Equally Well Implementation Plan

End 2008

Scottish Government launches Early Years Framework.

Scottish Government

EY1-11

Spring 2009

Publication of ante- and post-natal care pathways for vulnerable women and their families, which will be the foundation for reaching higher-risk groups and identifying and managing risks during pregnancy.

NHSQIS

EY2, EY4

End 2009

Scottish Government to have arranged a Scottish survey of Foetal Alcohol Syndrome.

Scottish Government

EY2

March 2008

Scottish Government issued Chief Executives' Letter ( CEL 14(2008)) requesting all maternity units to implement the UNICEF Baby Friendly Initiative Awards Scheme. ¹

NHS Boards

EY2, EY4

Early 2009 and 2011

Identification of barriers to breastfeeding in deprived areas and among disadvantaged groups: short-term research to report in early 2009, and longer-term research to conclude early 2011.

NHS Health Scotland

EY2, EY4, EY7

End-2009

Nurse Family Partnership pilot starts, which will provide holistic support services for families with very young children at risk of poor health and other poor outcomes. Staff will be recruited in Spring 2009 for the pilot.

NHS Lothian

EY2, EY4, EY5, EY6, EY7

End-2008

Clarify process of how to assess the physical, mental and emotional health needs of looked after children and young people.

Scottish Government, NHS Boards

EY8

Spring 2009

Guidance to be issued to NHS Boards for assessing the physical, mental and emotional health needs of looked after children and young people.

NHS Boards

EY8

Sept 2008

Start of two year project to increase health and wellbeing support in schools, with demonstration sites in four NHS Boards. The sites will identify the health and wellbeing needs of the school population, which will inform what additional resources from NHS and other community-based services are required to meet these needs.

NHS Ayrshire & Arran, NHS Lothian, NHS Forth Valley, NHS Grampian

EY5, EY6, EY7

End 2010 - early 2011

Roll-out of recommendations from health and wellbeing support in schools project across Scotland.

tbc

EY5, EY6, EY7

May 2008

Scottish Government published its drugs strategy The Road to Recovery. A Project Board ² has been established to drive forward progress on each of the 17 actions which will improve support for children and young people affected by parental substance misuse.

Project Board

EY5, ADV2

Education, information and engagement for young people

• Recommendation 10 - Curriculum for Excellence should continue its strong focus on literacy and numeracy, with every teacher taking responsibility for delivery across the curriculum.

• Recommendation 11 - Curriculum for Excellence should take a holistic approach to health and wellbeing outcomes, including active and healthy lifestyles, supported by the new school health team approach.

• Recommendation 12 - The ethos within which Curriculum for Excellence is implemented should place the child at the centre of the process.

• Recommendation 13 - Curriculum for Excellence should provide continuity and progression through school to post-school, aimed at retaining young people in learning after the age of 16.

• Recommendation 44 - Local agencies should provide high quality, consistent information to young people in a whole range of settings, including easily accessible drop-in services, staffed by health professionals and youth workers.

June 2008

Scottish Government published Curriculum for Excellence: Building the Curriculum 3: A Framework for Learning and Teaching. This is relevant to everyone who is involved in promoting effective learning for children and young people from 3 to 18. It builds on A Curriculum for Excellence: Progress and Proposals, provides guidance on a new framework and sets out considerations that are critical to the adoption of Curriculum for Excellence. It outlines important messages for all partners involved in planning the curriculum for children and young people, placing the learner at the centre of the process of planning and curriculum delivery. http://www.scotland.gov.uk/Publications/2008/06/06104407/0

CPP

EY6, EY9, EY10

Summer 2008

Scottish Government published light-touch guidance highlighting roles and responsibilities of local authorities, Skills Development Scotland ( SDS) and other key players for delivering 16+ Learning Choices. 16+ Learning Choices is our new model to support the delivery of the senior phase of Curriculum for Excellence, and will ensure that every young person has an appropriate, relevant, and attractive offer of learning made to them well in advance of their school leaving date.

CPP, SDS

EY9, EY10

Dec 2008 - Dec 2010

Implementation of 16+ Learning Choices (in selected areas during December 2008; across the whole of Scotland by December 2010).

Local authorities and their partners ( CPP)

EY9, EY10

Early 2009

Final versions of experiences and outcomes for literacy, numeracy, health and wellbeing for Curriculum for Excellence to be made available.

Learning Teaching Scotland ( LTS)

EY6

August 2009

Schools and local authorities use final versions of experiences and outcomes for literacy, numeracy, health and wellbeing in their planning (all schools to use the guidance by August 2010).

CPP

EY6

June 2009

Learning Teaching Scotland and Health Scotland to issue national guidance and self-assessment tool to local authorities and NHS Boards on evidence and effectiveness of the multi-faceted approach of combined education and services.

NHS Boards, local authorities

EY5, EY6, EY9

Summer 2009

Drop-in services offering general health advice, including sexual health advice at all schools, or easily accessible to schools and to be open for at least 2 hours per week.

NHS Boards, local authorities

EY2, EY3, EY5

Summer 2009

High quality, consistent information on all aspects of sexual health and location of services to be provided to young people in settings such as schools, libraries, youth projects and health centres.

NHS Boards, local authorities

EY2, EY3, EY5

Early 2009

Publication of a Youth Framework, which will provide a set of common principles for delivering on Scottish Government national outcomes 4 (our young people are successful learners, confident individuals, effective contributors and responsible citizens) and 7 (we have tackled the significant inequalities in Scottish society).

Scottish Government

EY6, EY9, EY10, EY11, ADV10

October 2008

Launch of Young Scot: Active, a proposal led by Young Scot in partnership with the Scottish Government and COSLA to engage all young people in their local public services. Young Scot: Active brings together government, the public, private and Third Sector in Scotland with a shared vision to effect a cultural shift in attitudes and approaches towards young people, in terms of how they are perceived, the quality of services and products provided to them, and the support given to them to develop to their full potential. The proposals are set in the context of the National Performance Framework and linked to a range of cross-sector strategies designed to support young people's development. Key organisations will work with and empower young people to experience more, achieve more, contribute to and enrich their communities. It offers an over-arching framework of information and engagement services to be developed and accessed by projects across Scotland and the young people they support.

Young people, local authorities, CPPs, NHS Boards, voluntary sector

EY6, EY9, EY10, EY11, MW8, ADV10

Sept 2008

Launch of the latest phase of advertising by the Choose Life programme, to reduce the number of deaths in Scotland by encouraging people to talk more openly about suicide, as part of the ten year Choose Life action plan and strategy (launched in 2002). It included poster, press and radio advertising as well as online advertising to direct people to the new public-facing website. www.suicide-prevention.co.uk

NHS Health Scotland

MW11

Sept 2008

Launch of the latest phase of advertising by the See Me campaign, to eliminate the stigma and discrimination faced by people with mental health problems throughout Scotland. The campaign included adverts run on STV, Channel 4 Scotland and radio stations across Scotland, supported by a range of poster images distributed to communities across the country. www.seemescotland.org

See Me Campaign

MW9, MW10

Early 2009

Scottish Government to publish an Action Plan to improve mental health and wellbeing, following consultation on Towards a Mentally Flourishing Scotland in 2007-08. The action plan will set out the Government's approach to mental health improvement, key priority areas for action and support for implementation, recognising both the need for a whole population approach and a targeted approach to address known inequalities.

