1. Scottish Centre for Healthy Working Lives Tromsø - 21- 23 September 2005 Steve Bell Strategic Director

2. Healthy Working Lives http://www.scotland.gov.uk/library5/health/hwls-00.asp

3. Context

4. Scottish Population Projection 2002-2018 (GROS, 2005)

5. Population Projections for Sutherland 2001-2017 (NHS Highland, 2005)

6. Life expectancy at birth in selected countries by sex for the year 2000 (Leon et al, 2003)

7. Selected Statistics 8% 25% 5.6% 10.2% 18.4% 179,000 85 Sources: 1&2 Scottish Executive 2004 3 ONS 2005 4&5 Health Scotland 2004 6 HSE 2004

8. Policy Agenda EconomyHealth Social Justice

9. Delivery Agenda Health Promotion Occupational Health and Safety Job Retention and Rehabilitation Return to Work Life-long Learning

10. More than the Sum of the Parts Safe and Healthy Working Scottish Centre for Healthy Working Lives

11. Scotland’s Health at Work Launched in 1996 – a unique partnership Based on the principles of the Ottawa Charter, the programme supports and rewards workplaces that introduce and implement health promoting policies and practices Awards made at Bronze, Silver, Gold & giving credit for any activity that demonstrates a safe, supportive and inclusive working environment. New Mental Health Commendation Award.

12. SHAW - Advice Smoke free workplaces Healthy food choices available in canteens Provision of facilities to promote exercise e.g. gyms, bike racks, showers Workshops & seminars on health issues during work time Needs assessments covering organisational, environmental & lifestyle issues Policy development & implementation

13. SHAW – Communication National Helpline Face to face with clients on site Networking events & workshops Printed and electronic resources (i.e. Written guidance on how to meet criteria, Toolkit for Small and Medium Enterprises, Website, Inter-active CD Rom) Quarterly Newsletter E-mail & Correspondence Advertising in Journals etc. Radio Campaigns

14. SHAW - Impact

15. SHAW – Key Outputs 78% of participants see improvement in staff health knowledge 66% see improvement in health behaviour 47% see increase in morale and motivation (Institute of Occupational Medicine, Dec 2002)

16. SHAW Registration & Awards

17. Provides an occupational health and safety advisory service through: –Network of 20 local staff –Free national Advice-Line –On-line services Clinical Sessions Pilot Safe and Healthy Working

18. SaHW – Service Framework Recruitment through: Web site, Advice line Regional Advisers, Partner organisations Workplace visit: Using broad checklist, Policies and procedures, Risk and CoSHH assessment, ID Main hazards, Emergency procedures, Occupational health, Health promotion Provision of a report: Based on Actions Red - 1 Amber - 2 Green - 3 with guidance to resources and local contacts Return visit: To talk through report and practical actions

19. SaHW – Service Data Sector 9% Charity; 9% Healthcare; 7% Food and drink; 6% Retail Company size 1-10 = 31% 11-50 = 21% Call backs 89% no call back; Research 5%; 2% voice message; 2% request Enquiry Type Visit 33%; Service info 9%; Occ Health 7%; H&S dev 5%; Law 4%; RA/Stress/Training/Welfare 3% Call duration average 21mins 6 -10 mins = 37%; 11- 20 mins = 22%; 21- 50 mins = 25%

20. External Evaluation - 2003 The following quotes are taken form the usefulness of the service - follow- up of advice line callers – Employers and Employees (Nov 2003): 68% of employers and 60% of employees thought the advice was ‘very useful’ 48% of employers and 28% of employees said that they had already recommended the advice line to others. Of those that had not yet recommended the service 85% of employers and 94% of employees said that they would be likely to recommend the service in the future. 92% of employers (n=23) and 96% of employees (n=24) said that they would be likely to use the advice line again. 80% of employers and 48% of employees said that the action taken had improved health and safety. 40% of employers and 24% of employees said that the action taken had resulted in other improved outcomes.

21. Internal Evaluation (2005)  Internal evaluation 2005  83 (69%) of the 120 feedback forms issued were returned to OHSAS. Adviceline  72% were very satisfied, 1% were satisfied and 27% did not use the service. Advisers visits and reports  92% were very satisfied and 8% did not use the service. Follow up visit  88% were very satisfied, 1% were satisfied and 11% did not use the service.

