A note for the incoming government: Why we need local solutions to local problems to improve workforce health
Authors: Victoria Shreeve
29 April 2015
The call to take a more local approach to issues, allowing local bodies to develop the best solutions for local problems, was a key aspect of the coalition government’s agenda. A key promise upon coming to power was to oversee and support the movement of powers for a number of key policy areas away from central government, to local bodies across England. The reform of health and social care, the movement of public health into local authorities and a new commitment to supporting local economic growth were key parts of this new ‘localism agenda’.
Now, as this government’s first term draws to a close, we ask, to what extent has this localism agenda worked to improve the health and wellbeing of the working age population? Have localism measures such as the creation of Health and Wellbeing Boards (HWBs), Clinical Commissioning Groups (CCGs) and Local Enterprise Partnerships (LEPs), been used to their full extent, to address this important challenge for many parts of England and to ensure their populations are healthy and able to contribute to the local economy. Looking forward to the next government – what could they do differently to encourage local bodies to take more joined-up local action to improve workforce health and wellbeing?
The costs of ill health in the working age population are often discussed in the context of the costs to government, employers, and individuals. Yet less prominent in this narrative, is the significant burden which ill health in the working age population places on local economies through the increased costs of health and social care, lost productivity and increases in long-term sickness absence. For example, for those individuals who are off work claiming health and disability related benefits (Employment Support Allowance) - for every claimant moving back into work, it is estimated that the local economy could gain a boost of £13,100, (whilst national government would gain £6,900) (CESI, 2015).
However, as we argue in our paper, Healthy, working economies, the third from the Health at Work Policy Unit, although some localities now recognise the challenges and are taking action locally to improve workforce health, the majority are not. We believe that there has not been a clear enough signal from central government about the level of priority workforce health and wellbeing should be given locally, nor the resources to go with it, and this is leading to a systematic failure to take comprehensive local action to improve the health of the working age population.
We argue that government needs to send a clearer message to local bodies about their roles and responsibilities for improving the health of the working age population. Our recommendations include that government should introduce a standardised set of measures to be included in the Joint-Strategic Needs Assessments performed by Health and Wellbeing Boards, including standard measures of employment outcomes for individuals with health conditions. This would then encourage more local areas to consider including employment as a strategic priority in their Joint Health and Wellbeing Strategies.
There needs to be action to support and encourage joined up working locally to achieve shared objectives. For example, we recommend that given the substantial evidence around the relationship between health and employment it should be a statutory requirement for HWB membership to include an employer. This would bring a much needed employer perspective to the HWBs work.
The full package of recommendations, outlined in the paper, provide the incoming government with a template for how they encourage local solutions to this local problem. It is our hope that the incoming government heeds this warning, considers if local organisations are really being used to their full extent to improve the health of the working age population and considers making policy changes to encourage more joined-up action at a local level.
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