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



"There is a sound evidence base for workplace policies that support the wellbeing of employees. Most of our top performing organisations have already embraced this."
- Iain McMillan CBE, Director, CBI Scotland

With approximately 2.5 million people in Scotland in some form of employment, the workplace can play a significant role in the health and wellbeing of a large proportion of Scotland's population.

Workplace health and safety is regulated by legislation reserved to the UK Government. This creates a statutory duty for the employer to ensure the health and safety of its workforce, to specifically assess workplace health and safety risks and to act to prevent or control those risks. Employees have a duty to cooperate with their employer.

Many workplaces employ health and safety professionals who play an important role in ensuring that the working environment does not harm the health and wellbeing of employees. This has contributed to Great Britain having one of the best health and safety records in the world.

Enforcement of health and safety regulation is undertaken by the Health and Safety Executive ( HSE) and local authority environmental health officers ( EHOs). The Centre's advisers have no enforcement powers, but aim to be perceived as an alternative source of advice to the 'enforcement authorities'.

The Centre and the HSE in Scotland are developing arrangements to avoid duplication of approaches to employers and to share information on client needs that will allow the Centre's advisers to target those businesses that would benefit from healthy working lives advice.

The Employer's Role

As well as ensuring that they meet their statutory health and safety duties, good employers will also take steps to promote the health and wellbeing of their staff more generally.

Examples of workplace health and wellbeing activities:

First ScotRail19 - Offer physiotherapy, at-work massage, chiropody and ergonomic improvements to reduce time-off after accidents. 40% of cases referred to physiotherapy returned to work after an average of five sessions. Sickness absence decreased from 6.2% to 4.2%, saving around £3 million p.a.

Glasgow Prestwick Airport20 - The airport halved its sickness absence rates after a Fit for Life @ Work Programme was set up, which included a health promotion suite and staff taking part in a variety of activities, including pilates and jogging classes. There are cycle routes around the airport and, in addition to providing bike parks, they are looking into the possibility of a cycle to work programme and offering gym facilities.

BP Sullom Voe - The oil terminal offers regular health checks to its 450-strong workforce which includes both BP employees and contractors. The checks - which include blood pressure, weight, body mass index, full cholesterol screening and blood glucose testing - are used to provide customised health plans, tailored to individual employee's requirements.

Ross Harper LLP - The legal firm ran a 'Better Backs' campaign looking at posture and exercise, and taking breaks from sitting at a desk. Smokers have been encouraged to quit by providing smoking cessation sessions after work.

Scottish Government - Has recently achieved its Gold Healthy Working Lives Award. This has involved a range of activities including provision of gym facilities, supporting participation in running and jogging activities, introduction of a bicycle purchase scheme, ensuring healthy choices in staff canteens, and negotiating discounts for membership of health clubs.

It is not just the physical work environment that affects the health and wellbeing of workers. A 'good' job also comprises 'softer' issues such as strong workplace relationships, meaningful work, fair procedures, job security, flexibility about how work is done and achieving a balance between effort and reward.

As well as workplace policies that promote health and wellbeing, employers can also be more proactive in supporting employees returning to work following sickness absence as part of a programme of rehabilitation. Waddell, Burton and Kendall 21 noted that vocational rehabilitation cannot be delivered by health services alone and employers have a key role to play in supporting return to work.

Employers should make use of the support that is available. The Healthy Working Lives advice line offers a wide range of advice. This is being enhanced as part of a DWP-funded pilot to provide advice on common mental health conditions. Further advice on good management practices can be obtained from the Health and Safety Executive ( HSE).

Action 1: The Centre to work with DWP to develop and promote an enhanced advice line to small enterprises - by end 2009

Given the overarching imperative of growing the economy and the need for improved productivity, we aim to enlist those bodies tasked with economic development to promote the importance of maintaining employee health and wellbeing to enterprises that they support and ensure that it is reflected in business plans.

The conclusions from the Communication and Business Engagement workstream note "the current economic situation makes it all the more important for employers to engage with Healthy Working Lives in order to support staff motivation and productivity, as well as to control costs".

The workstream recognised the different healthy working lives needs of organisations of different size and the need for the services of the Centre to take this into account (figure 1).

Figure 1. Segmentation of employer benefits of promoting healthy working lives by size of organisation

Figure 1. Segmentation of employer benefits of promoting healthy working lives by size of organisation

A challenge for the Healthy Working Lives programme has been to encourage SMEs to take up the services offered by the Centre.

