Health & Safety Conference October
A report aiming to highlight the importance
of workplace health to improve the health and wellbeing of workers
in the public sector in Scotland
There is more and more emphasis being
placed on health and wellbeing in the workplace, which now takes
a much broader view of workplace health than the traditional occupational
health issues, envisaged in legislation such as the Health &
Safety at Work Act, 1974 and subsequent European legislation.
Many employers are coming to recognise that
addressing some of these wider issues can create a more productive
workforce, with less absenteeism and greater retention of employees,
whilst at the same time enabling their workers to lead more full
and satisfying lives. Despite this the UK has the lowest level
of occupational health provision in the developed EU and one of
the worst records in Europe for the return of employees to work
after long-term illness.
UNISON Scotland has identified several aspects
of workplace health and has carried out a freedom of information
request of all employers in those areas of the public sector where
UNISON organises, asking them to provide information and any policies
they may have on the following topics:
Occupational Health, together with an indication
of whether this is provided in-house or is outsourced
Counselling service, again seeking information
on whether the service is offered in-house or is outsourced
Stress - policies available and whether
these incorporate the HSE Stress Management Standards
Health Promotion such as healthy eating
and fitness programmes
Bullying and harassment policies
Alcohol and drug use policies
Mental health provision
Suicide prevention strategies
Driving at work policies
Health & Safety policies
This report aims to look at the latest developments
and research in these and other areas, such as musculo-skeletal
diseases, (often associated with the use of Display Screen Equipment);
identify best practice and assess how these are being applied
across the public sector in Scotland.
2. SCOTTISH GOVERNMENT POSITION
Governments in both the UK and Scotland have
recognised the importance of promoting health and wellbeing for
all those in work. In March 2007 the Scottish Executive (now Scottish
Government) published its Health & Safety Action Plan. The
Plan acknowledged that Health & Safety at Work was a reserved
issue but the then Justice Minister, Cathy Jamieson said that
the Scottish Government had an important role to play in promoting
health and safety, in partnership with the STUC, with employers
across all sectors of the workforce in Scotland.
The Action Plan had been developed by the Partnership
on Health & Safety in Scotland (PHASS), and organisation set
up in 2005 by the Health & Safety Commission (HSE), supported
by UK and Scottish Ministers, to implement their strategy for
workplace health to 2010 and beyond in Scotland.
Commitments in the Plan included
Expanding the advisory services on health
and safety for employers and employees
Developing and promoting worker involvement
in workplace health and safety
Extending the provision of specific information
and guidance on the protection of public service workers.
A £1.2m investment was allocated for 2007-08
to provide additional services to employers and employees primarily
through the Scottish Centre for Healthy Working Lives.
3. THE SCOTTISH CENTRE FOR HEALTHY WORKING
The Scottish Centre was established in 2003
to improve the health of working age people in Scotland by ensuring
healthier and safer workplaces, promote healthier lifestyles and
to develop the field of employability throughout Scotland. The
Centre originally operated the Scotland's Health at Work Award
Scheme, (SHAW), transformed in February 2007 into the Healthy
Working Lives (HWL) Awards.
Building on the success of the SHAW awards,
the programme encompasses a wide range of topics enabling organisations
to select those that are most relevant to the workforce, including
health promotion, occupational health and safety, health and the
environment, mental health and well-being, community involvement
SHAW was a national health partnership comprising
CBI Scotland, STUC, Scottish Enterprise, Highlands and Islands
Enterprise, COSLA, the Health & Safety Executive, the Federation
of Small Businesses, the Scottish Executive, NHS Health Scotland
and the 15 NHS Boards. The programme, aimed to encourage and support
workplaces to make the active promotion of good health an integral
part of Scottish corporate culture, through a network of specialist
workplace advisors, based within each NHS Board.
The Centre also has the responsibility for implementing
the Scottish Executive's strategy ‘Healthy Working Lives - A Plan
for Action', published in 2005. The starting point for implementing
the strategy was to join together and unify the SHAW national
award scheme, Safe and Healthy Working and the business and employability
strands of Scotland Against Drugs for national delivery under
its overarching banner.