22. More than the Sum of the Parts Safe and Healthy Working Scottish Centre for Healthy Working Lives

23. Diverse Delivery SHAW DWP Occ. Health Providers Local Authorities SAD HSE SaHW NHS Health Scotland SBC NHS Boards Voluntary Sector Unions

24. Joining Up Delivery SHAW DWP Occ. Health Providers Local Authorities SAD HSE SaHW NHS Health Scotland SBC NHS Boards Voluntary Sector Unions Scottish Centre for Healthy Working Lives

25. Joined-Up Delivery SHAW DWP Occ. Health Providers Local Authorities SAD HSE SaHW NHS Health Scotland SBC NHS Boards Voluntary Sector Unions Scottish Centre for Healthy Working Lives

26. Strong Foundations 38% of the Scottish Workforce in SHAW registered organisations. 1,500 businesses visited by SaHW Advisers, and over 8,000 advice line/e-mail enquiries dealt with. Advice-Line expertise. On-Line Services expertise. Highly skilled staff dealing with Health Promotion and Occupational Health and Safety. Employability delivery capability (SAD and pilots). Established tradition of partnership working. Policy and partnership backing.

27. National Advisory Group Andrew CubieChairman Bill SpiersSTUC Iain McMillanCBI Scotland Rory Mair CoSLA Kevin DoranJob Centre Plus Scotland Pam WhittleScottish Executive Lesley HindsNHS Health Scotland Graham RobertsonNHS Health Scotland Stewart CampbellHealth and Safety Executive John PhillipsScottish Enterprise Rory MackailFederation of Small Businesses Ewan MacdonaldFaculty of Occupational Medicine Tom BellRoyal Environmental Health Institute of Scotland Steve BellScottish Centre for Healthy Working Lives

28. Strategic Objectives To implement the SE strategy for HWL and influence the future development of that strategy. To engage and work with partners and stakeholders in the delivery and development of opportunities for HWL in Scotland. To provide or offer access to high quality support, advice and guidance on all aspects of HWL to: –Employers, –Employees, –Those wishing to enter the workforce. To establish, develop and disseminate the evidence base for investment in the delivery of HWL at all levels. To co-ordinate the design, delivery and review of activities support the development and delivery of the HWL strategy. To recognise the achievements of Scottish employers in contributing to health improvement in Scotland.

29. Phase One (2005-6) Ensure delivery and development of SHAW and SaHW. Integrate business/employability functions of SAD. Review and develop existing pilots. Take forward With Work in Mind. Establish and implement new operational framework. Establish arrangements for joint working with partners. Develop and begin to implement new integrated marketing strategy. Develop evaluation framework. Develop workforce development strategy. Complete first phase of review of the award criteria. Soft launch Centre in Autumn 2005 followed by hard launch early 2006 Populate management structure. Establish office base and management systems.

30. Phase Two (2006-2008) Review existing research and commission new research as required. Continue to grow services currently delivered by SHAW and SaHW within a single system. Ensure service developments are co-ordinated with HSE Workplace Health Direct pilot. Introduce new credit system to the recognition programme. Design and deliver new training to workplaces and professionals. Develop new pilot projects, such as on personal health plans. Introduce programmes of vocational rehabilitations. Develop systems that support individuals to re-enter the workforce. Contribute to national health improvement policy development Develop proposals in preparation for the Scottish Executive spending review, which will in turn become phase three.

31. Existing Structure Chief Executive NHS Health Scotland Strategic Director SCHWL Scotland’s Health at Work Safe and Healthy Working NHS Health Scotland Action Plan Work stream development SHAW Advisers SaHW Advisers Local NHS Systems

32. Future Structure NHS Health Scotland Strategic Director Integrated Operations Integrated Marketing and Communications Work-stream Development Cross-cutting Programme Development Advice-Line and On-line Services Partnership Development Evidence and Evaluation Training and Professional Development Evidenced BasedMarket Led Employability Services Safety Services Occupational Health Services Health Promotion Services Recognition HWL Advisory Group