Scottish Government

MW9, MW10, MW11

August 2008-11

Scottish Government funds pilot initiatives to widen access and offer innovative approaches to self-help cognitive behaviour therapy and guided self-help for people with depression and anxiety.

NHS Boards, NHS24

MW10

Tayside test site: Integrating mental health improvement in a defined community within Dundee

This test site aims to work in a defined community in Dundee to improve wellbeing, to test how well-evidenced interventions impact on the community, what measures demonstrate impact, and to test the added value of focusing partnership resources on achieving wellbeing. The community will be engaged with to set the agenda, developing and delivering focus groups to investigate mental wellbeing issues, determinants, action and measures and hold dissemination and awareness-raising sessions on wellbeing interventions. Partnership analysis will determine wellbeing implications and priorities in local plans. The test site is testing three elements: improvement in wellbeing; what interventions lead to this; and how to measure it.

The Scottish Government's Health Improvement Social Marketing strategy delivers social marketing addressing smoking, alcohol, physical activity, diet, sexual health, breastfeeding and wellbeing. Tackling health inequalities is a core principle and the core audience for the strategy is from socioeconomic groups C1, C2, D and E.

The first social marketing campaign within the strategy, Take Life On, was launched in June 2008. It covered physical activity, healthy eating, wellbeing and alcohol moderation. The central message is that simple achievable changes in everyday life can bring real benefits for health and wellbeing, helping to reduce the risk of heart disease, cancer and diabetes and making people feel more positive in themselves. Take Life On provides practical advice that aims to be empowering and demonstrate how changing behaviours can be realistic in a busy schedule within constrained resources.

In October 2008 Lidl supermarkets promoted affordable healthy food choices, alongside alcohol moderation and physical activity messages. A similar partnership project will run with Coop/Scotmid stores in January 2009.

Early evaluation of the impacts of Take Life On indicate that the campaign's key target audience, women aged 25-50 from more deprived groups, find the campaign to be "incredibly motivating" to take small steps to lead a healthier lifestyle. It has also had a significant motivational impact amongst those with children.

Delivering for mental health in a rural and remote area

The focus of mental health services within remote and rural communities must be on the early detection of disease, with pro-active case finding targeted at difficult to reach people and those in need, the aim of which is to prevent disease escalation. One such example is Guided Self Help Workers in NHS Highland, who identify people with depression at an early stage and focus upon the prevention of escalation of disease.

Remote and rural areas can also develop creative solutions to prevent mental health crisis by utilising Choose Life Coordinators, and building on work by the Mental Health Foundation, SAMH and the Mental Health Collaborative improvement programme on reducing hospital re-admissions and developing an assessment/appraisal tool for NHS Boards and partners to use to assess progress against delivering these standards.

Autumn 2008

Scottish Government supporting CPPs in the continuous improvement of their Fairer Scotland Fund plans (by written feedback and policy team visits).

Scottish Government, local authorities, CPPs

MW1, MW2

June 2008

Scottish Government held a seminar for local authorities to disseminate good practice developed by the 11 local authorities that received funding from the Financial Inclusion Fund authorities for two years (2006-08).

Scottish Government, Financial Inclusion Fund authorities

MW1, MW2, MW3

January 2009

Launch of Community Regeneration and Tackling Poverty Learning Network (coordinated by the Scottish Centre for Regeneration). The network will provide advice, support and a forum to share best practice as CPPs look to mainstream approaches to tackle regeneration, poverty and income inequality.

Scottish Government, local authorities, CPPs

MW1, MW2

2008-11

Scottish Government collaborating with DWP to maximise the impact of the Scottish Financial Inclusion Champions Team. ³

Scottish Government, DWP

MW2

2009-11

Scottish Government to invest in income maximisation work, including a focus on benefits uptake for older people and other key groups, building on what works and developing new approaches to boost the income of those in poverty or at risk of poverty. This will include building on pilots with Age Concern Scotland and DWP to increase pension credit take-up by older people in the East End of Glasgow and Aberdeenshire.

Scottish Government, DWP, local authorities, Third Sector

MW1, MW2

November 2008

Scottish Government launched Achieving our Potential, its framework for tackling poverty.

Scottish Government, local authorities, Third Sector

EY1, MW1, MW2, MW3

March 2009

Effective links with income maximisation activity being undertaken under other programmes and frameworks (such as fuel poverty) to be in place.

Scottish Government

EY1, MW1, MW2, MW3

Spring 2009

The National Food and Drink policy workstream on affordability, access and security to provide a research inquiry into food prices and the impact on the affordability and access of healthy, wholesome food and provide recommendations.

Scottish Government

MW1, MW5, BK5, EY2

Macmillan Cancer Support has worked with local authorities across Scotland and other key stakeholders to develop policies and services highlighting issues of unclaimed benefits and other socioeconomic inequalities affecting cancer patients. This has created a platform for discussion leading to improved advice services for cancer patients and carers throughout Scotland.

Since its Benefits and Financial Advice services were launched in 2004, Macmillan has helped patients in Scotland access £30m of otherwise unclaimed benefits. The Macmillan Money Matters service in Forth Valley, which spans three local authorities (Stirling, Clackmannanshire and Falkirk Councils), has supported cancer patients, their carers and family members access £3m in the past three years. An innovative service at Beatson West of Scotland Cancer Centre was launched in October 2007 and has, to date, generated £1.8m for service users.

New benefits services will be launched in several locations during 2009, including partnerships with Glasgow City Council, Edinburgh City Council and the three local authorities on Tayside.

NHS Greater Glasgow and Clyde has developed a financial inclusion pilot service for people affected by stroke (patients, carers and family). The pilot service meets the immediate financial needs of people affected by stroke within the acute setting and facilitates a transition to specialised community based financial inclusion services when, or if, required. The service offers general advice over the telephone, as well as hospital and home visits. The service is advertised within ward and visitor areas, and key staff involved in patient care have a three question screening tool that is proactively used to identify a person's need for money advice. Referrals can be taken from patients, staff, carers or anyone affected by a stroke. Once a referral has been made, a money advisor will assess a client's short- and long-term money needs, and provide an intervention in place to support these needs. Short-term needs can prevent any catastrophic events from taking place, such as being taken to court, accounts being suspended, or someone losing their home. Long-term needs can include maximising income, benefit claims, re-ordering finances, and general financial capability support.

