Health Works A review of the Scottish Governments Healthy Working Lives Strategy A report on implementation May 2013

3. Conclusion

Health and health inequalities are clearly influenced by a person's economic activity, and work is a recognised social determinant of health. In an inclusive approach to tackling health inequalities, as identified in the Chief Medical Officer's annual report (2), actions to keep people in meaningful occupation (which may or may not be paid employment) is a vital component in improving and sustaining a healthy population and reducing inequalities in health. The implementation of Health Works is a contributor to this action.

The NHS is a first point of contact for many people with health and work issues and, as such, is a vital part of a person's employability journey. In most cases, the NHS will be a gateway or a link to more specialist employability services. NHS staff need more knowledge and awareness of the benefits of occupation for good health to make this linking effective.

This is an issue the Scottish Government will be seeking to address in 2013−2014 through a project involving NES, the third sector and other partners. It will include education to enable staff to confidently ask about health and work and offer effective advice when issues that require further interventions or assistance emerge. The project will also develop a recommendation in relation to the definition of the "work question" in health care.

The NHS provides a range of specialist interventions related to health and work, including vocational rehabilitation in mental health and adult physical rehabilitation. These services have developed over the last three years and have shown beneficial outcomes through service improvements, redesign, joint working and increased skills and awareness, leading to a significant rise in NHS engagement in health and work activities.

Partnership working is at the heart of many good practice examples, including effective access to employability networks for people identified by NHS services as requiring employability support. All NHS boards now have a named lead for Health Works, engagement in employability pathways or "pipelines" is commonplace (although not yet universal) and there are several examples of excellent joint services or projects across a range of clinical specialties and settings.

The integration agenda offers further opportunities in this area: skills sharing and closer working across employability pathways to integrate practice and ensure optimum use of available resources is imperative. The needs of older people compound this requirement. Services will need to be able to adapt to support people, including older workers, as retirement ages rise and people are required to self-manage health conditions while working for longer.

The Scottish Government recognises the achievements of Health Work's implementation to date and will remain committed to supporting this important work within NHSScotland and across agencies. The Government also works closely with colleagues responsible for reserved matters related to welfare and health, work and well-being by the UK Government, including the DWP. The recent UK Government's response to the sickness absence review (35) is an example, and the introduction of a Health and Work Assessment and Advisory Service is of particular interest. The Scottish Government is keen to engage with DWP to deliver this new model of service, recognising that it will draw on existing strengths within NHSScotland and support the delivery of person-centred, safe and effective services in line with the ambitions of the Healthcare Quality Strategy for NHSScotland (15).

The Scottish Government will continue to engage with the cross-government Health, Work and Wellbeing strategy (10) in relation to employers' and workplace health and well-being.