4. HEALTH AND SAFETY
The promotion of health and wellbeing in the workplace
will not be effective, however, unless it is part of a comprehensive
approach to Health & Safety.
Employers, together with workers and their representatives,
have a statutory duty under the Health & Safety at Work etc.,
Act 1974 and later regulations under that legislation, together
with more recent European regulations, such as the Management
of Health and Safety at Work Regulations 1999, which required
employers to carry out risk assessments on all of their workers
and to introduce measures to minimise the effects of any hazards
which may be present.
Measures and policies introduced under the legislation
and subsequent regulations must be reviewed regularly, with trade
union representatives, who can make valuable contributions about
any improvements needed in a workplace. Under the Health &
Safety at Work, etc. Act, safety representatives have a wide range
of rights and functions and regular meetings of health and safety
committees are the ideal fora to discuss issues of mutual concerns.
As would be expected, all of the employers in
our survey had Health & Safety policies, as required under
the 1974 Act.
5. OCCUPATIONAL HEALTH
Occupational Health Schemes have a major part to
play in preventing ill-health through work and in ensuring that
people can return to work as quickly as possible after an illness.
The Health and Safety Executive has identified two
elements to occupational health. Firstly, in the effect of work
on employees' health and the health of others, by identifying
what can cause or contribute to ill health in the workplace; by
determining the action required to prevent people being made ill
by work and by introducing suitable control measures to prevent
ill health, such as back pain. Secondly to ensure that people
with health conditions, or who have a disability or impairment
are not unreasonably prevented from taking up job opportunities
and by adapting work practices so that people at work are fit
to perform required tasks.
There has been greater emphasis on the latter element,
due to the requirements of the Disability Discrimination Act and
to the Government's attempts to cut the amount of people claiming
Incapacity Benefit by encouraging them to engage in rehabilitation
programmes and returning to work. Specifically through Workplace
Health Connect a government funded service on return to work issues.
The Scottish Centre for Health Working Lives can
offer a variety of free and confidential occupational health and
safety services through their network advisers. The service allows
organisations and individuals to better recognise and address
occupational any health and safety problem or workplace issue
that they may be experiencing. Components of the service include
an advice line; a website with free downloadable material and
an email enquiry service and a network of advisors who visit workplaces
and can carry out a free and confidential workplace assessment
and provide an action plan for the organisation, where required.
The rise in Occupational Health Services has
come about mainly to address issues of sickness absence which
has become a great concern of organisations, both in the public
and private sectors.
Most of the employers in our survey either had
their own occupational health network or employed commercial enterprises
to provide a service. Many offered a mixture of both. Those
who preferred in-service provision often had their own doctor,
an occupational nurse and in certain places, physiotherapists.
One also employed the use of a Cognitive Behaviour Therapist to
assist with mental health and stress issues.
The public sector in Scotland has to a large
extent, however, followed the private sector in outsourcing what
are seen as non-core functions and this has meant a huge growth
in the provision of external occupational health services, which
is expected to grow by 35% over the next five to ten years in
the public sector. Occupational health is now required to deliver
a wide range of services, including health promotion schemes,
advice or involvement in the handling or psychosocial health issues,
employee assistance programmes, counselling, etc.
In many cases external services will replace
the existing in-house provision. However, despite external providers
being able to make a better business case for their services,
there are many disadvantages to outsourced services, and even
the perceived financial savings might be short-lived. When you
out-source, you lose control over the service and once you have
lost your internal expertise it is often difficult to get it back
again. An external contractor may offer a good contract, offering
considerable cost savings, but when it comes to renegotiating
the contract, and the contractor knows that your in-house provision
has gone, they are then in a position to charge much more and
the employer will have to pay it. Losing control can mean that
you have lost the ability to do things in-house and can be receiving
a worse service for more money. Certainly, in-house provision
is shown to be the best option when you have a large number of
staff located at a single site, when any travelling costs for
in-house OH practitioners will not be incurred.
It has also been found that it can take up to
two to three years for an external provider to gain an understanding
of the workforce and its activities and develop trust with staff.
Employers have also to be aware that any external
provider they may contract to advise them on occupational health
issues, particularly if they use them to advise whether or not
staff are unfit for service, cannot be regarded as independent
under superannuation regulations to determine ill-health retirals.