33. Customer Perspective Business Services Employee Services Returnee's Services Integrated Menu of Services Employability Services Safety Services Occupational Health Services Health Promotion Services Recognition On-Line ServicesLocal TeamAdvice Line Local NetworksVirtual Regional Team

34. Operational Framework Local Healthy Working Lives Network Regional ‘Virtual Team’ Local Delivery Partners On-Line Services National Advice Line National Office Regional Co-ordination Multi-disciplinary Local Teams Employers Employees Returnees to Work Clients Risk Assessment Tobacco Policy Support Smoking Cessation Sickness Absence Mgt Recognition Scheme Health Screening Job Retention Health & Safety Advice Lifelong Learning Return to Work Support Service Menu Delivery Components

35. Core Local Multi-Disciplinary Teams Occupational Health Health & Safety Health Promotion

36. Local Team Functions Client Management and client data recording. Integrated Workplace Assessment. Recognition Programme development and assessment. National programme and work-stream development. Marketing, communications and recruitment. Cross area working and training. Local partnership working (inc. Community Planning). Basic level competence in all team members. Practitioner competence in Health Promotion and Occupational Health and Safety within the team. Specialist competencies in team or Region/Nationally.

37. Centre Functions Strategic and Policy Direction Marketing and Communications Resource Development Work-stream Development Cross-Cutting Programme Development Partnership Development Training and Professional Development Competency Development Evidence and Evaluation Administrative Support Quality & Performance Monitoring and Support Advice-Line and Web-Based Services

38. Advice Line Functions First line point of contact for most new clients. Provide a confidential national telephone advice line on all aspects relating to workplace occupational health and safety, health promotion, and employability/return to work. Database management. Manage electronic and written enquiries. Routing clients to on the ground support (ie local adviser or delivery partner). Signposting to internal and external specialists Dealing with requests for resources and publications. Providing an internal specialist advice service to local Advisers. Contact point and focus for specific partnership initiatives and campaigns.

39. On-Line Services On-line tools for clients. Best practice examples. Information and knowledge databases. Contact details. Hyperlinks. Letter and report downloads. Diaries.

40. Performance Drivers HealthEconomyCTOG Stakeholders Competence Financial Learning and Growth Collaborative Advantage Personal and Community Capacity Competitive Advantage

41. Scenario One Employers Employees Needs Assessment Tobacco Policy Support Occupational Hygiene Sickness Absence Mgt Recognition Scheme Health Screening Job Retention Health & Safety Advice Lifelong Learning Return to Work Support Returnees to Work Local Healthy Working Lives Network Multi-disciplinary Local Teams Regional ‘Virtual Team’ On-Line Services National Advice Line National Office Regional Co-ordination Local Delivery Partners Clients Service Menu Delivery Components Health Promotion Client Manager

42. Scenario One Quantum Solutions is a small employer in Isolation Town which is struggling to recruit staff, and which also has sickness absence problems. They are thinking about relocating to Destiny because of this. They have been registered with Recognition Programme for over a year, but due to these pressures, have not made much progress. In a routine follow up meeting, the Client Manager is made aware of the problems, and introduces the business to Sickness Absence Management tools that are available on the website. She also arranges for a visit from the local Occupational Health Adviser, and the business begins discussions with the local occupational health service about purchasing a service. The adviser also discusses with the business possible opportunities that may exist for people wishing to return to work, and contact is made with the local employment office to discuss supported work placements. Working with the local college, Quantum is able to offer a placements to two people with basic IT skills who are recovering from mental health problems, and the business also works with the local mental health project on a mental health awareness and anti-stigma programme. Within 6 months, the business has achieved its Bronze award, and begins to look at how it could support its staff to be more active as a first step towards achieving silver.

