours, occupation type, and employment rates. Vocational rehabilitation has the potential to improve the confidence of people with MS around symptom management and feeling supported and empowered at work.