Fairer Scotland Fund ( FSF)

Glasgow City Council is investing £1.2m from its 2008-09 FSF allocation to deliver a new, city-wide Addictions Programme. The Programme aims to bring together previously separate streams of addictions funding under clear strategic priorities. This will ensure demand-led provision of services, as well as identifying the need for new or additional services. There will be a specific focus on helping people with addictions into employment.

Falkirk has provided £200k from the FSF over the next three years for a physical activity initiative for young people, targeted at the most disadvantaged areas. The project delivers a sports activity outreach programme that aims to create an alternative route for young people to become involved in sport outwith normal school or sports club settings. The project provides a positive diversion from areas where communities have identified issues of youth antisocial behaviour, underage drinking etc. Young people will be engaged to assist in directing the types of activities which are delivered. A particular focus will be on encouraging the participation of teenage girls, who traditionally have a lower participation rate in sport.

May 2008

Scottish Fuel Poverty Forum ⁴ reconvened, to advise the Scottish Government on how best to tackle fuel poverty in the future.

Scottish Fuel Poverty Forum

MW3

Nov 2008

Scottish Government announced that the Central Heating and Warm Deal Programmes will be replaced with an Energy Assistance Package (from April 2009).

Scottish Government

EY1, MW1, MW3

April 2009

Operation of the Energy Assistance Package, available to pensioners and low income families with a child under 5 or a disabled child under 16. This is a one-stop shop delivered via the Energy Saving Scotland Advice Centre Network. It will provide advice on all aspects of fuel poverty, checking those vulnerable to fuel poverty are on the best fuel tariff, maximising their income and improving the energy efficiency of their homes. Energy companies will provide a package of insulation measures, funded under the Carbon Emissions Reduction Target ( CERT) to fuel-poor households. Scottish Government will fund enhanced energy efficiency improvements to those households hit hardest by higher fuel bills (such as insulation for fuel poor households who live in private sector homes that have poor energy performance). Maximum cap grant to be increased from £3,500 to £4,000 for most homes under the Energy Assistance Package. Up to £6,500 to be available for homes off the gas grid that cannot be sufficiently improved under the lower cap. The Energy Assistance Package to be supported by funding worth £55.8m per year.

Energy Saving Scotland Advice Centre Network, Scottish Government, energy supply companies

EY1, MW1, MW3

March 2008

Scottish Government issued a Chief Executives' Letter to all NHS Boards ( CEL 14(2008)), requesting all acute sector units to take part in the Healthy Working Lives awards scheme and work towards an award.

NHS Boards

MW4, MW5

August 2008

Scottish Government reviewed the Scottish Action Plan on Health and Safety. All actions in the plan have either been completed or mainstreamed into the regular activities of relevant agencies.

Scottish Government

MW4

End 2008

Scottish Government and Urban Regeneration Companies ( URCs) to develop a monitoring and evaluation framework for URCs which includes specific health indicators.

Scottish Government, URCs

Summer 2009

Scottish Government to complete its review of Healthy Working Lives strategy, aligning the outcomes to Equally Well recommendations. Workstreams within the review of the Healthy Working Lives strategy will: (i) develop a communications strategy that includes messages on health and work tailored to specific stakeholder groups (healthcare professionals, SMEs, private sector organisations, etc); and (ii) clarify client pathways in journey to employment and improved health, with focus on delivery of occupational health and vocational rehabilitation services.

Scottish Government

MW4, MW5, MW6

June 2009

Scottish Government to hold the second National Health and Work Conference to promote relaunch of the Healthy Working Lives strategy, reinforce messages, and re-engage with key stakeholder groups.

Scottish Government

MW4, MW5, MW6

End 2008

Scottish Government to set up an interactive Employability Learning Network. The network is aimed at partners in local employability networks, including local authorities, NHS Boards, CHPs, and Third Sector organisations. The employability learning network will comprise: an employability website to provide a "home" for toolkits, learning points and other employability resources; a series of targeted learning events to disseminate and share lessons and experience, including facilitated networks and learning sets to build skills and apply lessons; and a regular e-bulletin to keep wider interests informed of developments.

Scottish Government, local employability networks

MW4, MW5, MW6

Jan 2009

The Scottish Centre for Healthy Working Lives to produce its three year Strategic Business Plan setting out a vision for the Centre and how it will develop products and services that are more focused on the needs of SMEs.

The Centre supports the work of Scottish Business in the Community and collaborates with Jobcentre Plus in promoting the message on the benefits of employers offering employment to people who are currently out of work because of ill health. Services will also be aligned with the Scottish Government's mental health strategy.

Scottish Centre for Healthy Working Lives

MW4, MW5, MW6

Lanarkshire test site: Sustained employment

The recent Black report highlighted the impact of worklessness on health. This test site is designed to support and enable frontline NHS, social work and housing staff to engage with patients/clients on the issue of employability and to make onward referrals to employability programmes. It will involve partner services that are not traditionally engaged with the employability needs of clients or patients, such as social work and housing. The aim is to support clients/patients claiming (or at risk of claiming) Employment and Support Allowance to enter or remain in the labour market. The test site will cover both North and South Lanarkshire.

Ongoing

Thirteen of the territorial NHS Boards provide pre-employment training and opportunities for people on benefits, including those from marginalised groups, through health care academies or similar schemes. Scottish Government has been highlighting and promoting research that evaluated current NHS Board activity in providing pre-employment opportunities and how this leads to permanent posts

NHS Boards, CPPs

MW4, MW5, MW6

2009-10

Scottish Government to work with COSLA in extending the scope of the Boards' schemes to all local authorities.

Scottish Government, COSLA, NHS Boards, local authorities

MW4, MW5, MW6

2009-10

Scottish Government to work with COSLA to promote to local authorities a common public sector recruitment approach to develop pools of appropriate individuals from which smaller public sector recruiters could also draw.

Scottish Government, COSLA, local authorities

MW4, MW5, MW6

2008-09

Scottish Government providing seminars and workshops to public sector organisations, explaining the benefits of community benefits clauses in their contracting processes. ⁵

Scottish Government

MW6

Healthcare Academies

The NHS Greater Glasgow and Clyde programme, Working for Health (WfH) began as a pilot in January 2004 and was set up to meet the needs and demands of NHS employers. Working age adults who had been unemployed for between six months and 10 years were eligible for the training. WfH is a partnership project involving the employer ( NHSGG&C), the funders (Scottish Enterprise Glasgow and Jobcentre Plus), and the training provider (The Wise Group).

The core programme was a six week training and work experience module covering confidence building, skills training (including ICT, interview skills and job-matching) and concluding with general aspects of the NHS induction.

Participants took a work placement and received support to apply for NHS jobs. A two week skills and job-matching option was also created, aimed at unemployed adults who have existing skills but are not aware of the current skills requirements of NHS jobs. Finally, for adults who needed supplemental training to ready themselves for the workforce, a 15 week occupational skills module was created which included intensive training and work placement.

