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Working for Health/ Fit for Work

Following Dame Carol Black's (Working for a Healthier Tomorrow) recommendation, the UK Government is providing funding for a series of 'Fit for Work Service' (FFWS) pilots across Great Britain. One of these is based on the vocational rehabilitation service in Dundee and the Scottish Government is working with a proposal led by Salus, the NHS Lanarkshire based occupational health service, which will deliver a Scotland-wide service accessible by all. These will also be thoroughly evaluated.

These evaluations will provide data that will allow for the development of a set of standards for service access and delivery that would form the basis for a 'Scottish Offer'. This would set out what can be expected by an individual in terms of obtaining access to work retention or return focussed healthcare services and what and how these services would be delivered. A feature of the current pilots, and the work done at Salus, is the use of  case management. This approach is also advocated in the  rehabilitation framework. The standards of service developed for the 'Scottish Offer' needs to identify a role for a key worker who will ensure that the individual is involved and engaged in the support that is offered and that they are supported through the various services that they may need to access.

Scotland-wide Pilot  A large scale, Scotland wide, FFWS accessible via a freephone national advice line, which will act as a gateway for clients across the country. Telephone advisers will 'triage' calls to determine support required, and will either provide advice and signpost self-help resources, or refer those that need more support onwards to the relevant local FFWS of which there will be 14 - one in each Health Board area. Services that qualify as FFWS's are already up and running in 3 of the 14 Health Board areas, one of which is Dundee (see below); FFWS funding will facilitate the set up of services in the other 11 areas. Each of the FFWS's will have a strong focus on small and medium sized enterprises (SMEs) without occupational health support and on those in low paid employment.

Dundee Pilot  Funding will enable this existing health and employability service, which qualifies as a FFWS, to expand the range of services it already provides exclusively to employees of SMEs in Dundee, and integrate into the Scotland-wide approach (above). This model is aiming to identify optimal support not only for sickness absentees but also for even earlier intervention, in providing support to 'presentees' - individuals with ill-health who continue to work but who are at risk of sickness absence and loss of employment - who currently form 72% of the current caseload. The service has already been running for one year; supporting its ongoing development provides an opportunity to generate longer-term data.