NHSScotland 'Once for Scotland' managing health at work workforce policies

On the 21 February 2025, the Scottish Government published a consultation on phase 3 of the ‘Once for Scotland’ NHSScotland Workforce policies. This consultation paper included:

• Adverse Weather Policy
• Alcohol and Other Substances Policy
• Control of Substances Hazardous to Health (COSHH) Policy
• Lone Working Policy
• Manual Handling Policy
• Menopause and Menstrual Health Policy
• Smoking and Vaping Policy
• Work-Related Driving Risks Policy
• Work-Related Stress Policy
• Work-Related Violence and Aggression Policy

Views and comments were sought on the policies and proposed supporting documents to identify any gaps and policy amendments required. The consultation also sought views on the potential impacts of each policy on equalities groups.

Adverse Weather Policy

• Detail on what counts as severe weather to support consistent decision making.
• Improved direction on responsibilities relating to the completion of risk assessments.
• Clarity on how contractors are covered within the policy scope.

Alcohol and Other Substances Policy

• Distinguish between legitimate use of prescribed medication and misuse within the policy.
• Strengthen the employee responsibilities to reflect accountability with the policy.
• The policy should explain the legal and ethical basis for any testing, including when it can occur and employee rights.

Control of Substances Hazardous to Health (COSHH) Policy

• Greater detail on the various routes through which exposure to hazardous substances can occur.  
• Clearer articulation that personal protective equipment (PPE) represents the least effective control measure, as it provides protection only to the individual wearer.
• Expanded clarity on employer responsibilities in relation to prevention and control measures.
• More precise phrasing on organisational arrangements and surveillance intervals.
• Incorporate best practice by encouraging the development of Site/Area Plans indicating where hazardous substances are stored and used, supporting both inventory management and emergency response.

Lone Working Policy

• Provide clearer, practical examples of lone‑working situations to improve accessibility and understanding of the policy.
• Clarity on the frequency and expectations for reviewing lone‑working risk assessments.
• Recommendation to use broader, more inclusive wording within the incident‑reporting requirements to ensure all relevant work‑related incidents are captured.

Manual Handling Policy

• More clarity on responsibilities around risk assessments and employee reporting duties.
• Improve monitoring and review, by ensuring managers know how to seek specialist advice.
• Explicit responsibilities regarding when defective or unavailable equipment is identified.

Menopause and Menstrual Health Policy

• Clear examples of symptoms to enhance understanding and awareness.
• Provide practical examples of workplace adjustments to assist managers in supporting employees effectively.
• Employees should have the option to speak with an alternative manager if they feel uncomfortable discussing their symptoms.
• Clarity is needed to ensure it is understood that menopause stages can involve symptoms that persist for several years, to promote inclusivity and accessibility.

Smoking and Vaping Policy

• Clearer distinction between smoking and vaping in relation to the 15‑metre hospital perimeter rule.
• NHS grounds do not provide designated smoking areas for employees, and this should be explicitly stated.
• Greater consistency and clarity are required regarding how the policy links to the uniform policy.

Work-Related Driving Risks Policy

• Clearer employee responsibilities, particularly around holding appropriate insurance and reporting any changes to driving‑licence validity.
• Clarification was required on whether travelling to and from work is considered work‑related driving.
• Further detail was requested on how risk assessments should be conducted, including methodologies and factors to consider.

Work-Related Stress Policy

• A stronger emphasis on preventative measures is required, rather than focusing solely on interventions once stress is evident.
• The policy should promote a healthy work-life balance, including encouraging regular breaks.
• Further clarity is needed regarding the process for conducting stress audits, their frequency, and the mechanisms for ongoing monitoring and review.

Work-Related Violence and Aggression Policy

• Greater clarity was required regarding whether all incidents, including verbal abuse, must be reported to the police.
• The policy lacked a clearly defined monitoring and review framework, which is essential for meeting RIDDOR and HSE expectations.
• The section on RIDDOR reporting required additional detail to ensure accuracy and compliance.
• Respondents recommended explicit inclusion of the hierarchy of control to strengthen the policy’s approach to risk management.

Consultation responses were analysed and carefully considered for policy amendment. Key themes from the consultation and suggested amendments to the draft policies were reviewed by the ‘Once for Scotland’ Workforce Policies Programme Board.   

Adverse Weather Policy

• Incorporated the Met Office definition of severe weather and its associated criteria.
• Amended manager responsibilities to explicitly include conducting risk assessments for anticipated adverse weather.
• Clarified the eligibility of contractors within the scope of the Adverse Weather Policy.