The NHS Tayside Healthcare Academy, a partnership between NHS Tayside, Skills Development Scotland, Careers Scotland, Jobcentre Plus, Triage, Claverhouse Group, Dundee City Council, Angus Social Work and Health, Dundee Social Work Department, Perth & Kinross Housing and Community Care, Angus College, Dundee College and Perth College was implemented in January 2006 following publication of the regional Strategic Workforce Development Plan. Within the context of Social Inclusion, Equality and Diversity, unemployed people have been targeted to participate in the Health Care Academy Pre Employment Training Initiative. Through analysis of age profiles within the workforce and discussion with NHS Managers, services identified as potentially accessing the Health Care Academy, included:

• Operations Directorate Staff.

• Administration and Clerical Support.

• Clinical Support roles.

The NHS Tayside Health Care Academy model is underpinned by close cooperation and liaison with Jobcentre Plus, Scottish Enterprise Tayside and identified training providers, one of these being Dundee college. Close collaboration with Social Care has been crucial.

Since 2006, NHS Tayside Academy has enrolled 164 students to a six week pre-employment training course. 146 students completed the course and 84 subsequently found permanent employment in the NHS and elsewhere.

Dec 2008

Early Years Framework highlights improving outcomes and children's quality of life through play. Scottish Government to lead a national debate on relative risks and benefits associated with play to children, involving a range of partners, including Play Scotland and the police.

Scottish Government

EY7, EY11, MW13

Ongoing

Scottish Government attendance at meetings of the Sustainable Scotland Network and regular discussion and development work with SOLACE and COSLA to support delivery of healthy physical environments, including how to deliver Greener objectives in the context of SOAs.

Scottish Government

EY7, EY11, MW13

June 2008

Scottish Government published Healthy Eating, Active Living ( HEAL), its action plan to improve diet, increase physical activity and tackle obesity in Scotland.

NHS Boards, local authorities

EY2, EY7, EY9, EY11, MW13

2008-09

Scottish Government to produce guidance on Beyond the School Gate. Beyond the School Gate (part of HEAL) will help support health promotion across communities and focus on action that encourages physical activity and access to healthier foods.

Scottish Government

EY2, EY7, EY9, EY11, MW13

End-2008

Scottish Government publishes Good Places, Better Health, a strategic framework for environment and health that aims to identify evidence and policies that can be taken forward to create environments that promote and nurture good health. Its first priorities in children's health are obesity, unintentional injuries, asthma and mental health and wellbeing.

Scottish Government

EY6, EY7, MW3

Sept 2008

greenspace Scotland published guidance on health impact assessmentshttp://www.greenspacescotland.org.uk/default.asp?page=462# HIA%20guide greenspace Scotland to explore how to apply health impact assessments to greenspace interventions, identify how they can increase the positive health impacts of greenspace actions, and model the planning and development of greenspace interventions that are intended to deliver health outcomes.

greenspace Scotland, local authorities, CPPs

EY11, MW13

2009-10

Development of guidance materials and toolkits for developing sustainable management approaches for planning and greenspace.

greenspace Scotland, SNH, Glasgow and Clyde Valley Network Partnership

MW13

June 2008

Scottish Government published guidance to the Scottish Sustainable Communities Initiative, which seeks to provide places that have high quality, affordable homes for all sectors of the community, fully integrated with public and active transport networks (rather than being car-dependent).

Scottish Government, local planning authorities, building and development industry

EY7, EY11, MW13, MW14

January 2008

Scottish Government published National Planning Framework 2: Discussion Draft for public engagement prior to final publication (spring 2009). A key part of the long-term spatial strategy is to help build safer, stronger and healthier communities by promoting improved opportunities and a better quality of life.

Scottish Government, local authorities, planning authorities

MW13, MW14

Glasgow test site: Integrated health and planning

This test site builds on previous experience of incorporating health considerations into the planning process through Glasgow's East End Local Development Strategy. That showed the potential to consider the health impact of neighbourhood design and development. An initial event with planners, architects and developers, and community representatives will build cross-sectoral momentum and ownership for the test site. The test site aims to develop good practice in incorporating health within the planning process; incorporate lessons learned from existing experience; provide new and innovative means for partners to engage with each other; offer new ways of shaping the health impact of private sector investment in buildings and land; and assess the impacts on inequalities in health and wellbeing.

Use of greenspace

At Hailes Quarry Park in the Wester Hailes area of Edinburgh, the City of Edinburgh Council had identified that the park was seriously underused but had the potential to improve quality of life for people in the surrounding area. Initial thoughts were that the park needed better paths and lighting but it was recognised that there was a need for community engagement to identify the way forward. The Council worked with placemaking scotland and with the Edinburgh and Lothians Greenspace Trust to involve local community groups and individuals. As a result, more is being done to encourage and support community uses of the park and to mark and signpost entrances to the park. In the two years since work began, the levels of informal use of the park have steadily increased, and attendance at community events has climbed from single figures to between 40 and 50 at most small events. The Fun Day at the park in May 2008 attracted more than 1,200 people.

By end-2008

Discussions between Scottish Government and external agencies regarding the content of the National Transport Strategy delivery plan.

National Transport Strategy Stakeholder Group

EY11, MW13, MW14

Early 2009

Scottish Government to publish the Road Safety Strategy, which will include objectives and actions regarding targeting children who are at greater risk of injury in road accidents and will encourage good practice by local authorities.

Local authorities

EY11

By 2010

Health inequalities to be considered as part of the Scottish Government's review of the National Transport Strategy in 2010.

Scottish Government

EY11, MW13, MW14

Aug 2008

Scottish Government announced the proposals to be funded by Smarter Choices, Smarter Places ( SCSP), a partnership project between the Scottish Government and COSLA, which is designed to increase active travel and use of public transport, and tackle transport emissions. Proposals were required to demonstrate a positive effect on health improvement and reducing health inequalities.

Local authorities

EY11, MW13

2009-12

Smarter Choices, Smarter Places projects in operation. www.scotland.gov.uk/Topics/Transport/sustainable-transport

Local authorities

EY11, MW13

May 2009

First baseline report from monitoring and evaluating the seven SCSP communities, including identifying current data on the physical activity levels and related health of the populations.

Scottish Government

EY11, MW13

2009

Scottish Government to establish Healthy Weight Community Projects, which aim to reduce the rate of increasing obesity, particularly amongst children and more deprived groups of people. The projects will bring together local stakeholders to raise community-wide awareness of the importance of healthier living, and help make clearer how people can be more active in everyday life and make healthier food choices.

