Organisational challenges in return to work (RTW)

When returning to work requires collaboration

Returning to work after a period of sickness absence can be a long and complex process. For individuals experiencing mental health issues or musculoskeletal pain, it is rarely just a matter of medical treatment. In this study, we investigate how organisational conditions within primary healthcare influence the return-to-work process following sickness absence due to mental health issues or musculoskeletal pain. Our focus is on collaboration between physicians and other professionals at primary healthcare centres, as well as between these centres, employers, and the Swedish Social Insurance Agency. Our research examines the impact of organisational processes, structures, leadership, professional roles, and collaborative practices on rehabilitation processes and the likelihood of a sustainable return to work. This project is based on qualitative and quantitative studies, and aims to develop knowledge of how collaboration can be organised to create more equitable, effective, and sustainable processes for people on sick leave.

What are we researching?

We are investigating how sickness absence management and return-to-work processes are organised within primary healthcare.

Among other things, we study:

•  how different organisational structures and collaborative approaches can facilitate sustainable returns to work
• how physicians, managers, psychologists, rehabilitation coordinators and other professionals collaborate within primary healthcare centres
• how collaboration functions between primary healthcare centres, employers and the Swedish Social Insurance Agency
• which organisational barriers and opportunities influence rehabilitation processes
• how leadership, routines and the distribution of responsibilities impact sickness absence management.

A focus on organisational solutions

Previous research has often focused on the individual, for example in relation to treatment, diagnosis or motivation. Here, we shift the focus to the organisation surrounding the individual.

We start from the assumption that returning to work is not only about a person’s health, but also how well different parties collaborate. When collaboration is ineffective, individuals risk falling between the gaps in different systems and having to coordinate their own rehabilitation.

The project therefore investigates how organisational processes and structures can be developed to provide better support for patients and professionals alike.

How is the research conducted?

The project is based on interviews, focus groups, surveys and register data.

We conduct studies with the following groups:

• physicians and other professionals within primary healthcare
• managers and employers
• representatives from the Swedish Social Insurance Agency
• people with experience of sickness absence and return to work

We will also develop and test collaboration and organisational support models within primary healthcare.

Why is this research important?

Long-term sickness absence has an impact on individuals’ health and on society as a whole. For many people, it involves financial insecurity, social isolation, and difficulties in returning to working life. At the same time, primary healthcare services, employers, and public authorities face significant challenges in coordinating rehabilitation and support.

By increasing knowledge about how collaboration functions in practice, the project can contribute to the following:

• more sustainable organisation of rehabilitation processes
• clearer responsibilities and a better working environment for professionals
• better support for people on sick leave
• reduced risk of long-term sickness absence
• more equitable return-to-work processes