What is it?
A stroke is a serious medical condition that occurs when the blood supply to a part of the brain is cut off. There are two main causes of stroke:
- Ischaemic – accounting for over 80% of all cases, where the blood supply to the brain is stopped due to a blood clot
- Haemorrhagic – where a weakened blood vessel supplying the brain bursts and causes brain damage
How is it treated?
A stroke is a medical emergency and prompt treatment is essential. The sooner that someone has treatment the less damage is likely to occur. The treatment will vary depending on the type of stroke.
Treatment following a stroke will aim to reduce the likelihood of the employee having a further stroke and other relevant treatments such as physiotherapy or speech therapy will help them to regain as much function as possible.
How does it affect people?
The immediate signs of a stroke are:
- Face : the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
- Arms : the person with a suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
- Speech : their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
The damage caused by a stroke can be widespread and long lasting. The effects of a stroke depend on which part of the brain has been affected and the extent of the damage. Many people will require a prolonged period of rehabilitation before they are able to regain their independence. The effects of a stroke vary, but can include:
- Weakness or paralysis of one side of the body
- Difficulty talking or understanding what other people are saying
- Problems with balance and co-ordination
How might it affect work?
Most employees are likely to have a long period of time absent from work while they have treatment to help them recover and to regain any loss of function following a stroke. Many people who have had a stroke are able to return to work, but their ability to return to full duties will depend on the extent of any residual loss of function. It is likely that the employee who has had a stroke may require a prolonged return to work plan to enable them to get back to full duties, but this will be on a case-by-case basis. They may require permanent modifications to duties or redeployment in the long term. The symptoms vary from one individual to another. However, employees may experience difficulty with some or all of the following tasks:
- Problems with balance
- Driving
- Walking
- Lifting and handling
- Climbing stairs
- Communicating
- Performing fine movements
What do I need to do as the manager?
Discuss any problems with your employee specifically in respect of the tasks above and how they relate to work activities. Identify what tasks they can and cannot perform and the length of time that they can perform them. Where changes can be reasonably accommodated, you should consider modifying duties to enable the employee to return to or continue at work. Review the work with the employee at least weekly to identify if their capability has improved. Make sure that they are able to cope and where possible increase their workload in stages to help facilitate their return to full duties. If you have specific concerns a referral to OH for assessment should be considered.
Key points to consider when managing someone who has had a stroke
- Focus on support; helping them to return to work as soon as possible
- Recovery can be prolonged, and improvements may be slow. Employees may require a prolonged return to work plan; careful consideration should be given as to whether this can be reasonably accommodated
- Modified duties should be considered as a temporary measure
- Consideration should be given as to whether permanent modifications or redeployment is required if temporary modifications are unsuccessful
- In cases of absence of more than 4 weeks, or difficulty in returning to normal duties after 4 weeks of modified duties, refer to Occupational Health for advice
Points to remember
Fit notes
If an employee produces a fit note indicating that they require modified duties, discuss this with them and consider if the modification recommended can be reasonably accommodated.
Job tasks and risk assessments
Review the risk assessment for the employee’s job role and work tasks including the ability to drive safely where required. Take into consideration any temporary modification that may be required to accommodate their reduced ability to undertake certain tasks.
General guidance
If you require further information, refer to the general advice on managing attendance.
Further information
NHS: www.nhs.uk/Conditions/Stroke
Ref: WPW0131 this information was reviewed January 2025.