Local authorities and partners

EY5, EY7, EY9, EY11, MW13

East Renfrewshire - Smarter Choices, Smarter Places

East Renfrewshire Council has the overarching objective of promoting a healthy and active lifestyle at the core of its Smarter Choices, Smarter Places sustainable transport demonstration town project in Barrhead. The project has a strong community focus and will concentrate on combining the benefits of a high quality infrastructure with a variety of behaviour change initiatives targeted at residents, children and employees. Included in the mix of 17 projects is the progression of the innovative work of the Auchenback Health and Open Space project which explores linkages between greenspace and health in one of the most deprived areas in Barrhead. Other projects include Walking and Cycling for Health in Barrhead, Personalised Journey Planning, Smarter Barrhead Schools Initiative, and Working with Business.

June 2008

Scottish Government published a Youth Justice Framework (Preventing Offending by Young People: A Framework for Action). This sets out a shared vision of what national and local agencies working with children and young people who offend (or are at risk of offending) should do to prevent, divert, manage and change that behaviour. It includes a commitment to expand positive opportunities for young people, through Curriculum for Excellence, CashBack for Communities, and the forthcoming Youth Framework. CashBack for Communities is linked with More Choices More Chances and demonstrates the Scottish Government's financial commitment towards providing opportunities for young people to take part in positive activities.

Scottish Government, COSLA, Association of Chief Police Officers Scotland ( ACPOS), Scottish Children's Reporter Administration ( SCRA), the Crown Office, local authorities

ADV1, ADV2, ADV3, ADV4, ADV5, ADV7, ADV8, ADV9, ADV10

2009

Scottish Government to produce an evidence base around what works in early and effective intervention for reducing offending in young people, and to disseminate good practice to CPPs.

Scottish Government

ADV5, ADV7, ADV8, ADV9

2009

Scottish Government, COSLA, ACPOS, Crown Office and Procurator Fiscal Services, SCRA, HM Inspectorate of Education ( HMIE), Social Work Inspectorate Agency ( SWIA), Care Commission to develop and publish a voluntary framework for management information, to help local areas to plan and manage their services relating to youth justice.

Scottish Government, COSLA, ACPOS, COPFS, SCRA, HMIE, SWIA

ADV5, ADV7, ADV8, ADV9

October 2008

Multi-agency Glasgow anti-gangs project launched, providing effective coordination of all services and the community and voluntary groups to reduce gang-related violence. It will provide fast-track referral to education, employment, diversionary activities, programme work and support services for young men who wish to stop being involved in violence and gang fighting.

National Violence Reduction Unit, local partners

MW6, ADV2, ADV4, ADV5, ADV7, ADV9, ADV10

Early 2009

Following a review of national Scottish policy, Scottish Government to publish new framework for preventing antisocial behaviour. This will include national actions and local recommendations across four themes, prevention, integration, engagement and communications.

Scottish Government

MW14, ADV2, ADV4, ADV5, ADV7, ADV8, ADV9, ADV10

Ongoing

Continuation of Injury Surveillance project for intentional injuries and ongoing evaluation as the project proceeds. Scottish Government to formally assess impacts of the project (by October 2010) and consider whether to replicate elsewhere.

NHS Lanarkshire, National Violence Reduction Unit, Scottish Government

ADV7

2008-09

Scottish Government to commission a pilot study to assess the level and quality of data collected in A&E Departments around unintentional injury.

ISD

March 2008

Scottish Government issued Chief Executives' Letter to NHS Boards ( CEL14 (2008)) requesting them to implement health promoting actions around brief interventions on alcohol misuse, and directing patients to an appropriate support service. Alcohol Brief Interventions Delivery Support Team established to support delivery of brief interventions across NHS Scotland.

NHS Boards, Alcohol Brief Interventions Delivery Support Team

ADV1, ADV2, ADV7

End 2008/ early 2009

SMACAP/ SACDM⁶ Delivery Reform Group to report on its consideration of the future of alcohol and drug delivery arrangements. The intention of this work is to deliver more effective, joined up services at local level to those most in need.

SMACAP/ SACDM Delivery Reform Group

ADV1, ADV2, ADV3, ADV4, ADV5

2008-09

NHS Health Scotland to develop a research evaluation framework to monitor the impact of the Government's interventions on alcohol misuse.

NHS Health Scotland, Scottish Government

ADV1, ADV2

Fife test site: Safer neighbourhoods

The overall objective of this test site is to reduce crime and antisocial behaviour ( ASB) through a targeted intelligence-led approach, based on Safer Neighbourhoods team area-based tasking in antisocial behaviour in the Templehall area of Kirkcaldy. By linking health services into the area tasking group and promoting greater integration of health and community safety interventions, the test site will address health inequalities and ASB, and embodies many of the basic principles of the Government's ASB review. The test site aims to reduce crime and fear of crime in the area; to reduce antisocial and nuisance behaviour; to use partnership data to generate a better baseline of health-related behaviours and health interventions; to increase understanding across all partners in the task group of the relationship between antisocial behaviour and physical and mental wellbeing; to promote community engagement in addressing poor mental and physical wellbeing in young people; and to expand the model from the Templehall area to other 'at risk' areas.

Medics against Violence

Sixty-five senior medics from the Glasgow area have voluntarily committed their time to Medics Against Violence, and that number is increasing daily. The first project they will undertake is an education initiative in schools, supported by lesson plans that are being developed with the help of education professionals. The Directors of Education at Glasgow and Inverclyde Councils have agreed to support this work. The Scottish Government has provided £80k funding to create the teaching plans, produce a short film and to provide additional materials and hand-outs for students.

Action on alcohol in Perth & Kinross

SIGN Guideline 74 sets out a strong evidence base of the benefits of screening and brief interventions in relation to alcohol consumption.

A training programme operating within Perth & Kinross CHP targets a broad spectrum of staff and seeks to increase their awareness of the effects of alcohol consumption and equip them with the skills to undertake screening and brief interventions. To maximise uptake and minimise disruption to staff, 20-30 minute training sessions are included in established staff and management meetings where staff are also introduced to the Screening and Brief Intervention Handbook for At-Risk and Harmful Alcohol Use. This will initially be aimed at health visitors, district nurses, public health nurses, young people's workers, minor illness/injury nurses, A&E staff, community hospital staff, GPs and pharmacists, before being rolled out to other groups of staff.

End 2008/ early 2009

SMACAP/ SACDM Delivery Reform Group to report on its consideration of the future of alcohol and drug delivery arrangements. Proposals will focus on structures, function and accountability for local partnerships working on alcohol and drugs; the importance and value on partners working together on the basis of outcomes; and the additional support required

to help partnerships deliver the drugs strategy.

SMACAP/ SACDM Delivery Reform Group, Scottish Government

ADV3, ADV4, ADV5

Sept 2008

Scottish Government issued a Chief Executives' Letter to NHS Boards on gender-based violence ( CEL 41(2008)). This sets up a national programme of work on improving the healthcare identification and management of gender-based violence (2008-11). At a strategic level, local Boards will work with multi-agency partnerships on abuse and community safety and community planning processes .

