Case 11: Recovery from heart attack


The company is a European convenience food group focused on the added-value sector of the food industry, and in particular the growing market for convenience and prepared foods both in the UK and Continental Europe. The site is a Food manufacturing site employing around 650 individuals.


A 52 year old employee (a team leader in production) attended the company’s Occupational Health Department (OHD) displaying symptoms of a heart attack. He was taken to the local general hospital and tests revealed he had indeed suffered a heart attack and would require a coronary artery bypass graft. 

Company policy

The referral criteria of individuals to the occupational health function is as follows:

  • Sickness absence or 8 or more calendar days
  • Absence review as per trigger points for short term and long term sickness absence as per policy
  • On the day of an industrial injury, or as soon as possible
  • On the first day of absence if it is possibly work related
  • Should managers have concern regarding an employee’s fitness to work.


The case was monitored by the OHD. The employee was discharged from hospital after 2 weeks and placed on the waiting list for the surgery. After 3 months, following discussion with his medical team and the occupational health physician, he was considered fit to return to work on reduced hours until his surgery, with weekly reviews and monitoring.    

Return to work

The employee returned to work for 4 hours a day (20 hours per week) as agreed by the factory manager, it was considered necessary for him to remain on these reduced hours until he was next assessed by his medical team. At a subsequent review meeting is was discovered that his department (line) manager had informed him that he would be required to return to full-time hours to cover for holidays. The line manager was contacted and expressed an opinion that the gentleman was ‘milking’ his heart attack and was no use to him; the factory manager was updated on events. If the rehabilitation program could not be accommodated then the individual would need to be absent from work, due to the company’s duty to provide him with a safe place of work without detriment to his health.  The employee was moved to another area and a department manager who was more supportive.      

Rehabilitation team

OHD, consultant cardiothoracic surgeon, GP, factory manager, department manager and the employee concerned.

Continued progress

The employee underwent heart surgery and after 12 weeks of cardiac rehabilitation his medical team agreed it was appropriate to rehabilitate him back to work on graduated hours, and graduated physical activity. It was very difficult in the initial stages as, from his previous experience,  the employee had no confidence that the program would be adhered to. However, he did eventually return to work 4 months post-operative and within 3 months was on full-time hours and performing well.

Detriment to the business

  • Increase of total disability cost to the organization through increased long-term sickness due to anxiety caused by his line manager putting pressure on him to work outside the recommended rehabilitation plan
  • Returned to full duties with health status restored, however with increase in anxiety and concerns regarding returning to work
  • Without OHD and the involvement of the factory manager, this employee’s health might have suffered further, possibly resulting in long-term sickness absence.

The problems with this case were identified by teamwork highlighting issues requiring attention.  This gentleman suffered from undue anxiety during his rehabilitation program due to poor support from his line manager. Much more time and senior management involvement was required to resolve the issues satisfactorily. 

Benefits to the individual

  • Restored the individual to the highest possible level of activity as soon as possible after he was reassured that his rehabilitation would be supported.  

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Updated 2023-06-15