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Section 5: Maximising Functional Capacity - Supporting Individuals
Introduction
5.1 Despite the progress that has been made in recent years in expanding occupational health and safety services throughout Scotland, we recognise that provision remains patchy across the country. We also know that there is little integration between the health-based services offered by the NHS and private-sector suppliers and the wide-ranging support required to maximise an individual's functional capacity.
Aim
5.2 Our long-term vision is of an easy to access network of support services within Scotland which brings together health services providing fast-track rehabilitation through specialisms such as physiotherapy, occupational and sports therapy with the support services traditionally associated with the broader employability agenda such as advice on education, training, supported employment, career management and the benefits system.
5.3 It is known for example, that a vast majority of the people who began receiving ill-health benefits expected to get back into work within a few months of their first claim. 23 Most have manageable health conditions such as depression, chronic pain and musculoskeletal problems, where there should be a good chance of such a return and when that return is accomplished, it in itself promotes improved health. In such circumstances, there are clear benefits from offering individuals access to a structured, personal evaluation of needs, backed by fast-track access to the kind of service or support they require.
5.4 Such an approach will allow all individuals to maximise their functional capacity by having opportunities to:
- Work, paid or voluntary.
- Work in environments wherein the risks to their occupational health and safety are properly controlled.
- Modify work and working patterns in ways that reflect their age, health, disability or any other determinant of functional capacity.
- Enjoy ready access to appropriate occupational health and safety services which enable them to deal in a timely and effective manner with those health problems that prevent them from working.
- Access advice and services from the education and employment sectors which support a commitment to lifelong learning and career development.
Approach
5.5 The phrase "one-stop-shop" may be a little over used, but it does at least provide an idea of the kind of integrated, person-centred service we believe to be essential for the delivery of Healthy Working Lives. We want to see occupational support and advice that is available and accessible to all people of working age, delivered in ways that meet their particular needs, regardless of traditional supply side boundaries.
5.6 The aim is to provide employees and potential employees with access to occupational support services based on individual need and that these same services are amenable, accessible and attractive to all socioeconomic groups. This will be provided through a range of channels including telephone advice lines, the web and face-to-face advisers in appropriate settings.
We will therefore look to expand the service currently offered through Safe and Healthy Working to reflect the broader nature of our agenda and pilot new approaches to delivering advice through workplaces and in settings such as GP surgeries.
5.7 This vision may take some time to deliver and has significant implications for resource prioritisation within the NHS in particular. However, we do believe that it is right to set a stretching goal in this important area of health improvement and design structures, working relationships and pilot projects which will lead towards its delivery. This will begin with a comprehensive mapping exercise to assess service provision in Scotland that builds upon the preliminary work already done to support the business case for Safe and Healthy Working. This exercise will provide a firm foundation upon which to build working relationships with partners, establish projects to fill identified gaps and inform the development of local Joint Health Improvement plans as part of the Community Health Planning process.
5.8 We also recognise the valuable services being delivered throughout Scotland by occupational health professionals not represented by either the SHAW or S&HW organisations. This strategy signals the need for engagement with this wider occupational health community and for efforts to be made to explore how their expertise can be harnessed to support the development and implementation of Healthy Working Lives in Scotland.
5.9 The successful delivery of Healthy Working Lives will also require the development of comprehensive needs assessment services for individuals up to, and including, the potential to undertake a structured personal working-life health plan. This is likely to be a long-term project which will require commitments to partnership working and information sharing across traditional boundaries. However, we intend to begin work on piloting potential approaches which deliver plans which take a holistic view of individual needs and are able to refer clients to specialist organisations providing services such as:
- In-work support for clients encountering physical or mental health problems.
- Occupational health and safety assessments and services.
- Advice and assistance in raising occupational health and safety or other workplace concerns with an employer.
- Careers advice and assistance with basic skills or vocational training opportunities.
- Advice for those currently, or about to become, unemployed or economically inactive through health problems on relevant benefits, tax credits, housing and care facilities and motivational support in order to support the transition back to work.
- Services aimed at improving functional capacity including physiotherapy, occupational therapy, health and fitness programmes or occupational psychology.
- Community-based outreach centres promoting health and employment information to ethnic minorities and diverse communities.
- Education and training support to further commitment to lifelong learning.
- Assistance with self employment and social firms, for those with health-related problems.
Actions
5.10 We will fund a mapping exercise of existing employer/employee occupational health services across Scotland to determine current capacity and gaps in service provision and inform future national plans and community planning priorities through the workplace strand of the Joint Health Improvement Planning process.
5.11 We will rationalise existing contact points and establish a consistently branded and marketed support service through a single integrated set of telephone-, web- and field-based access channels which reflect the breadth of the Healthy Working Lives agenda.
5.12 We will engage with the RCN Occupational Health Nurses Group, the Faculty and Society of Occupational Medicine, the Institution of Occupational Safety and Health and other professional groups to establish how links can be developed with the wider occupational health community to harness their support for development and implementation of the Healthy Working Lives strategy.
5.13 The Scottish Executive Health Department will explore with the Department for Work and Pensions and other partners, opportunities for piloting a vocational rehabilitation service within GP surgeries.
5.14 We will pilot the development of personal development plans for Healthy Working Lives for a nominated target group and a service offering targeted rehabilitation services for people who come into contact with clinical services through work-related conditions.
5.15 We will develop a national framework for employee health screening services that meet the aspirations of the wider Healthy Working Lives agenda. This will be tested in a range of workplace settings and be linked, as appropriate, to GPs and local support services.
5.16 We will explore how links to ethnic minority and diverse communities groups including local voluntary organisation councils that exist outwith the traditional framework for accessing health and employment services can be further established to secure wider engagement with the Healthy Working Lives strategy.
5.17 We will develop links with all relevant Executive departments to adopt a cross-cutting approach to the promotion and support of employability amongst disadvantaged health groups.
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