Scottish Government, NHS Boards, community safety units, CPPs

ADV6

End 2008

Scottish Government to issue guidance to NHS Boards for all staff on the different components of gender-based violence. This will include detailed guidance on routine enquiry, how to record and handle disclosure, and will initially be targeted at priority areas of mental health, sexual and reproductive health, A&E, addictions, primary care, and maternity services.

Scottish Government, NHS Boards

ADV6

2009-10

Learning and training for health staff to facilitate routine enquiry into domestic abuse. Local training consortia will support Health Boards in undertaking training for staff around the implementation of routine enquiry.

National Training Steering Group, local training consortia, NHS Boards

ADV6

tbc

Scottish Health Network on Gender-Based Violence to be established, which will provide a national forum for health staff to share best practice, disseminate research and information, and obtain support and guidance.

Scottish Government

ADV6

Early 2009

All health checks undertaken as part of the Keep Well programme to include screening for anxiety and depression, followed by appropriate support and treatment. Funding has been set aside during 2009-11, within Keep Well budgets, to assist in implementing both screening and treatment.

NHS Health Scotland, Keep Well Health Boards and local partners

BK4, BK5

2008-10

Well North is being implemented. This is a programme to increase the reach and impact of health improvement interventions that deliver anticipatory care for those most at risk of poor health outcomes in remote and rural areas. The overall aim is to provide inequalities-targeted anticipatory care, addressing the major risk factors for poor health outcomes, by developing approaches in areas which pose significant and different challenges to service deliverers. Parallel approaches to be delivered in Forth Valley, Dumfries and Galloway and Borders (2009-11).

NHS Health Scotland, NHS Grampian, NHS Highland, NHS Orkney, NHS Western Isles, NHS Shetland

BK4, BK5

Ongoing

Scottish Government will work with NHS Boards towards establishing inequalities-targeted high risk primary prevention as part of the normal offer of the NHS across Scotland. Scottish Government will provide up to £13m from within Keep Well budgets, to allow further refining and testing of anticipatory core approaches during 2009-11. This will draw upon the anticipatory care work initiated under Have a Heart Paisley, and the unmet needs projects, and will represent the smooth transition from the Keep Well and Well North programmes into a mainstreamed approach.

Scottish Government, NHS Boards

BK4, BK5

2008-09

Early discussions regarding the provision of anticipatory care programmes that target prisoner and South Asian populations.

Scottish Government

BK4, BK5, BK8

2009-10

Roll-out of anticipatory care for prison populations.

NHS Boards, Scottish Prison Service

BK8

2008-09

Development of Life Begins programme, which aims to give every 40 year old the opportunity to assess their risk of future illness, especially coronary vascular disease, and to inform them of measures they can take to reduce those risks.

Scottish Government

BK4, BK5

2009

Implementation of Life Begins in Scotland. The universal (Life Begins) and targeted (Keep Well, Well North) approaches to health checks will complement each other, increasing the population who have been invited to assess their risks and change their lifestyle where necessary.

NHS Health Boards

BK4, BK5

Oct 2008

GMS funding contract for 2009-10 announced by Scottish Government will allow for funding to be better targeted at practices in deprived areas with the highest prevalence of ill health, to enable them to improve core general medical services, participate in more directed enhanced services and better address health inequalities. ⁸

NHS Boards, GMS Practices

BK4, BK5

Oct 2008

NHS Forth Valley to report on how to improve offenders' oral health; NHS Highland to report on how to improve oral health amongst homeless people; NHS Ayrshire & Arran to identify good practice for improved oral health amongst older people.

NHS Forth Valley, NHS Highland, NHS Ayrshire & Arran

BK6

2009-10

Start roll out of coordinated core and client-centred oral health improvement programme for homeless people.

NHS Boards, local authorities

BK6

2009-10

Start to roll out oral health strategy for offenders.

NHS Boards, Scottish Prison Service

BK6

Delivering anticipatory care in rural and remote areas

Based upon the principles of Keep Well, Well North is being implemented in remote and rural areas in the North of Scotland. Well North is a programme to increase the reach and impact of health improvement interventions that deliver anticipatory care for those most at risk of unequal health outcomes in remote and rural areas. The overall aim is to provide inequalities-targeted anticipatory care, addressing the major risk factors for poor health outcomes, by developing approaches which work in such areas. The Scottish Government is providing £750,000 to six projects over five NHS Boards, which will:

• Target individuals or households of any age at risk of preventable serious ill-health in defined remote and rural areas. The target population includes those with undetected chronic disease.

• Target disease according to patient/local needs and disease risk factors (eg blood pressure, cholesterol, smoking and diabetes) in recognition that this will have benefit in relation to other serious conditions and wider lifestyle factors (eg housing).

• Seek to improve reach, access and methods of engagement with services/the wider primary care team, thereby addressing the inverse care law (availability of good medical care tends to vary inversely with the need for it in the population served).

• Take account of the dispersion of deprivation that is unique to remote and rural Scotland.

• Generate further evidence of effective working practices that will inform the future roll-out of anticipatory care.

Uptake of Cardiology Services in NHS Tayside aimed to improve access to modern, evidence-based cardiology services for people most at risk from coronary heart disease, and so increase uptake of services. All services that could be delivered away from the main cardiology department were delivered in a community venue or in a clinical mobile unit (van). In addition, potential patients were identified through attendance at local events (including gala days, bingo halls and at mosques). 1,781 people engaged with the project. Most of the people who were involved were from the poorest areas of Tayside, and 10% were of South Asian ethnicity (a group that has an increased risk of coronary heart disease). 161 people received a consultation at the specialist cardiology clinic, of whom 82 had no known coronary heart disease by described significant symptoms. The project improved access to modern cardiology services for people in deprived and minority ethnic communities.

Improving access to coronary heart disease services was an unmet needs project run in Greater Glasgow. The project was developed as part of Have a Heart Paisley, and aimed to identify whether intensive outreach and support (a) encourages people from deprived communities to access primary prevention services, and (b) encourages uptake of health checks for coronary heart disease in deprived communities. The project team used a variety of community engagement techniques, including on-street interviewing, attendance at local social activities, post office queues during benefit-collection times, and opportunistic recruitment on local buses. Those who were approached were given a leaflet highlighting the service offered and encouraged to come forward. The project had set out to screen 133 clients. It resulted in screening 247 clients (159 women and 88 men). In addition, a second screening (6 months after the initial screening) resulted in 75% clients returning to be screened. The project demonstrated the success of using flexible approaches to engagement, with a particular focus on community engagement techniques.

Health and homelessness

Through the Edinburgh Homeless Practice the City of Edinburgh Council and NHS Lothian provide a full range of primary health care services, while also addressing people's wider needs, such as more secure tenancy. The practice aims to support people to transfer to mainstream services. It offers many services, including drug treatment, a psychiatric clinic, a women and children's midwifery, and public health nursing service .