There are two specific recommendations from the workstream in respect of delivering to business:

  • A simple, practical resource for SMEs should be produced. This SMEHealthy Working Lives Toolkit will be modelled on the Federation of Small Businesses/Scottish Government Energy and Environment SME Toolkit, the proposal for which is backed by the business representative organisations;
  • There should be greater use of case study based promotion and business-to-business engagement models. Businesses speaking to other businesses about the value they have gained is the strongest message of all for another business, and this is something that SMEs should be encouraged to become involved in to make the message as relevant as possible to smaller businesses.

Action 2: The Centre to work with business organisations to develop and deliver a SMEHealthy Working Lives Toolkit; and to work with clients to develop and promote compelling case studies

Enterprise Agencies

Scottish Enterprise manages around 2000-3000 business clients at any one time. Highlands and Islands Enterprise and local government Business Gateways have contact with many more. This creates scope for advice on the importance of workplace health and wellbeing to the bottom line to be provided to a large number of employers and potential employers, with signposting to more specific services. Scottish Government encourages these economic development agencies to collaborate with the Centre to carry relevant advice and links in their websites and literature, and to provide business advisers with sufficient knowledge to provide appropriate advice to clients on the importance of workforce health and wellbeing.

Action 3: The Centre to work with Scottish Enterprise, Highlands & Islands Enterprise and local government Business Gateways to promote importance of workplace health and wellbeing to business success as part of advice given to clients; and to promote services of the Centre to clients as part of their business support

Trades Unions

Many workplaces have trades union safety representatives. The 'safety reps' have traditionally had a role in working with employers to develop, maintain and promote measures to ensure health and safety at work. However, there is scope for these representatives to develop a wider role around wellbeing in the workplace. In working towards Healthy Working Lives awards, employers are encouraged to involve the workforce and where there are trades union representatives they could expect to be involved. However, a wider role to promote wellbeing would enable 'safety reps' to advise both employers and employees on good practices to promote both physical and mental wellbeing. The Centre has already developed a number of projects in collaboration with the STUC and should explore the scope for work to enhance the safety representative role.

Action 4: The Centre to work with the STUC to identify the scope for a programme to develop the wellbeing capabilities of trades union safety representatives

Scottish Centre for Healthy Working Lives

An external consultancy was commissioned to review the work of the Centre, in order to identify ways to improve its operation and service delivery and to keep its activities relevant to the overall strategy. The conclusions of this review will be used to inform the development of the Centre's strategic business plan, taking into account the conclusions of the review of the overall Healthy Working Lives strategy.

A brief summary of the activities of the Centre is given at Annex B.

The review of the Healthy Working Lives strategy has identified that there is a very clear need for the Centre to target its services better, with promotional material that communicates the benefit it offers to businesses and particularly SMEs, and more flexible services that can meet the needs of SMEs without requiring large investment in time and money by the employer.

The key conclusions of the Communication and Business Engagement workstream are:

  • The Centre, supported by Scottish Government, for example through the Regulatory Review Group, needs to work more closely with employer organisations (e.g. CBI, Federation of Small Businesses, Scottish Chambers of Commerce, Scottish Council for Development & Industry) to develop services that align with the business priorities of employers, particularly small and medium sized enterprises, and to improve communications in positive, business-friendly language, to achieve better engagement and commitment from employers to the Health Works agenda;
  • Employers need services that are accessible and easily understood - keep it simple has been a key message from businesses;
  • The Centre needs to make use of appropriate marketing tools and campaigns to target SMEs in particular and to work with business organisations and other agencies such as the HSE to run joint campaigns;
  • The Centre will work with business organisations and economic development agencies (Scottish Enterprise, Highlands and Islands Enterprise and Business Gateway) to help them to promote the business benefits of good workplace health and wellbeing, and the services of the Centre, through their networks;
  • The Centre should work with business organisations and individual employers to develop the evidence base and case studies of good practice .

The Centre also needs to be able to react to external circumstances that might impact on workplace health and wellbeing, such as H1N1 flu and the economic recession, and develop appropriate advice to help employers.

It is important that the Centre's clients can be confident that the services offered will provide them with the benefits they expect from developing good workplace health and wellbeing practices. The Centre's services are undergoing an evaluation programme over the next 2-3 years, to allow further active development of the Centre's engagement with employers in improving the health of their workforce.

Action 5: The Scottish Centre for Healthy Working Lives to develop a 3-year strategy and strategic business plan, informed by the conclusions of the independent review of the Centre and the conclusions of the review of the Healthy Working Lives strategy