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Section 6: Leading Change
Introduction
6.1Healthy Working Lives will only be successful if it enjoys broad-based support from employers across Scotland, remains a high priority for both national and local government and secures the buy-in of the voluntary sector. We need to build upon the commitment demonstrated by different stakeholders during the development of this action plan as we move into the delivery phase. Healthy Working Lives must continue to be recognised, not only as one of the key pillars of our national health improvement strategy, but also as a key enabler of a confident and economically successful Scotland.
Strategic Ownership
6.2 The Scottish Executive's top-level stakeholder group on health improvement provides the opportunity of ensuring that the development and delivery of this strategy remains high on national and local agendas. Links will be maintained between the provisionally-named Scottish Centre for Healthy Working Lives and the stakeholder group which will enable workplace health to maintain a high profile within the overall health improvement challenge and allow us to represent the views of partners delivering reserved functions within the Scottish context.
6.3 This commitment will also be taken forward by the Health Improvement Directorate within the Scottish Executive. They will maintain a strategic relationship with the Westminster Government through the development of liaison arrangements with equivalent policy teams across UK Government Departments. They will also work with colleagues across the Scottish Executive to ensure that our programme of action remains inclusive and genuinely cross-cutting.
Private Sector Involvement
6.4 Private sector involvement and investment is crucial to success. Their role both in terms of increasing commitment to Corporate Social Responsibility and in creating safe and healthy environments for people must continue to be recognised and rewarded. Businesses of all sizes have a potential contribution to make and it will therefore be necessary to ensure that the private sector is represented at all levels of the future development and implementation of this plan.
Public Sector Leadership
6.5 The public sector currently provides 33 per cent of the jobs within the Scottish economy and has been a significant engine for the growth of employment opportunities over the past few years. This provides the public sector with a huge opportunity to demonstrate real leadership in the creation of opportunities to promote healthy working lives. The NHS, local government, the Scottish Executive and government agencies have the opportunity to provide a lead on key issues such as occupational health and safety and employability as well as committing themselves to sharing their experiences as part of the process of developing a national business case for change.
Training and Resourcing
6.6 An increase in occupational health and safety support has significant implications for training and resourcing strategies in Scotland. At a minimum there is a need to fill current vacancies within different branches of health promotion, public health and occupational health and safety services and to adopt a training strategy which clearly anticipates and responds to future demand. Beyond this however, the "one-stop-shop" approach is likely to fuel demand for a different type of employee, who is equipped to deliver services right across the spectrum combining experience and knowledge of public health, occupational health and safety and health improvement. We therefore need to start work on an assessment of future demand and the development of a comprehensive national training strategy which can enable the development of existing staff and bring about a broadening of emphasis within providers of professional and accredited training.
Role of NHSScotland
6.7 The NHS in Scotland will have a key role in supporting this programme. Healthy Working Lives should result in an increased demand for public health, health promotion and occupational health and safety services. This in turn should reduce demand overall for NHS services and improve the health, safety and wellbeing of the NHS workforce for the benefit of patients.
6.8 As part of this supporting role, the Minister for Health & Community Care has given a commitment to review occupational health and safety services delivered by NHSScotland. The remit for this review will take account of current work on the NHSScotland reform agenda to promote greater integration of the planning and accountability process. It will also seek to provide an improved service to patients nationally, regionally and locally; explore the added value the service delivers to NHSScotland staff and to the other private and public enterprises it serves; and ensure service provision matches the needs of patients.
6.9 This exercise will be approached through four distinct but related strands, established to secure the following outcomes:
- An organisational structure able to plan and deliver the style of service and assistance required by NHSScotland employers to support the delivery of agreed and consistent standards of service that benefit patients on a local, regional and national basis.
- Practical proposals which enable the Service to take forward and deliver "one-stop-shops", fast-tracking systems, and the ability to cope with increased demands on service.
- Recommendations for developing a system to ensure occupational health and safety standards and consistency of treatment are applied for patients on a Scotland-wide basis and development of an appropriate structure and finance arrangements for non NHS work.
- Development of an integrated healthy working lives policy for NHSScotland staff which promotes the health and wellbeing of staff both at work and in their private lives and ensures they are not made ill by their work.
6.10 This work will also link with development of a NHSS diversity strategy that will positively help to address recruitment and retention difficulties by supporting employability initiatives aimed at helping individuals back into the labour market.
6.11 The goal will be for all healthcare workers to consider the Healthy Working Lives agenda as part of care plans and ensure appropriate referral of working-age people with health problems for focused rehabilitation and employment advice. NHS health promotion agencies will also play a major role in this agenda.
Assessing Progress
6.12 The Scottish Executive's endorsement of the Occupational Health Strategy for Great Britain defined in the Health and Safety Commission's publication Securing Health Together24 provides an existing targeting framework for Healthy Working Lives. By 2010 this commits the Executive to working together with the other Government bodies concerned towards achieving the following targets:
- A 20 per cent reduction in the incidence of work-related ill-health.
- A 20 per cent reduction in ill-health to members of the public caused by work activity.
- A 30 per cent reduction in the number of days lost to work-related ill-health.
- Greater awareness of rehabilitation opportunities for those off work due to ill-health or disability.
- That everyone not currently in employment due to ill-health or disability should, where necessary and appropriate, be made aware of, and offered opportunities to prepare for, and find work.
6.13 The action plan described in this document will form an important part of the Scottish Executive's commitment to achieving these targets. However, in recognition of this new approach, we believe it is appropriate to go further and describe a broader suite of performance targets which can be measured and reported to Ministers on a regular basis. These will be agreed as part of the creation of the new Centre to drive delivery. They will take account of economic circumstances, but could include:
- Percentage increase in uptake of services.
- Percentage increase in participation and achievement of SHAW.
- Percentage increased numbers of workplaces with policies, e.g. Occupational Health, Mental Health, Drugs and Alcohol, Tobacco, etc.
- Percentage reduction in sickness absence rates.
- Percentage increased uptake of DWP return to work initiatives by Incapacity Benefit claimants.
- Percentage satisfaction with working life across Scotland.
Actions
6.14 We will develop national standards for occupational health and safety providers in conjunction with the Royal College of Nursing, the Faculty of Occupational Medicine, the Institution of Occupational Safety and Health and the National Education Board for Scotland as the basis for the development of a national training strategy to support the delivery of Healthy Working Lives.
6.15 We will identify a broader suite of measurements to underpin this plan. These will build on existing targets and be agreed with the Joint Ministerial Steering Group on Health Improvement.
6.16 We will work with the HSE to establish a baseline of information about current practice within Scottish employers covering access to occupational health and safety services, policies on smoking, drugs and alcohol misuse, health promotion approaches in the workplace and other health issues and approaches to the management of health and safety.
6.17 NHSScotland, COSLA and the Scottish Executive will develop processes that drive and oversee the delivery of Healthy Working Lives for staff within their respective organisations.
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