March 2008

Scottish Government issued Chief Executives' Letter ( CEL 14(2008)), requesting all NHS Boards to implement health promoting actions on smoking.

NHS Boards

EY2, BK1, BK2

May 2008

Scottish Government published the Smoking Prevention Action Plan, Scotland's Future is Smoke-Free, which sets new separate targets for 13 and 15 year old boys and girls, and for 16-24 year olds.

Scottish Government

EY2, BK1, BK2

2008-11

Implementation of Smoking Prevention Action Plan ( SPAP). Scottish Government has provided £9m to local authorities and NHS Boards to support delivery of SPAP - local authorities will use funding to enforce tobacco sales law; NHS Boards will use funding to coordinate local action by local tobacco control alliances to underpin SPAP measures.

NHS Boards, local authorities, local tobacco control alliances

EY2, BK1, BK2

Late 2008, early 2009

Launch of Enhanced Tobacco Sales Enforcement Programme ( ETSEP). This identifies new targets for an outcomes-focused scheme to secure more rigorous enforcement of tobacco sales law.

Scottish Government, COSLA, Society of Chief Officers of Trading Standards in Scotland ( SCOTSS)

EY2, BK1, BK2

End-2008

Production of practical resources and support to assist delivery of ETSEP/ SPAP, including best practice guidance and evidence-based training.

NHS Health Scotland, Partnership Action on Tobacco and Health ( PATH)

EY2, BK1, BK2

2008-09

NHS Health Scotland to develop a research evaluation framework to monitor the impact of SPAP.

NHS Health Scotland

EY2, BK1, BK2

West Dunbartonshire test site: Targeting tobacco in Whitecrook

Smoking prevalence in Whitecrook is 40.2% compared to a national average of 24.7%. The area has high rates of coronary heart disease, cancer and cardio-vascular disease. The test site aims to reduce the prevalence of smoking within the population of Whitecrook, an area that suffers considerable and multiple socioeconomic deprivation. The test site will focus on several themes: prevention and education (including work in schools and nurseries with parents and children, and wider activity using social marketing approaches); enhanced smoking cessation services (including evidence-based group work and piloting more intensive individualised support whilst linking quitters into a wide range of local services); and targeting tobacco sales (including test sales and awareness work with retailers).

2008-10

Implementation of The same as you? The same as you? national implementation group, ⁹ led by the Scottish Government, will work with NHS Health Scotland and the Scottish Consortium for Learning Disability to develop targeted health promotion activities.

National implementation group

BK7

2008-09

Development of training materials for health professionals, social care workers and family carers targeted at the health improvement of people with profound and multiple disabilities.

PAMIS¹⁰

BK7

2008-10

Certain NHS Boards to build on existing work to take forward a change programme of health services for people with learning disabilities, to explore a range of service models that tackle the known health inequalities of this group. Other NHS Boards to bid for resources in 2009-10 to develop change programmes.

Scottish Government, selected NHS Boards

BK7

End 2008

Scottish Government to publish national framework for regular health checks for people with learning disabilities.

Scottish Government

BK7

End 2008

Scottish Government to receive proposals from NHS Boards for specific actions in each Board's area to address the inequalities faced by people with learning disabilities when being treated in health settings. Proposals will identify a lead person in each area to take responsibility for the programme of change.

Scottish Government, NHS Boards

BK7

Ongoing

Scottish Government developing its approach to independent living, with the aim of ensuring that disabled people feel valued as individuals and have the same choice, control and freedom as any citizen. This includes establishing a reference group on independent living, which will meet in early 2009.

Scottish Government, NHS Boards, local authorities

2009

Scottish Government will identify opportunities to develop health literacy aspects within current health policy and practice areas. We will look at targeting groups and communities likely to benefit most.

Scottish Government

Health and literacy projects

The NHS Lothian CLAN Health and Literacy Project works to address health inequalities in areas of deprivation in Edinburgh. Low literacy and numeracy skills in 23% of the Scottish adult population ( OECD, International Adult literacy survey, 1997) have an impact on their health and their access to services. CLAN offer training to health staff on literacy awareness and clear communication. Health staff then refer people for learning advice and the project provides some initial individual literacy learning for particularly vulnerable learners. In partnership with local learning providers they offer new learning opportunities to suit the needs of people referred through health.

Healthwise Aberdeen is a health and literacy project based within the South Adult Literacies team in Aberdeen. The South Adult Literacies team works in partnership with the NHS to offer a learning advisor service in three local health clinics, and has close links with a number of relevant agencies. Learners come from a range of backgrounds and often have complex problems, such as drug and alcohol abuse or criminal justice issues; some are lone parents, often living in disadvantaged areas. Learning activities aim to build basic literacy skills to help learners understand and interpret health information. The team has found that improving skills in relation to health, literacy, lifestyle and parenting can provide significant benefits to individuals and, in turn, their families.

June 2008

Scottish Government published A Review of Self-directed support in Scotland, which provided qualitative evidence of the experience of clients in receipt of self-directed support ( SDS) and explored innovative work going on to deliver SDS in three local authorities.

Scottish Government

MW10, BK7

End 2008

Scottish Government to establish a pilot project in NHS Lothian to identify ways of improving how funding is used in self-directed support packages.

Scottish Government, NHS Lothian

MW10, BK7

Spring 2009

Develop and publish a self-directed support strategy.

Self-directed support reference group ¹¹

MW10, BK7

End 2008

Scottish Government to identify, establish and fund three test sites for improving the uptake of self-directed support, which will run for two years and aim to inform decisions for the next comprehensive spending review.

Scottish Government, COSLA, NHS Boards and local authorities

MW10, BK7

Ongoing

Identify how best to ensure that offenders and ex-offenders have access to the health services they need and benefit from the same quality of service as the rest of the population.

Scottish Government, NHS Boards, SPS, local authorities

MW12, BK8

End 2008

Scottish Government to respond to the recommendations in the Report of the Scottish Prisons Committee (July 2008) Scotland's Choice.

Scottish Government

MW12, BK8

Ongoing

Scottish Government working closely with COSLA to ensure that the needs of adult offenders (including their health needs) are reflected through the community planning process and in the 2009-10 SOAs.

Scottish Government, COSLA, local authorities, CPPs

MW12, BK8

2009-10

COSLA to sponsor a workstream on community reintegration (as highlighted by recommendation 18 in the Report of the Scottish Prisons Committee, which recommended that the Government promote recognition across all Government departments, all public services, all sectors and all communities of a duty to reintegrate both those who have paid back in the community and those who have served their time in prison).

COSLA, Scottish Government

MW12, BK8

Ongoing

Discussions between Scottish Government, NHS and Scottish Prison Service regarding potential transfer of health services in prisons to the NHS.

Scottish Government, SPS, NHS Boards

MW12, BK8

2009-10

Anticipatory care to be provided for prison populations.