This reflects wider staff concerns over the independence
of contracted OH services. These contractors are inevitably focused
on contract renewal and as a consequence are more likely to value
the requirements of employers offering the contract than staff
who are the recipients of the service. The need to offer the lowest
price can also impact on the quality of the service. UNISON Scotland
is increasingly concerned over the number of cases referred to
the union that reflect less than satisfactory occupational health
services. We will be undertaking further membership surveys on
this point and advising branches to scrutinise more closely the
training, qualifications and experience of occupational health
staff and monitor that they are complying with the Faculty of
Occupational Medicine's Guidance on Ethics.
A good Occupational Health Service should cover
many elements, including:
Prevention of injury or damage to workers'
Health surveillance and screening
Fitness for Work
Health education and counselling
Problems that can arise from Occupational Health
Recommendations not acted upon
Competent staff not appointed
No follow up measurements
Ineffective workplace monitoring
Inappropriate health checks
Ineffectual remedies suggested
6. COUNSELLING SERVICES
Counselling services are being used
more and more by employers to provide a free and confidential
mechanism for employees to discuss a variety of issues including
general and specific illnesses, such as cancer; mental health,
stress, equality or discrimination issues, etc.
Many employers incorporate their counselling
services into their general Occupational Health provision, sometimes
by the same provider. Most of the services are provided externally.
Stress is now the second most common
work-related illness, with over 500,000 people a year affected
in the UK each year, although this is not always recognised by
employers. However, a recent survey of HR professionals in the
public sector believed that stress was the greatest threat to
The HSE defines work-related stress as:
"The reaction people have to excessive demands
or pressures, arising when people try to cope with tasks responsibilities
or other types of pressure connected with their jobs, but find
difficulty, strain or worry in doing so."
Many organisations, including UNISON and the
TUC, have published guidance on tackling workplace stress and
in 2004 the HSE produced its Stress Management Standards in an
attempt to persuade employers of the need and benefit to them
of introducing the Standards into their health and safety practices.
Evidence shows that relatively low-impact measures
to redesign work have disproportionately high effects on both
business outcomes and the stress and mental health of their employees.
The main principles in the HSE Management Standards
Demands, such as workload, work patterns
and the work environment
Control - how much say the employee has
in the way they do their work
Support - such as the encouragement, sponsorship
and resources provided by the organisation, line management
Relationships - such as promoting positive
working to avoid conflict and dealing with unacceptable
Role - such as whether people understand
their role within the organisation and whether the organisation
ensures they do not have conflicting roles
Change - such as how organisational change
(large or small) is managed and communicated in the organisation
Many of the public sector employers surveyed did
have stress policies, but several of these were out of date and
did not include the HSE Standards.
8. MENTAL HEALTH AND RECOGNISING SUICIDE
Closely associated with stress, but not
always connected, is the issue of mental health. NHS Scotland
describes good mental health as a:
"basic component of positive health and well-being.
It is necessary to help us manage our lives successfully, and
provide us with the emotional and spiritual resilience to allow
us to enjoy life and deal with distress and disappointment,"
So everyone has mental health needs and according
to the Office of National Statistics, nearly three out of ten
employees will have a mental health problem in any one year (1995).
In the workplace, difficulties can be compounded if those suffering
mental health disorders are discriminated against.
There are several steps that can be taken to
address problems caused by mental health in the workplace, which
Recognising that all staff have mental health
Raising awareness of what people can do
to look after their own and others' mental well-being
Identifying and addressing factors that
can affect mental health in the workplace
Building a working culture in which mental
health issues are not taboo.
Providing support mechanisms which are confidential
and do not stigmatise
Reviewing work practices to ensure that
staff with a history of mental health problems are not excluded.
As mental health has not been recognised as an issue
in the workplace until quite recently, it is not surprising that
most of the employers surveyed did not have specific policies.
Some did recognise it as an issue and referred to it in their
occupational health and counselling policies. Only one or two
had actual policies which covered the issue satisfactorily, and
clearly this is an area for much more attention in the future.
The Scottish Centre for Healthy Working Lives has introduced the
Mental Health Commendation Award as part of its Award schemes,
and one or two employers said they were working towards this.