Alcohol and Other Substances Policy

• Enhanced the definitions to specify that misuse includes using prescribed or over‑the‑counter medication contrary to intended guidance.
• Revised the employee responsibilities to provide expectation to comply with the policy and its procedures.
• Outlined the legal and ethical framework for testing, specifying consent requirements, authorised circumstances, and employee rights.

Control of Substances Hazardous to Health (COSHH) Policy

• The Manager Guide now provides enhanced detail on the full range of exposure routes, including injection.
• The policy and supporting guides have been updated to align with the hierarchy of control, emphasising PPE as the final and least effective measure, used only when higher level controls are not practicable.
• The policy reflects statutory COSHH wording, stating that employers must reduce exposure to as low as reasonably practicable, providing clearer alignment with regulatory expectations.
• The policy and guides now clarify that health surveillance must include appropriate organisational arrangements and defined repeat intervals, with Occupational Health responsible for examinations and recordkeeping.
• The Manager Guide explicitly includes the expectations for area/site plans for inventory and emergency response

Lone Working Policy

• Expanded the guides to include clearer examples of common lone‑working situations.
• Clarified that lone‑working risk assessments should be reviewed and updated annually, or sooner where circumstances change.
• Updated employee responsibilities to require staff to report all work‑related incidents and risks, ensuring more comprehensive and inclusive reporting expectations.

Manual Handling Policy

• Confirmed managers must ensure necessary documentation is completed, and that employees must report injuries or near misses involving manual handling.
• Added Occupational Health referral route where individual needs/complex risks are identified in Manager Guide.
• Employee duties now include reporting any defects or unavailability of equipment to their manager.

Menopause and Menstrual Health Policy

• Introduced comprehensive examples of menstrual, perimenopausal and menopausal symptoms, supporting improved understanding and enabling more effective supportive conversations.
• Provided a non-exhaustive list of workplace adjustments, such as access to period products, appropriate ventilation and lighter uniform options to equip managers in supporting employees.
• Provided an avenue for employees to speak with another manager if they feel uncomfortable discussing symptoms, and outlined the expectations for managers in these circumstances.
• Updated definitions to reflect that postmenopausal symptoms may continue for many years for some individuals, supporting a more inclusive and accurate representation of lived experiences.

Smoking and Vaping Policy

• We clarified that, in line with legislation, smoking is not permitted within 15 metres of any NHS hospital building. To strengthen consistent messaging, we also specified that smoking and vaping are not permitted within any NHS premises and service grounds including car parks; in NHS vehicles; any vehicle located on service grounds.
• Added explicit wording to the guidance confirming that NHS Boards do not provide designated smoking areas for employees.
• Enhanced the policy to clearly state that employees must not smoke while in uniform or at any time when they can be identified as being an on-duty NHS employee.

Work-Related Driving Risks Policy

• Strengthened the policy by explicitly stating that employees must hold business‑use insurance when using their own vehicle for work purposes, and must report any changes to their driving‑licence status to their manager.
• Clarified within the policy’s definitions that commuting is not classed as work‑related driving, ensuring consistent interpretation across NHS Boards.
• Enhanced the Manager Guide with additional detail on the risk‑assessment process, including a more robust framework and examples of medical conditions that may impact fitness to drive.

Work-Related Stress Policy

• The Manager Guide has been expanded to provide more comprehensive support, including indicators of stress, guidance on the use of HSE resources, and step‑by‑step instructions for carrying out both individual and group stress risk assessments.
• Policy wording has been strengthened to ensure managers actively promote a healthy work–life balance and encourage employees to take regular breaks. Additional behavioural, physical, and attendance‑related early warning signs have been incorporated to support managers in making informed decisions.
• The policy has been strengthened by outlining expectations for regular review of risk assessments and ensuring alignment with the organisational stress audit and associated supporting documentation.

Work-Related Violence and Aggression Policy

• Clarified expectations around police reporting, providing contextual guidance within both the Policy and the Manager Guide, including the importance of timely reporting for potential compensation processes.
• Introduced a comprehensive monitoring and review section, outlining requirements for regular incident analysis, reporting to relevant committees or partnership forums, and identifying annual improvement measures.
• Updated the RIDDOR guidance, specifying that over‑7‑day injuries must be reported within 15 days, that only physical injuries are RIDDOR‑reportable, and that psychological harm alone does not meet reporting criteria.
• Embedded the hierarchy of control within the employer responsibilities and risk assessment sections, and provided further elaboration in the Manager Guide to support consistent implementation

The Scottish Workforce and Staff Governance Committee (SWAG) formally approved on 7 October 2025 the full suite of NHSScotland Managing Health at Work workforce policies. These policies and associated documents, set the standard for employment practice for NHS Boards and can be accessed at https://workforce.nhs.scot/