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



To ensure that Health Works is delivering benefits for the working-age population, data is required to measure performance and to provide feedback to the strategy to allow fine tuning and to take account of change in the policy and delivery environments.

Performance management objectives should reflect implicitly or explicitly the contribution that good workplace health and wellbeing can make to overall performance and delivery.

Community Planning Partnerships should recognise in local plans that the promotion of health and wellbeing of the working-age population can make a significant contribution to economic development, through improving the productivity of employers' businesses and by improving the wellbeing of potential recruits.

NHS Health Scotland is developing an outcomes framework for the health and work continuum. This will provide a clearer understanding of the short, medium and long term outcomes that we can expect from interventions to support the health and wellbeing of the working-age population, and of the delivery mechanisms and organisations that play a part in a journey through the client pathway. In particular the model will allow demonstration of the linkages between high-level, long-term outcomes and the detailed local planning and performance management activities required from Community Planning Partnerships.

The outcomes framework will demonstrate the links between Health Works outcomes and the Scottish Government's purpose targets. It will also allow Community Planning Partnerships to plan programmes that build the links between health and work, and the wider outcomes on economic development and inequalities.

Action 23:NHS Health Scotland and Scottish Government to complete development of the outcomes framework and performance management model for Health Works that demonstrates links to health improvement, health inequalities and economic development outcomes; to disseminate it to NHS Boards and Community Planning Partnerships - by summer 2010

A cross-Government analysts group has been set up with membership drawn from the Scottish Government, Welsh Assembly Government, DWP, HSE and Department of Health. The group is working on the recommendation by Dame Carol for the systematic gathering of data to measure progress and inform policy development. The work aims to establish a set of data to set a baseline for measuring progress of the implementation of the UK Government's actions in response to Dame Carol's recommendations. A small group of officials from the Scottish Government and NHS Health Scotland is working with researchers from Glasgow University to develop measures for the Health Works strategy and is in close contact with the cross-Government group to ensure that the work remains relevant to Scotland.

Scottish Government is supporting the development of a Scottish Observatory for Work and Health which will support the analysis of data on the working-age population to inform the development and implementation of relevant polices.

In order to understand how healthcare services improve people's ability to work, and in order to improve services it is important that relevant data are collected. A database has been developed for use by the vocational rehabilitation pilots. It will also be adopted by the Scotland-wide FFWS. Use of the database across all NHS occupational health and vocational rehabilitation services is to be promoted. This will allow a core data set to be developed across Scotland that will allow for service and performance management standards to be set and for a data resource for epidemiological studies for health and work. The data collected will be managed in compliance with the requirements of the Data Protection Act 1998.

Action 24: Scottish Government and the Centre to work with NHS Boards to adopt a standardised, core database for health and work treatment - by March 2011

The UK Government's Health Work and Wellbeing unit ( HWWB) intends to establish a Centre for Health Work and Wellbeing with the aim of developing the evidence base on working-age health, collating existing evidence and supporting further work to address gaps. The Scottish Government will work with HWWB and the new Centre to consider how specific Scottish needs for evidence can be met.

Dame Carol recommended that an electronic GP medical statement be developed in order that data is collected on 'sicknotes' issued by GPs. This would allow epidemiological studies on certified sickness absences to be carried out which would provide data for service and policy development in the future. A trial is currently underway in Wales to collect electronic data. The Scottish Government will work with DWP on determining the scope for rolling out an electronic 'sicknote' (or 'fitnote' from April 2010) in Scotland once DWP have developed a proposal. This will also present an opportunity for the Scottish Centre for Healthly Working Lives to develop support measures for employers to help them to understand the implications of the 'fitnote' for them and the steps they can take.

Action 25: Scottish Centre for Healthy Workings Lives to work with DWP to develop advice for employers (and employees) on the implications of the new 'fitnote' - by April 2010