The Scottish Government

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Section 3: Building on Best Practice

Introduction

3.1 In outlining a strategy for Healthy Working Lives, it is important to recognise that we are not starting from scratch. Scotland already benefits from high quality support and services designed to protect and improve the occupational health and safety of its workforce and encourage the creation of supportive environments. Whilst all of these services impact on individuals, many are designed to focus on the needs of specific groups. The challenge is to harness the range of skills and expertise in a more integrated way to enable a focused approach to improving the health of working-age people and enabling them to enjoy healthy lifestyles.

Existing Support Services

3.2 Employers and workers within Scotland have access to a range of services and initiatives designed to help improve and protect the health of workers. These include:

• The Health and Safety Commission (HSC) and the Health and Safety Executive (HSE) - who are responsible for the regulation of almost all the risks to health and safety arising from work activity in Great Britain. Their mission is to protect people's health and safety by ensuring risks in the changing workplace are properly controlled, providing advice, ensuring compliance, facilitating partnership working and preparing guidance on health and safety issues. The current HSC Strategy for Workplace Health in Great Britain to 2010 and beyond19 contains strong commitments to rising to the challenge of occupational health and safety through improved partnership and providing accessible advice and support. This builds on the work in Securing Health Together, a long-term occupational health strategy for England, Scotland and Wales. 20 The HSE shares enforcement responsibility for health and safety legislation with local authorities and work is in hand to bring a more co-ordinated approach to this relationship.
• Environmental health management, policy and training services - provided by Local Authorities who have enforcement responsibility for health and safety in the service, retail and leisure sectors. This enforcement work is co-ordinated through a joint HSE and local authority committee (HELA). Local Authorities also provide a range of support for employers including advice on workplace health and safety matters. In addition some authorities can provide basic health and safety training accredited by the Royal Environmental Health Institute for Scotland (REHIS).
• Occupational health and safety services - provided in-house by a number of large employers, and commercially in a number of NHS Board areas by both NHSScotland and private-sector suppliers. These include technical services such as ergonomic advice, noise surveys and advice on chemical hazard control, management and policy services such as accident investigation and health and safety audits, training services and the delivery of clinical services to individual employees on behalf of an employer to keep people in employment and to facilitate early return after sickness absence.
• Scotland's Health at Work (SHAW) - the national health partnership comprising CBI Scotland, STUC, Scottish Enterprise, Highlands and Islands Enterprise, COSLA, the Health & Safety Executive, the Federation of Small Businesses, the Scottish Executive, NHS Health Scotland and the 15 NHS Boards. The programme, established over 7 years ago, aims to encourage and support workplaces to make the active promotion of good health an integral part of Scottish corporate culture. Working through a network of specialist workplace advisors, based within each NHS Board, SHAW already covers 27 per cent of the Scottish workforce and is aiming towards securing 40 per cent coverage of the Scottish workforce by the end of March 2006. The Scottish Executive has committed investment of £2 million over 3 years to expand coverage of SHAW to increase the engagement of small- and medium-sized businesses (SMEs) in the programme.
• Safe & Healthy Working - the national occupational health and safety support service for small- and medium-sized enterprises (SMEs). Backed by £3 million over 3 years, it offers confidential advice to both employers and employees and access to occupational health and safety advice through a website, confidential telephone helpline and network of field advisors who carry out occupational health and safety needs assessment in the workplace. It is also piloting clinical services run by Grampian, Fife and Glasgow NHS Boards which will enable GPs to refer their patients for an expert occupational assessment at a monthly half-day session, run by either an occupational consultant or occupational health nurse adviser.
• Age Positive - a Department for Work and Pensions sponsored working group set up to tackle age discrimination and promote diversity in employment.
• Personnel policy advice and training - practical advice for business leaders and/or Human Resource Departments or leads from NHS Health Scotland and local NHS Board health promotion teams on issues such as smoking, alcohol, stress, work-life balance, bullying and harassment, breastfeeding, dental and oral health and physical activity, as well as more general guidance on writing and implementing staff health policies.
• Health promotion - local NHS Health Board departments throughout Scotland working in partnership with a number of agencies to offer specialised support by identifying, supporting and delivering programmes and initiatives to improve the health and wellbeing of the population. As a direct consequence of the additional SHAW funding, local NHS Boards have been able to enhance the dedicated support for workplaces within their Health Promotion Teams. These staff are closely linked to emerging Community Health Partnerships and play a vital role in facilitating partnership working at local level. They provide valuable support promoting a range of national initiatives including the Scottish Healthy Choices Award for healthy food, physical activity resources such as the "Walk in to Work Out" pack and the Jog Scotland programme of training for workplaces. They also support national campaigns such as No Smoking Day, the European Week of Health & Safety and Mental Health Week through the delivery of locally developed initiatives appropriate to the needs of local employers.
• Towards a Safer and Healthier Workplace - the strategy for the NHS workforce which has expanded multidisciplinary occupational services across the NHS to improve the health of NHS employees and in some NHS Board areas, developed the capacity to provide commercial services to non NHS organisations.
• Work Positive - a NHS Health Scotland-sponsored step-by-step process that assists organisations in taking the necessary action to identify and reduce potential causes of organisational stress.
• Working Backs Scotland - a NHS Health Scotland-sponsored campaign in which 20 partnership organisations have worked together to address acute low back pain, one of the biggest causes of absenteeism.
• The National Programme for Improving Mental Health and Well-Being - a Scottish Executive-funded programme which aims to stimulate local and national action on workplace mental health support for employers, reduce stigma and discrimination and increase the employment access of people with mental health problems.

