1. The working age population of Scotland is approximately 2.5 million.  About 75% of these are economically active.
2. There are approximately 150,000 registered businesses in Scotland.  99% of these employ less than 10 people.  47% of those in paid employment work for a small or medium sized enterprise (<250 staff).
3. The cost of ill-health in the working age population is estimated at approx. £10 billion p.a. to the Scottish economy (loss of earnings, loss of productivity, loss of taxes, increased health and social care costs).
4. There are approximately 280,000 people claiming health-related unemployment benefits (incapacity benefit, employment and support allowance).
5. Approximately 23% of the working population of Scotland are employed in the public sector – principally Health and Local Authorities.

Health Works: a review of the Scottish Government’s Healthy Working Lives Strategy :November 2009  http://www.scotland.gov.uk/Publications/2009/12/11095000/0

Objectives: 

1.    To contribute to economic growth and other national outcomes by promoting health, safety and wellbeing in and through the workplace;

2.    To improve the recognition by healthcare professionals that work is a social determinant of health and that a return to work is an integral outcome of patient care;

3.    To improve support for those who are unemployed as a consequence of a health condition to move back toward work.

Key Points:

1. The review of the Healthy Working Lives strategy established that work (paid or unpaid) is a key social determinant of health.  In other words, Health is a key asset for work and work is a key asset for health.
2. Many employers recognise that a healthy workforce is important for productivity and profitability.  However, many do not access or have access to relevant information and advice.
3. The Scottish Centre for Healthy Working Lives is funded, as part of NHS Health Scotland, to provide advice and information to employers on workplace health, safety and wellbeing.              http://www.healthyworkinglives.com/
4. The Centre offers a range of services including:
   • Free health and safety checks for Small & Medium sized Businesses (SME’s);
   • A free and confidential adviceline offering a wide range of advice on workplace health, safety and wellbeing; Tel 0800 019 2211
   • A network of advisers who offer advice on promoting health and wellbeing in the workplace;
   • A comprehensive website offering advice;
   • The Healthy Working Lives Award scheme which recognises and rewards good workplace policies and practice to promote health, safety and wellbeing. 
5. Other initiatives currently underway include a national programme to improve the delivery of services to people with musculo-skeletal disorders (MSK), including relevant referral into return-to-work support.  This is being piloted in NHS Lanarkshire and NHS Lothian with links to NHS 24 for referral of patients. 
6. Following the publication of Realising Potential, the AHP Action Plan in 2010, two national pieces of work have been carried out to scope the vocational rehabilitation models of practice being used by Allied Health Professionals working in mental health and forensic services and to recommend future development. This work has emphasised the presence of a clear evidence base for a model which provides superior paid employment outcomes for individuals with severe and enduring mental health conditions. Key principles of this model, Evidence Based Supported Employment, include early access to a place then train approach which focuses on paid employment; client-centred, time-unlimited support and integration of mental health and vocational services. More information about this work can be found at:

 Towards Work in Forensic Mental Health (Jean McQueen – AHP Consultant: Vocational Rehabilitation and Forensic Mental Health)                       )       http://webmail/exchweb/bin/redir.asp?URL=http://www.forensicnetwork.scot.nhs.uk/news/AHP/Toward%2520work%2520in%2520forensic%2520mental%2520health%2520lo%2520res.pdf

Realising Work Potential (Lisa Greer – AHP Lead: Vocational Rehabilitation/Mental Health)     link still to come!

1. Work is being undertaken to develop a “Scottish Offer” that sets out the services and standards that working age people can expect of NHSScotland to support return to work and this is being developed as an integral part of the NHS Scotland Healthcare Quality Strategy. 
2. The Scottish Government collaborates with the UK Government and the Welsh Assembly Government on the cross-government Health Work and Wellbeing (HWWB) Strategy.  A number of initiatives are being taken forward across Great Britain in response to the recommendations of the review of working age health conducted by Dame Carol Black in 2008.

                  www.dwp.gov.uk/docs/hwwb-working-for-a-healthier-tomorrow.pdf

1. In Scotland these include:
   • introduction of a fit note to replace the traditional sick note issued by doctors;
   • a Scotland-wide pilot fit for work service (Working Health Services Scotland) to allow access to quick assessment of a health condition and referral into relevant health and other services for people working for small and medium sized businesses without in-house occupational health.  This is delivered through Salus Occupational Health (part of NHS Lanarkshire)in Hamilton. 

            http://www.healthyworkinglives.com/working-health-services-scotland/about.aspx

1. • an adviceline offering occupational health advice to employers, aimed particularly at small and micro-sized businesses Tel 0800 019 2211
   • a Health Work and Wellbeing Coordinator, hosted by Scottish Government, promoting the benefits of healthy workforces to employers.
2. Many people who are on health-related welfare benefits would like to get back to work.  Collaborative work with Jobcentre Plus in Scotland and with other charitable and independent services is underway to improve local delivery of services to support people back toward work by improving local partnership working between health and employability service providers. More detail on partnership working can be found;

            http://www.employabilityinscotland.com/healthandemployability.aspx

      11. Finally NHS Lothian have recently produce DVD which provides a visual description of what vocational rehabilitation is and also emphasising the message that VR is everyone’s business. The product is a marketing and                              educational tool and Lothian have made it widely available by sharing the          following link:             http://www.nhslothian.scot.nhs.uk/services/az/workinghealthservices/pages/default.aspx

December 2011