Employers were also asked whether they had any policies
on Suicide Prevention and not surprisingly, very few referred
to the issue at all, although a few did refer to it in their occupational
health and counselling policies.
Through its strategy and action plan, "Choose
Life", the Scottish Government is attempting to highlight
the issue, and decrease the rate of suicides in Scotland. UNISON's
Scottish Committee together with the Health & Safety Committee
are currently examining the policy, with a view to introducing
a limited stewards' training programme to recognise people who
may be at risk and to enable stewards to persuade them to seek
further help from appropriate agencies.
9. BULLYING AND HARASSMENT PROCEDURES
Bullying and harassment on the other hand, have
been recognised as workplace issues for some years, and most employers
did have policies in place to deal with it, on both bullying and
harassment, and, increasingly, Dignity at Work policies. However,
it is a growing issue, particularly in the public sector and stewards
and safety reps need to be vigilant, particularly as many people
do not report it and it can remain a hidden problem which is accepted,
or even encouraged by the culture of the organisation.
A new booklet by the TUC identifies a number of
positive steps that safety reps can take to raise awareness of
the issue and tackle bullying in the workplace. Posters and leaflets
can raise the issue with members which may encourage them to discuss
any problems with the steward. Routine safety inspections can
also be used to speak to members about it. Surveys are another
way of helping members to report problems.
Examples of bullying behaviour can include:
Staff being constantly criticised, having
responsibilities removed or given trivial tasks to do
Staff being shouted at
Regularly making one person the butt of
Constantly attacking someone in terms of
their professional or personal standing
Regularly and deliberately ignoring or excluding
individuals from work activities.
Bullying can have serious consequences for the individual
in question, leading to stress and ill-health, with many consequential
problems. In addition, employers can pay a high price for failure
to address a bullying culture, both in sickness absence, low morale,
leading to low productivity across an organisation, and often
high turnover of employees who would rather leave than raise the
issue. There are also financial penalties if a member of staff
successfully pursues a claim against their employer.
Many employers are introducing Dignity at Work schemes
and this is a positive development in tackling the underlying
10. ALCOHOL AND DRUG POLICIES
Again, most employers have alcohol and
drug policies, often combined, which allow employers and employees
to benefit, by providing fair and consistent procedures, health
education and assistance for those with alcohol problems.
Statistics still show that75% of problem drinkers
are in employment and that 25% of accidents are reported as
being alcohol-related, with 6-14 million working days in the
UK estimated to be lost each year due to alcohol-related sickness
Drugs can also interfere with the ability carry
out work tasks, and it's not only illegal drugs like cannabis
and ecstasy, which cause problems. Prescribed medicines and some
over the counter remedies can impair tasks, such as driving and
operating machinery. Some strong painkillers, tranquillisers,
epilepsy or sleeping medications, as well as hay fever and cold
remedies can also cause drowsiness.
Employers are increasingly turning their attention
to the introduction of more stringent driving policies. In many
public sector organisations, driving is the biggest risk to their
workforce and increasing emphasis is being placed on managing
this risk by the introduction of driver testing and fitness to
A few employers sent in driver policies and several
indicated their intentions to introduce such policies in the near
future, which were being prepared at present, together with Driving
at Work guidance.
12. MUSCULO SKELETAL
Musculo-Skeletal disorders are the biggest cause
of sickness absence in the UK, with back pain in particular being
the most common. Most people who suffer back pain will not suffer
any long-term problems, as most back pain settles quite quickly,
although it can reoccur on future occasions and experts now recommend
activity as the best remedy to make sufferers feel better. Most
back disorders are blamed on the accumulation of months or even
years of poor posture, faulty body mechanics, stressful living,
loss of flexibility and a general lack of physical fitness.
A recent study by the British Chiropractic Association
has shown that it is office workers who are at greatest risk of
back problems than excessive lifting and carrying previously thought
to carry the greatest risk. The sedentary posture of most computer-using
office workers is contributing to their problems with lumbar problems.
