Patients recovering from a heart attack are being offered personalised, one-to-one occupational therapy on the NHS to help them get back to work more quickly.
The pilot scheme in Yorkshire could be rolled out across the country as part of the government’s plans to cut the number of sick notes – or “fit notes” – and reduce the spiralling benefits bill.
The rehabilitation programme offers patients tailored support to help them go back to work, including advice on managing fatigue and sleep, and phased returns.
Health Secretary Wes Streeting said it was “not good enough” that millions of people were being given fit notes to stay off work without any real support to get them back into employment.
He said the scheme, the Mid Yorkshire Cardiac Rehabilitation Service, went beyond just managing people’s conditions and was “helping people rebuild their lives after a heart attack”.
Under the service, patients recovering from a heart attack or cardiac procedure – and who want to return to work – are offered personalised occupational therapy as part of their traditional NHS rehabilitation.
Typical ‘cardiac rehab’ programmes are an important part of recovery and already involve exercise and healthy eating advice, educational talks about living with a heart condition, and guidance on taking medicines and managing stress and anxiety.
Since the pilot scheme was launched in April 2025, 33 people recovering from heart attacks or cardiac surgery have received specialist vocational rehabilitation, while 20 of those have successfully returned to work.
The service, which covers Wakefield District and North Kirklees, aims to support at least 75 patients over one year.
Patients are offered one-to-one rehabilitation sessions and the scheme provides advice about managing their health during a return to work, and for their employer.
Individuals are given flexible, personalised occupational therapy through home visits, telephone appointments and virtual consultations. The scheme also provides guidance about staggered returns to work, and dedicated health reports.
Occupational therapists work closely with cardiac nurses and therapists to offer holistic care.
Of the 11 million fit notes issued by GPs in England last year, 93 per cent declared patients “not fit for work” without any constructive alternative to help them back into employment.
The recent Keep Britain Working Review by Sir Charlie Mayfield said fit notes were “not working as intended” because neither employees nor employers were getting the occupational health support needed to get workers back to the office.
Around 2.8m people in England are currently out of work due to health conditions, which ministers believe is a major drag on economic growth.
As part of plans to improve the system, the government is providing local areas with funding for pilot schemes to improve support for patients receiving a fit note, and to try to reduce pressure on GPs.
If no action is taken, forecasts show that 600,000 more people could be added to the economically inactive total by 2030, the government says.
Under the 10 year health plan launched by Streeting earlier this year, £45m of funding from the Department for Work and Pensions is being awarded to local NHS pilot schemes – like the Mid Yorkshire Rehab service – to give more support to patients who receive sick notes.
Streeting said: “For far too long, we’ve handed out fit notes that simply tell people they can’t work, without offering them any real support to get better and get back into employment. That’s not good enough.”
He said supporting people to return to work is “as crucial to driving economic growth as it is to improving the health of our nation”.
Streeting added: “The Mid Yorkshire Cardiac Rehabilitation Service shows exactly the kind of proactive, joined-up approach we need.”
He said such schemes encouraged “better health outcomes, stronger financial security, and renewed independence” for each person supported back into work.
Sarah Jessop, the service’s clinical lead occupational therapist, said the scheme “supports people to rebuild confidence, manage energy levels and return to meaningful, sustainable work”.
She added: “Supporting someone to stay in or return to work isn’t an ‘extra’ – it’s part of rehabilitation. This service brings that principle to life every day.
“Many patients would previously have had no specialist support to return to work after a cardiac event.”
Flight attendant cleared for takeoff
Poul Sorensen has been undergoing one-to-one rehabilitation therapy after a heart disease diagnosisPoul Sorensen, a 60-year-old flight attendant, has been signed off work sick since May after an advanced heart disease diagnosis.
But after undergoing three angioplasties with stents inserted to widen his arteries and receiving support from the rehabilitation scheme, he is preparing to return to his job in the new year.
He said: “Getting back to work has been a bit of a struggle, really – because it’s cardiac and we spend lots of time over water and not land, obviously, I’m worried that something might happen.”
“Part of this process has been to build my confidence up. I’ve been going to cardiac rehab gym sessions twice a week, and Katie [my cardiac occupational therapist] has been in constant touch with me to find out what my progress is.
“I had an appointment with the cardiologist yesterday, and he’s absolutely over the moon with my progress. And my fit note runs out on New Year’s Eve and he’s not giving me a new one.
“I think probably the biggest [impact] is the financial impact,” Sorensen said. “But also, it was probably about six weeks ago starting to affect my mental health a bit because I wasn’t involved in anything… I was just sitting at home.”
“The whole of that cardiology team have been amazing, and I’ve been able to phone up and speak to people. They phone me and check in on me. And it’s just nice knowing that there’s like a lifeline, really, so if things get really tough, there’s somebody out there that I can reach out to.”
One patient, recovering from a heart attack, needed support to return to his role managing a large office block.
Following a referral in August 2025, his occupational therapist carried out a detailed assessment, identifying barriers, work demands and possible adjustments.
This included a structured phased-return plan, which helped him build his confidence and stamina. By October 2025, he was back to full-time hours, managing well at home and at work and was discharged from the service.
As the support is tailored to each patient, their time spent with the service can vary.
Jeremy Gee, West Yorkshire Rehabilitation Lead, said: “For some, this may require a one-off discussion whilst for an office manager, who was referred in August 2025 following a heart attack, three months of personalised support considering the person, their health and their work was required for them to return to work feeling confident and empowered to do so.”
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