NHS Boards

MW12, BK8

October 2008

Publication of the second Throughcare Addiction Service ( TAS) audit report. http://www.scotland.gov.uk/Publications/2008/10/03142010/0

Multi-agency TAS Working Group ¹²

MW12, ADV3, ADV4, ADV5, BK8

Ongoing

Scottish Government auditing progress of the TAS across Scotland.

Scottish Government

MW12, ADV3, ADV4, ADV5, BK8

Ongoing

Prisoners to be registered with a GP and referred to community-based services on release.

Scottish Prison Service, TAS workers

MW12, BK8

2009

Scottish Government to present a summary of best practice for providing services to offenders with mental health issues at a meeting of the National Advisory Body on Offender Management. ¹³

Scottish Prison Service

MW12, BK8

Community Link Centre in Edinburgh, ensures continuity of contact with short-term prisoners, offering them pre-release help with specific problems, and continuing that contact and assistance post-release. This is delivered by SACRO (Safeguarding Communities - Reducing Offending), a national community justice voluntary organisation that works across Scotland to make communities safer by reducing conflict and offending.

Families Outside provide support to families affected by imprisonment and run the Scottish Prisoners' families telephone helpline.

End 2008

Scottish Government to launch a Continuous Learning Framework for the social services sector, which will provide a wider concept of the skills and competencies required in the social services sector and identify synergies with related skills frameworks in other sectors. The Continuous Learning Framework will provide transparency across disciplines and ensure possibilities for greater joint training and initial education across the social services sector and between related sectors.

Scottish Government

Early 2009

Scottish Government to set up a short-term working group to identify common values, knowledge and skills across different sectors. This will help develop a training framework that is sensitive to inequalities and the concept of a key worker role that is transferable across and between different sectors, making links with the Continuous Learning Framework and other areas. This action will help with health outcomes and link with the Early Years Framework (improving accessibility and flexibility of services and strengthening the ability of universal services to meet additional needs through developing new workforce roles).

Scottish Government

Perth & Kinross test site: Coordination leads for meeting needs in Rattray area of Blairgowrie

Rattray is an area identified as a priority for community regeneration, with a large number of clients/service users with multiple and complex needs. Service providers in the area recognised the need for services and support that encourages prevention and early intervention. The test site aims to support service users with multiple and complex needs, and improve the responsiveness and relevance to those with a history of non-engagement with services. The test site will develop the central role of lead workers who will be responsible for co-ordinating the interventions of statutory services and support vulnerable individuals and families to participate in the process. Service redesign will be the responsibility of a local network of public sector managers, who will challenge obstacles to effective service delivery and develop shared information systems.

NHS Greater Glasgow and Clyde Health Board's Inequalities Sensitive Practice Initiative ( ISPI) has aimed to find out: 1) what will help improve the effectiveness and efficiency of frontline services in reducing health inequalities; and 2) what type of planning and policy arrangements are required to sustain service improvements.

The initiative has focused on practice across four settings: addictions, primary care mental health, maternity, and integrated children's services.

A key theme emerging is the need to strengthen health professionals' confidence and competence in carrying out sensitive enquiry into the social determinants of a person's health, for example gender-based violence and poverty. The initiative is developing tools to support staff with inequalities-sensitive practice. These include care pathways and a series of DVDs.

Bridging the Gap is an online resource developed by NHS Education for Scotland which provides flexible learning opportunities for pre-registration, qualified nursing, midwifery and allied health professionals, and others involved in tackling health inequalities in Scotland. The resource introduces some of the key evidence, issues and themes in health and social inequalities, provides access to a range of add-on resources and links to further information. It is accessible to all via the NHS e-library and can be accessed at Bridging the Gap in the 'quick link' menu at: http://www.equalityinhealth.scot.nhs.uk

The Remote and Rural Healthcare Educational Alliance ( RRHEAL) coordinates educational development in response to the specific needs of healthcare staff in remote and rural areas. One of RRHEAL's early actions was to establish a project to develop a rural-proofing framework for educational interventions using six projects as the pilot.
The projects are:

• Assisting the development of a new multi-professional leadership programme in Orkney, with results that can be transferred to other locations.

• Developing educational programmes to support midwifery, nursing and allied health professionals with special interest in remote and rural Scotland.

• Assisting the development of the NES Child Health Emergency care outreach training programme in remote and rural areas.

• Working with NES to ensure that the design of a new HNC in speech and language therapy is appropriate and accessible to all support workers in Scotland.

• Developing refresher courses and learning opportunities for isolated GPs.

• Scoping, commissioning and rural-proofing education programmes to support radiography staff in remote and rural areas.

RRHEAL will work with education providers to use the most rural-proofed methods of education delivery possible. Often this will take the form of a blended learning approach, with use of technology, rural e-library resources, small group teaching and peer networking support. The aim is to ensure that educational programmes are as accessible as possible to frontline healthcare staff across all areas of Scotland.

Ongoing

Scottish Government investing £93.6m in the Third Sector over the period 2008-11, recognising and supporting the vital contribution of the Third Sector to a more successful Scotland. The funding will support a vital, innovative and sustainable Third Sector through pump-priming direct investment, support to the sector's local infrastructure and activities to open markets and address barriers to the effective operation of Third Sector bodies. ¹⁴

Scottish Government, Third Sector

June 2008

Scottish Government launched its investment strategy for the Scottish Investment Fund, whose purpose is to build capacity, capability and financial sustainability in the Third Sector; ensuring a strong and active Third Sector reaches its potential and makes a key contribution to the Scottish Government's national outcomes. Priority for the first year are organisations that address issues of employability, environmental action, and tackle the underlying causes of health inequality.

Scottish Government

2009-10

Scottish Government to provide additional funding for Meeting the Shared Challenge, ¹⁵ to build on the success of its first year's operation.

Scottish Government, Scottish Community Development Centre

tbc

Scottish Government to provide training for public sector purchasers to help open all markets to the Third Sector.

Scottish Government

tbc

Scottish Government to provide funding through Firstport ¹⁶ for social entrepreneurs to establish new social enterprises.

Scottish Government

Meeting the Shared Challenge in Scotland

The Scottish Borders regional development group held a Healthy Borders community-led health event in November, which aimed to raise awareness of the community-led health approach with Heads of Services in the NHS and local authorities. The event aimed to enable decision makers to see the real value of community-led health initiatives and to recognise how they fit in to the wider health structure. Five community groups showcased their activities and impact, and a DVD of case studies was shown.

The Fife Meeting the Shared Challenge Programme is focusing on local work in Auchmuty, a neighbourhood area in Glenrothes. The programme is supporting the development of joint dialogue between staff from the NHS, Fife Council and local tenants association members with a programme of work that supports a shared understanding and solutions to local health and wellbeing issues. The programme intends to produce learning on (a) communities and public bodies working together on health and wellbeing issues; and (b) the development of policies and service delivery that enhance the capacity of communities to take action on issues of local importance.