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Background CR is a cornerstone of secondary prevention following cardiac events, with return-to-work (RTW) a goal for many patients. 1 With increasing pressure from government initiatives, (e.g., Restart Scheme, Universal Credit reductions by the Department for Work and Pensions), timely and supported RTW is crucial. Evidence suggests the development of vocational rehabilitation strategies that target both socio-occupational reintegration and employment maintenance.2 Aim Evaluate the effectiveness of an embedded VR pathway within a UK CR service, specifically focusing on employment, RTW outcomes, patient-reported confidence and navigation of welfare-to-work policiesMethods A prospective cohort of working-age patient in CR highlighted employment concerns at their first assessment, were referred to our CR VR service, February - May 2025. Intervention included person centred assessments using the Work ability Support Scale (WSS), measuring patient’s ability to work and used to support RTW planning, psychosocial needs, employer communication, benefits and signposting. An Allied Health Professional Health (AHP) and Work Report, summarising the assessment was completed at patient request.Pre and post-intervention outcomes included patient-reported WSS scores and RTW status. A Wilcoxon Signed Rank test was performed.Results 37 patients referred, occupational status in table 1. 4(10.8%) did not respond. Age, mean(SD) =54.6(7.8), gender, male =28(75.7%), ethnicity, white British 27(73.0%). 33(89.2%) engaged, 27(81.8%) completed WSS, 29(88.0%) completed a structured work questionnaire (WQ), 25(75.8%) AHP reports written.Follow-up to date, 20(60.1%) of patients had RTW (full or modified duties). Work functioning improved significantly, with median WSS scores increasing from, md 98.5(IQR=22.00, n=27) pre-intervention to md 109.5(IQR=9.5, n=20) post-intervention (Z= -3.73, P<0.05), with a larger effect size (r=0.83).Abstract P20 Table 1Occupational status on referral to CR service Employment Status (n=37) No. Participants Percentage (%) Employed full time 19 51.4 Employed part time 8 21.6 Self employed full time 3 8.1 Self-employed part time 3 8.1 Unemployed 4 10.8 Conclusion Findings support the inclusion of VR within CR programmes highlight the need for further development in this field to optimise long-term occupational outcomes.Our interventions could be scaled nationally to ensure equitable, health-led employment support. Further research should explore scalability and cost-effectiveness.References BACPR (2023) The BACPR Standards and Core Components for. Available at: https://www.cardiacrehabilitation.org.uk/site/docs/BACPR-Standards-and-Core-Components-2023.pdf.Soulaidopoulos S, Tsioufis KP. Return to work: the challenge of cardiac rehabilitation in the modern era. European Journal of Preventive Cardiology 2022;30(2):180–181. Available at: https://doi.org/10.1093/eurjpc/zwac289.