43. Scenario Two Employers Employees Needs Assessment Tobacco Policy Support Occupational Hygiene Sickness Absence Mgt Recognition Scheme Health Screening Job Retention Health & Safety Advice Lifelong Learning Return to Work Support Returnees to Work Local Healthy Working Lives Network Multi-disciplinary Local Teams Regional ‘Virtual Team’ On-Line Services National Advice Line National Office Regional Co-ordination Local Delivery Partners Clients Service Menu Delivery Components OH or Safety Client Manager

44. Scenario Two An employee on a small fish farm is beginning to have increasing amounts of time off work due to a recurring back problem, and is concerned about his job. He phones the advice line, having seen an advert in a newspaper, and is given basic advise, as well as being sent Working Backs literature. A referral is also made to the local physiotherapy service which is involved in the local Healthy Working Lives Network. The employee is also provided with some information about the services provided by Healthy Working Lives, included in which is training for trainers around manual handling and local contact details, and he raises this with his manager who approaches the Local Adviser. An audit of the database also throws up the fact that a number of employees on fish farms have approached the Advice Line over recent months, and a proactive campaign targeting the industry is organised. The employer also registers for the award programme, and as a first step makes begins working with a local voluntary employability project. It hopes that this can help address recruitment problems it is facing

45. Scenario Three Employers Employees Needs Assessment Tobacco Policy Support Occupational Hygiene Sickness Absence Mgt Recognition Scheme Health Screening Job Retention Health & Safety Advice Lifelong Learning Return to Work Support Returnees to Work Local Healthy Working Lives Network Multi-disciplinary Local Teams Regional ‘Virtual Team’ On-Line Services National Advice Line National Office Regional Co-ordination Local Delivery Partners Clients Service Menu Delivery Components

46. Scenario Three Iain has not worked for a number of years following a head injury sustained in a traffic accident. He knows that he is not going to be able to return to his job as a teacher, from which he took ill health retirement, but does feel he has something to contribute. Having seen a poster in his local library, Iain views the Healthy Working Lives Website, and is encouraged to approach the Advice Line, where he talks to an specialist about returning to work. He is also put in touch with a employability project in Hope Springs that has been put on the project database by a Local Adviser. As it happens, he is able to find a placement with a business that has been involved with SHAW for over four years, and which began working with the local employability project as a means of achieving its Healthy Working Lives Silver Award, something it needed to do following the change in the award criteria earlier in the year.

47. Scotland’s Health at Work Case – Mariners Harvest (Fish Farms) Manual handling training (on installations) Immediate physiotherapy referral following injury Health checks for all staff Health info notice boards on all sites Tobacco policy in place Smoking Cessation ‘buddy training’ being set up Drug and Alcohol policies under development Inter site football matches SHAW Bronze Award holder – moving to silver Significant fall in sickness absence reported

48. Safe and Healthy Working Case – Farm-safe Pilot Pilot between SaHW, Health & Safety Executive and Scottish Farms Quality Cereals. SFQC Advisers trained in basic H&S awareness SFQC Advisers conduct rapid H&S assessment Where need identified, SaHW adviser visits and undertakes assessment and collects data. Follow up visit organised Internal and external evaluation being undertaken

49. Rehabilitation & Job Retention Case – Lanarkshire HOPE Project Healthcare, Occupational and Primary for Employees Aims to improve awareness of work related ill health, improve treatment, and develop a clear picture of its impact 2,105 clients referred since 2000 55 referred to Occupational Health Physician Average cost per client - £200. Evaluation suggests faster return to work and improved functional capacity for clients.

50. HOPE Project - Method Each patient interviewed screened by OHN Patient interviewed by telephone and data collected Consent, demographic and categorisation of condition returned to HOPE If YES - patient given information leaflet and signs consent section Patient screened - is condition related to work? Patients present to GP - AED - Health Professional Workplace Assessment OH Physician Physiotherapy Counselling Literature

51. Lost Working Days 2000-2005 Category Employees (n) Mean lost working days (n) Total lost working days (n) MSD5582714,787 Mental Health/Stress3323110,351 Accident1,10555,165 Respiratory disorders3817638 Other2416386 Skin conditions546308 Toxic subs (possibly)821170 Infectious diseases112 Hearing411 Total2,1421531,818

52. So what’s new?

53. Contact Details Steve Bell Strategic Director Scottish Centre for Healthy Working Lives Woodburn House Canaan Lane Edinburgh EH10 4SG Tel (0131) 536 5565 E-mail – steve.bell@health.scot.nhs.uksteve.bell@health.scot.nhs.uk www.healthyworkinglives.com