In the workplace, employers and safety representatives
must review risk assessments for Display Screen Equipment on a
regular basis and ensure that staff are not being put at risk
because of the work they do. Staff must be encouraged to report
aches and pains as soon as they occur and management must take
these seriously. Employers must introduce adjustments if necessary
to help employees remain at work and if sickness absence occurs,
help them back to work as quickly as possible.
The European Health & Safety Week, 2007 will
concentrate on Musculo-Skeletal Disorders, including back pain,
to highlight the problems caused to millions of workers across
13. HEALTH PROMOTION
Very few employers had specific policies, however,
most reported that they had achieved the SHAW awards at the various
levels and were now working on converting these to the Healthy
Working Lives awards.
Most employers reported that via Health Improvement
strategies they encouraged staff to eat more healthily and had
instigated fitness programmes, often in conjunction with their
leisure and sports departments. The introduction of the Smoking
Act has continued to highlight smoking cessation programmes and
many employers encourage their employees to participate in these
programmes, often with time being granted to attend.
14. VIOLENCE AT WORK
Closely linked to bullying, harassment and stress
is the high level of violence both physical and verbal that public
service workers endure every working day in Scotland. In September
2006 we published the most comprehensive survey on this issue
that showed some 20,000 reported incidents every year in Scotland
in the health and local government sectors alone. We set out the
actions that needed to be taken and will shortly be producing
an update report on this issue.
Creating a healthy workplace can be of great benefit
to both employees and the organisations they work for. How healthy
a person feels affects their productivity and how satisfied they
are with their job affects their own health, both physical and
Where organisations proactively improve their working
environments, by organising work in ways that promote health,
all adverse health-related outcomes, including absence and injuries,
There are, therefore, many benefits to both employees
and employers of a healthy workplace, including:
Fewer injuries and accidents, leading to
lower insurance and compensation claims
Improved employee morale and staff retention
Employees more receptive to and better able
to cope with change
Good occupational health schemes have a major part
to play in preventing ill health through work and a greater priority
and higher profile needs to be given to them. Public bodies must
ensure that their employees have reasonable access to occupational
health services that are not only cost effective but also maintain
staff confidence in both their quality and independence.
16. NEXT STEPS
This report is being launched at UNISON's
Scottish Health & Safety Conference on 12 October 2007 for
delegates to consider how they can assist in improving the health
and wellbeing of their members in their workplaces.
UNISON Branches must work with employers to
ensure that health and wellbeing at work policies are introduced
and implemented throughout all public sector workplaces in Scotland.
In particular, Health and Safety representatives must examine
all of their employers' policies to assess whether they take into
account the latest evidence and good practice in all areas, and
if there is no particular policy, work with the employer to produce
UNISON has growing concerns over the accountability
and control of OHS across the public sector. We will be undertaking
further work on this issue in the coming months.
Branches should encourage workers to become
involved with their employers in working towards the Healthy
Working Lives awards by participating in healthy eating and
fitness programmes. This can be publicised via joint bulletins
17. CHECKLIST FOR SAFETY REPS
UNISON Safety Representatives have a key role
to play in the provision of occupational health services that
operate in their workplace. In particular to ensure that OHS
operates as a team and there is effective accountability and
control. The following checklist provides a starting point.
Does your employer have an occupational
Do you know who is in charge of occupational
health and safety?
Do you know how they are provided?
Were you consulted on the type of services
and who provides them?
If outsourced have you been consulted over
the contract specification?
What scrutiny is undertaken of the qualifications
and experience of OHS staff?
What monitoring takes place to ensure OHS
staffs comply with the Faculty of Occupational Medicine's
Guidance on Ethics?
Do you know the type, content and frequency
of health assessments?
Do you get copies of reports produced by
the occupational health service and are the reports analysed
For example can you identify work related
health issues that have been identified to you Safety Committee
by your OHS?
Do the occupational health services and
health and safety staff work together?
UNISON Guide to Occupational Health Services
TUC rehabilitation pages
Scottish Centre for Healthy Working lives
British Occupational Hygiene Society
Faculty of Occupational Medicine
For further information on this report contact:
Dave Watson, Scottish Organiser
Diane Anderson, Information Development Officer
Policy and Information Team
UNISON House, 14 West Campbell Street, Glasgow G2