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Health Works: A Review of the Scottish Government's Healthy Working Lives Strategy

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7. MANAGING CHANGE

In order to deliver the health services necessary to help people to remain in or return to work, there needs to be clear leadership at a strategic level. This leadership will support the necessary realignment of healthcare resources to enable a seamless progress for the client through services with a work outcome as part of the patient care plan. This requires collaboration with other employability service providers and integration across healthcare services, including occupational health physicians, nurses and allied healthcare professionals.

At a national level, this will include a strengthened health and work unit in the Scottish Government including a DWP-funded Health Work and Wellbeing Coordinator who will have a remit to promote the messages on the importance of work for health and health for work. The unit will continue to sponsor and commission work from the Centre.

A NHS Board Chief Executive will be invited to join the Scottish Employability Forum ( SEF) to support and develop a coherent approach between health and employability at a strategic level.

The health and work unit will work closely with the Employability and Health Development Manager in the Scottish Government Workforce Plus team to support local partnerships to improve outcomes for health and employability services and to inform future policy and delivery through SEF.

A post of National Programme Lead for the Delivery Framework for Adult Rehabilitation is being located in Salus occupational health services to lead on all the work of the rehabilitation framework, ensuring that Rehabilitation Co-ordinators are delivering on the high impact changes and leading on the main impact evaluation programmes, these being vocational rehabilitation, falls and musculoskeletal pathways.

Leadership will be required to address the NHS Board contribution to the 'Scottish Offer'. This needs commitment at a senior level in each Board. The NHS contribution to the wider health and work agenda will be included in the agenda for Boards' annual accountability reviews with Ministers, including reporting on the HEAT target proposed earlier.

Development of a Scotland-wide Fit For Work Service ( FFWS) will require strong integrated working across NHS Board boundaries and across healthcare professions. Delivery of an effective FFWS will need strategic support at Board level.

Links are required to relevant clinical networks to ensure that they contribute to the development of the 'Scottish Offer' and develop patient plans with work outcomes where necessary.

Action 21: Scottish Government health and work unit to work with other Government directorates to identify and engage clinical networks on health and work - by end 2010

Health issues must be part of the local employability partnerships' work, with active and high-level NHS input but also forming part of local collaboration across all the partner organisations. This will require NHS Boards and Community Health Partnerships ( CHPs) to take a strategic view of local health and non-health services, working with local community planning partners to build the necessary collaborative partnerships that will offer simple, unambiguous access points into the pathway for clients and enable a case management approach to be developed. Local leadership should be in the form of a strong and committed health presence either on existing local Workforce Plus employability partnerships or through other local partnership arrangements. To achieve this, territorial NHS Boards will require to ensure strong internal strategic leadership and ownership of the local health and work agenda. Such leadership will include making sure that local NHS staff have the skills to be able to ensure a work outcome for the patient, where relevant. Support from NES and the Scottish Government will be available as outlined above.

Action 22: Territorial NHS Boards to work with local community planning partners to establish a clear agenda with assigned roles and leadership for health and work