3.3 There are also a number of initiatives in Scotland which aim to promote employability amongst groups who find themselves at a long-term disadvantage in the labour market because of problems relating to health as well as lack of skills and other barriers to employment. Some of the main ones include:

• New Futures Fund - a Scottish labour market programme which engages client groups in receipt of Incapacity Benefit and Income Support, including ex-offenders, people with mental health problems, substance misusers, the homeless, people who are HIV positive and disabled people.
• Healthy Return - a Glasgow-based DWP sponsored Job Rehabilitation and Retention Research Programme pilot which aims to evaluate interventions aimed at helping people whose jobs are in jeopardy due to illness to remain in employment.
• Pathways to Work - a DWP-sponsored project in several UK sites including Renfrewshire, Inverclyde, Argyll & Bute Jobcentre Plus District which, in close collaboration with NHSScotland, is providing support to IB clients looking to find employment.
• New Deal & New Deal for Disabled People - Six main New Deal programmes, sponsored by DWP/Jobcentre Plus, targeting different client groups in order to help them find work. Participation is voluntary for individuals over 50, lone parents, disabled people and partners of unemployed and mandatory for other groups.
• Training for Work - a Scottish Executive-sponsored programme, aiming to help long-term unemployed into work, with early entry available to members of disadvantaged groups.
• Progress2Work - a DWP/Jobcentre Plus programme aimed at helping particularly hard to help clients with a history of drug misuse to find work and Progress2Work Link Up which extends the approach to other clients including the homeless, ex-offenders and people recovering from alcohol misuse problems.
• Access to Work - a DWP programme that offers practical advice and help in a flexible way to overcoming practical obstacles disabled clients may experience in finding and retaining employment.
• Modern Apprenticeships - a Scottish Enterprise sponsored programme offering people aged over 16 the chance of paid employed linked with the opportunity to train for jobs in craft, technician and management skills.
• Skillseekers - a Scottish Enterprise sponsored programme for young people wanting to develop skills and equip themselves for the world of work. It is open to people who have left school and have a job or who are looking for work.

Future Development

3.4 We acknowledge the progress being made for clients of these services and argue they should provide the key mechanisms for delivering Healthy Working Lives. However, whilst these are in the main complementary, they support a number of separate strategic objectives. All have relevance to the wider Healthy Working Lives agenda but lack a shared vision of that agenda and a common understanding of how programmes can contribute effectively to the delivery of any such vision. We now wish to build upon the opportunities offered by joint working to deliver an approach that shares learning, pools expertise and addresses gaps in the provision of services for employers and those in work, or wanting to work, across Scotland.

3.5 The starting point will be to bring together Scotland's Health at Work, Safe and Healthy Working and the workplace health activities of NHS Health Scotland to form a single, integrated organisation to promote Healthy Working Lives. This will better integrate these critical activities, minimising the risk of duplication and providing a single focus for workplace health.

3.6 Provisionally called the Scottish Centre for Healthy Working Lives, this new organisation will be established as a discrete entity within NHS Health Scotland so that it maximises potential synergies with other parts of the health improvement agenda. It will be structured and managed in a way which is outward facing so that it is capable of building its profile, establishing credibility and successfully engaging with employers across Scotland. It will be tasked with bringing coherence to the agenda of Healthy Working Lives, developing and implementing a research programme to move that agenda forward and building constructive working relationships with key stakeholders and potential delivery partners beyond the NHS such as the Department for Work and Pensions, the Health and Safety Executive and Local Authorities.

Actions

3.7 We will bring together Scotland's Health at Work, Safe and Healthy Working and NHS Health Scotland's workplace team into a single, integrated organisation provisionally called the Scottish Centre for Healthy Working Lives.

3.8 We will draw together a small group of stakeholders with a knowledge of workplace health issues, drawn from business, local authority, academic, STUC and voluntary sectors, occupational health and safety and health promotion professionals to produce recommendations covering the structure, reporting relationship, remit, branding, marketing and timetable for this unit so that it is able to drive the delivery of Healthy Working Lives.

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