One thing bothered me for years in my occupational health (OH) practice. It’s how we spend a lot of time assessing, advising and supporting employees who are absent from work for health reasons. We talk about their condition, how they’re feeling, what their job involves, what they can realistically manage, and what they can’t. Then write a report recommending a safe and sensible return-to-work plan which can include:
- A phased return.
- Temporary adjustments.
- Regular review meetings with the manager.
The report goes off to the employer.
And then… we never know what happened.
- Did the plan work?
- Did the manager hold the review meetings?
- Did the employee return as predicted?
- Did the process take longer than expected?
- Or did everything unravel once real workplace pressures took over?
It’s a strange gap in a profession that prides itself on being evidence-based.
The curious absence of feedback
In many OH services, sickness absence and return-to-work planning make up a large (and lucrative) part of the clinical workload. Some ask managers about OH practice but there is little structured investigation into how the recommendations were implemented. The feedback loop is largely random. We rarely collect structured information about whether our recommendations were implemented or whether they helped people successfully return to work.
That’s a pity, because return-to-work is not just a medical issue. It sits right at the intersection of health, management, psychology and workplace culture. If we never follow up outcomes, we don’t know what works and what doesn’t.
What research already tells us
Even though research in OH can be thin compared with other medical specialties, a number of studies give useful clues.
One consistent finding is how manager support plays a huge role in successful return-to-work outcomes. Studies examining workplace interventions and supervisory behaviour show that supportive managers and structured review meetings significantly improve the chances of a successful return (Franche et al., 2005; Van Hees et al., 2024).
Another theme that appears repeatedly in the literature is that return-to-work timelines are notoriously difficult to predict. Medical recovery does not automatically translate into work recovery. Personal motivation, workplace pressure, job design and organisational culture all influence how quickly someone returns to normal duties (Young et al., 2005; Mustard et al., 2025.)
A third finding is that employee involvement matters. Return-to-work programmes tend to work better when employees feel involved in planning their rehabilitation rather than simply being told what will happen (Franche et al., 2005.)
None of this will surprise experienced OH practitioners. Most of us see it in practice every day. Which means that much of OH practice in this area, relies heavily on professional experience and judgement rather than structured outcome data.
Closing the Loop
One way to improve this is to use a feedback form. At the end of a return-to-work programme, employees could be invited to complete a short anonymous questionnaire about their experience. Not to reassess their medical condition, and not to report on their employer, but help OH professionals understand what’s happening in practice.
Questions might include things like:
- Did the return-to-work plan reflect your capabilities at the time?
- Was the plan followed as recommended?
- Were review meetings held during your rehabilitation period?
- Did you return to work as expected, sooner, or later than predicted?
- Are you currently back at full duties, adjusted duties, or not working?
Over time, this type of feedback could reveal valuable patterns.
- Perhaps some recommendations are rarely implemented.
- Maybe some return-to-work schedules are consistently too ambitious.
- Perhaps manager support is the factor that makes the biggest difference.
- Maybe some OH practitioners have better results than others.
Without feedback, we don’t know.
A Step Toward Collecting Evidence
A feedback loop (a completed questionnaire) from employees could help close the gap. And I have constructed one for you to use, links below.
Responses should be anonymous and voluntary, and employees should know that their feedback will not be shared with employers or influence employment decisions. Online tools (I’ve used Google Forms) make it easy to collect this type of information without gathering identifiable details. The goal is not to monitor individuals, but to learn from patterns. Giving better insights into the realities of return-to-work programmes, strengthen the evidence base for OH practice, and help design recommendations that work better for both employees and employers. With a knock-on effect of demonstrating the value of an OH intervention.
Because the occupational health report should not be the end of the process but the beginning of learning what happened next.
Selected references
- Franche RL et al. (2005). Workplace-based return-to-work interventions: a systematic review. Journal of Occupational Rehabilitation.
- Young AE et al. (2005). A developmental conceptualisation of return to work. Journal of Occupational Rehabilitation.
- Van Hees S et al. (2024). Workplace interventions to strengthen supervisor support for employees with mental health problems. Scandinavian Journal of Work and Organizational Psychology.
- Mustard C et al. (2025). Return-to-work outcomes following treatment among workers with PTSD. Journal of Occupational Rehabilitation.
If you are interested in collecting data relating to return to work programmes, I have constructed a feedback questionnaire that fulfils the criteria of confidentiality and success or failure of a return to work programme. Find it here in Google Docs
Using This Questionnaire
This anonymous questionnaire has been designed to help hone your management referrals and specifically a return to work plan.
The aim: to understand whether return-to-work plans work in practice and learn how they be improved.
How the Questionnaire Works
The questionnaire asks employees about their experience of a return-to-work programme following OH advice. It focuses on practical questions such as whether the recommended plan was followed, whether review meetings took place, and whether the employee returned to work as expected.
No personal identifying information is collected because the form does not collect identifiable personal data and intended only for service evaluation or research purposes.
When to Send the Questionnaire
The questionnaire should be offered after the return-to-work programme has been completed, for example when:
- The phased return has finished
- Employee has returned to full duties
- When the rehabilitation is scheduled to end
Note: Do not send while the employee is still absence.
How to distribute
The link can be sent directly to the employee by the OH professional, for example in a follow-up email or as part of final OH correspondence.
Example wording:
“If you would like to help improve occupational health practice, you can provide anonymous feedback about your return-to-work experience using the short questionnaire below. Participation is entirely voluntary.”
Adapting the questionnaire
OH providers are welcome to copy and adapt the questionnaire for their own services. In Google Forms the questionnaire can be duplicated and modified to include organisational branding or additional service-specific questions.
The steps to adapt are as follows:
- Use this link to make your own copy of the questionnaire (you will need to have a google account.)
- Click on the three tiny dots (top right of questionnaire)
- Select ‘make a copy’
- Make your adaptations to the questionnaire and save it as your own for your own link (copy it.)
That way you can:
- edit the questions,
- add your company logo
- change the wording,
- add extra questions
- collect group results by connecting to your own spreadsheet.
The intention is not to create a fixed research tool, but to encourage OH teams to collect outcome feedback from employees.
Conclusion
Return-to-work planning is a major part of occupational health practice, yet practitioners rarely receive feedback about the outcomes of their recommendations.
This simple anonymous feedback loop could help build a stronger evidence base for occupational health and improve how return-to-work programmes are designed in the future.
Here is the link to send to the employee to fill in the feedback form: Employee Link
If you use or adapt my form I would be interested in how useful and helpful it has been for your practice. Reply via my substack account and/or join my mailing list there.
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