Long COVID and work in the UK: challenges, support and perspectives

Long COVID (LC) presents significant challenges for working age individuals, leading to major inequalities in access to work, employment and relevant support. This study investigates the workplace support provided to people with Long COVID (PwLC) in the UK, focusing on their return-to-work (RTW) experiences. It encompasses perspectives from both PwLC and managers of PwLC.

Semi-structured interviews were conducted with 20 PwLC and two managers experienced in managing employees with LC. Inductive thematic analysis was performed using NVivo14.

This qualitative research explored barriers and facilitators to supporting PwLC's RTW. LC is characterised by a wide range of mostly "invisible" and fluctuating symptoms and unpredictable recovery trajectories during which relapses can occur. Existing support mechanisms for RTW with LC include phased return, reduced hours, Occupational Health services, work adjustments, and government support. However, the study identified challenges in implementing these measures, such as unrealistic phased return plans, managers neglecting advice or guidance (e.g. from Occupational Health), unsuitable work adjustments and the burden of navigating government support. The financial impact of reduced hours or sick leave was one of the main reasons for returning to work. Both PwLC and managers highlighted significant gaps in knowledge, resources, policy and guidance for RTW support, emphasising the need for tailored support. Managers reported limited resources and inflexible policies as main challenges, which they addressed through creative solutions.

This qualitative study highlights potential barriers, challenges and gaps in supporting PwLC's RTW. To ensure equitable access to work for PwLC, a flexible and personalised approach is crucial, given the variability in LC symptoms and recovery rates. RTW support that fails to accommodate these characteristics may exacerbate symptoms or cause relapses. A supportive work environment is essential, as LC symptoms can be invisible and concerns about stigma may prevent PwLC from communicating openly and seeking support. Lack of resources is a major barrier for managers in supporting PwLC. Effective government support can potentially fill this gap but must be well-designed and implemented to reduce the burden on applicants.