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Long Term Conditions Collaborative: Making the Connections - Food For Thought



Evidence demonstrates that whether or not a person works, the kind of work they do and their working conditions are all important factors that influence health. This is particularly true for those people who are working and living with a long term condition.

A range of NHS services and activities are being established, developed and co-ordinated to support people to improve their health, prevent or reduce sickness absence and to return to work quickly following a period of sickness absence. These services include:

  • Healthy Working Lives
  • Fit For Work Services
  • Condition Management Programmes
  • Vocational Rehabilitation

Other services and support can be accessed through Jobcentre Plus, Careers Scotland, employability initiatives, trades unions and training and education establishments.

Healthy Working Lives

The Scottish Centre for Healthy Working Lives was established in 2005 as a result of the 2004 Scottish Government paper, 'Healthy Working Lives: a plan for action'. The programme aims to sustain and improve the health and well-being of the population of Scotland by delivering and developing services, either directly or through delivery partners, that promote the Healthy Working Lives agenda.

Fit For Work Services

Fit For Work Services (for people employed in small and medium sized enterprises) aim to maximise the functional capacity of the client so that they can return to the workplace at the earliest opportunity. They seek to provide early access to rehabilitative services for people with mild to moderate health conditions to minimise days lost from the workplace. The service adopts a bio-psychosocial model to identify contributing factors to the client's presenting problem and provide support and solutions. The client will have a dedicated case manager as a key element of the service to provide continuity from point of assessment to delivery of co-ordinated rehabilitation

Condition Management

The Condition Management Programme ( CMP) is a voluntary, individually tailored programme provided by the NHS and Jobcentre Plus through the Pathways to Work package. The programme is confidential and available to anyone claiming health related benefits due to a health condition. It is delivered by registered health care practitioners.

The CMP model is underpinned by the principles of Cognitive Behavioural Therapy. Practitioners work with clients to:

  • Promote a better understanding of their health condition and how to manage it, particularly in a work situation
  • Build self confidence and belief in their ability to work
  • Develop helpful thinking and behaviours which support improvement in quality of life

Vocational Rehabilitation

The need for a vocational rehabilitation model

Social engagement and purposeful occupation are central to nurturing a sense of self worth and well-being, and have been particularly prominent in rehabilitation offered within mental health services. Dedicated vocational rehabilitation is a crucial element to improve the health and well-being of working age adults, assist those with disabilities into employment and reduce sickness absence.

The most common causes of work related ill health are musculo-skeletal disorders ( MSD), stress, respiratory disorders, heart disease, skin problems and infectious diseases. Evidence suggests that 40% of all sickness absence is due to musculo-skeletal injuries and 30% is due to mild/moderate mental health issues. Most physical causes of work absence are often accompanied by emotional and psychological problems which develop while on prolonged sick leave. Short term sickness accounts for 80% of absences and 62% of lost time. As the majority of absences are accounted for by minor complaints, the potential for management of these absences is even more apparent through earlier intervention.

What the vocational rehabilitation model does

The vocational rehabilitation model identifies the need for a rapid access referral process through which individuals can secure support and specialist advice from a dedicated vocational rehabilitation team consisting of a range of professionals that use case management approaches. The emphasis is to provide earlier intervention to reduce longer term sickness absence and assist those individuals within the workplace.

Testing the vocational rehabilitation model

There are three projects running currently in Tayside, Borders and Lothian to test this model in conjunction with the Scottish Centre for Healthy Working Lives. In each of the projects a dedicated team delivers vocational rehabilitation for small to medium enterprise businesses in these areas. The vocational rehabilitation project will link with related programme teams including the local Pathways To Work Condition Management Programme, Keep Well and Occupational HealthServices Extra to provide a single point of access into these services with the aim of helping individuals to remain/ return to active employment.


If a full return to work is not possible, someone might like to volunteer in some capacity. Volunteering can provide meaningful activity with opportunities for skills development and may lead to employment if the volunteer considers that to be appropriate for them.

There is a network of volunteer centres across the country and the national body for volunteering is Volunteer Development Scotland. Volunteers also make valuable contributions to the NHS and there is a 'Designated Person Responsible for Volunteering' in each NHS Health Board.

Food For Thought:

  • How well do you link with your local vocational rehabilitation, Fit for Work and condition management services?
  • Do you know who the Designated Person Responsible for Volunteering is in your NHS area?