Challenge 11.4

What is the problem, and how does it affect the Challenge Sponsor organisation, service users and/or People of Scotland?

The numbers of people experiencing long term health conditions at earlier stages in their lives in Scotland is growing. One of the most common types of working age long term health condition is Musculoskeletal conditions such as back pain, arthritis, and repetitive strain injuries, a leading cause of working-age disability and long-term sickness. These conditions can be painful, reduce quality of life, limit independence, and contribute to mental health challenges.

 Individuals with MSK conditions often navigate disjointed systems across healthcare, social care, employability services, and in the workplace, often without support from services that may be overburdened. For people experiencing these conditions in the work place many employers lack access to occupational health services, and where these do exist, the support services may be underutilised. Individuals with MSK conditions are often addressed too late leading to long-term sickness and absence from work. The longer the period of inactivity, the harder it is for a person to enter or return to work. This can lead to secondary impacts of prolonged periods of economic inactivity including making them more likely to experience poverty and even a lower life expectancy.

The key questions that should be considered for this challenge include:

• How can the risk of Musculoskeletal conditions be identified early to enable action that helps prevent conditions worsening?

• How can we support individuals to self-manage Musculoskeletal conditions and confidently prepare for return-to-work at their own pace?

• How can employers and health professionals coordinate personalised support without overburdening existing systems?

• How do we identify the best timing and approach for a phased, successful return to work and track what works?

Addressing these questions will contribute to reducing economic inactivity as well as help tackle health inequality and support Scotland’s fair work agenda. This challenge has a national importance and supports a “whole system” response, to reduce health inequalities and targeting support to those most in need.

Addressing economic inactivity is a Scottish Government priority. Solutions are needed to help prevent, detect and treat Musculoskeletal conditions supporting people in work, and those who have been inactive that wish to be supported into work.

Economic Inactivity is a problem for most developed nations. It means that a person is not in employment or has not been seeking work within the last four weeks or is unable to start work within the next two weeks.

While focused on Musculoskeletal conditions, solutions or approaches which can be applied to address other long term health conditions such as long-COVID or mental health conditions are encouraged.

There are also opportunities for technological solutions, when applied, to target particular geographic areas, communities, protected characteristics, business type or sectors, which will help to address gaps in data and potentially hidden issues and inequalities in sickness absence and economic activity.

The design of systems that co-ordinate progress across public, private, and third sector is in alignment with Scottish Government’s progressive agenda on collaborative working in the service of Scotland.

How will we know the Challenge has been solved?

Measures of success on this challenge will be across the following themes:

Data

• Data on MSK conditions, work readiness, and service use is siloed, limiting personalised support and system learning.

• Reduced number of days absent from work due to Musculoskeletal conditions.

• Reduction in economic inactivity caused by Musculoskeletal conditions in annual population survey by Office of National Statistics.

• Qualitative data in terms of case studies and personal experiences.

Usability and Engagement

• People are empowered by greater flexibility and control over their health and care through digitally enabled access to information, resources, treatment and services.

• Tackle structural barriers, stigma, fear of disclosure or lack of employer flexibility which may hinder people to remain, seek or re-enter work.

• Evidence through feedback on users' confidence in relation to the product.

• User feedback that reports on mobility, confidence, and return-to-work readiness.

• The solution  is accessible for a range of stakeholders, for instance NHS Boards, SMEs, or rural employers as well as occupational health providers.

Integration of technology product with existing systems and avoidance of duplication

• Alignment with GDPR, cyber resilience, and accessibility standards of NHS and the Scottish Government.

• Interoperability with existing NHS, occupational health, or employability platforms.

• API integration should cater for a range of HR systems including for Small and Medium Sized Enterprises (SMEs), noting the technology capacity of the majority of SMEs may be limited.

• Share non-clinical progress data (with consent) to support benefit applications or reduce assessment duplication.

Who are the end users likely to be?

We expect the following end users:

• Individuals with Musculoskeletal problems in work and made inactive due to it

• Employers across the public and private sector

• National Health service providers including NHS and through Working Health Services Scotland (WHSS)

Has the Challenge Sponsor attempted to solve this problem before?

Glasgow has experience in supporting people with MSK conditions into work. As part of the Glasgow Works project, activity was undertaken in collaboration with vocational rehabilitation teams in NHS GGC to support physiotherapists and occupational therapists as part of a holistic employability approach. In Glasgow a specific contract is in place, delivered in partnership and led by Enable to support people with health conditions and disabilities, including MSK. This has a focus on providing support to individuals and their employer where the person is in work but at risk of falling away from the labour market due to ill health.

The Scottish Government has taken policy measures to address health related inactivity generally through measures such as enhancement to the Healthy Working Lives website as a single point of access for all mental and physical health support and extended opening hours for Working Health Services Scotland.

A Health and Work action plan is being developed with partners and stakeholders for publication late 2025. These initiatives will benefit from the continued harnessing of technology and innovation to solve problems of health related economic inactivity.

Are there any interdependencies or blockers?

Complex health and social care systems and data landscape influence how data is used to identify and support people at risk. Integration may be essential for coordinated care and return-to-work planning. Poor integration may lead to or perpetuate fragmented support, when the objective is to address economic inactivity. 

Respondents may benefit from understanding the requirements for developing technology products that qualify as a medical device.

Related to integration of existing systems it will be important to address risks and concerns over sharing of personal health data and remote monitoring of staff, and current attitudes to Occupational Health along with fair work principles to make the end-product a success.

Consideration to be given to language barriers, accessibility, digital literacy and access to IT.

Will a solution need to integrate with any existing systems / equipment?

Depending on the nature of the proposed solution, it may need to be integrated with existing systems such as electronic health records and cloud-based human resource management systems. The costs of any such integration have not been identified.

A solution should re-enforce data protection and buy-in is needed from employers, for instance to support work assessments used by the Department of Work and Pensions (DWP). Consideration to be given to language barriers, accessibility, digital literacy and access to IT to extent that a solution is able to help people to access services that might help them return to work.

Is this part of an existing service?

No.

Any technologies or features the Challenge Sponsor wishes to explore or avoid?

CivTech is tech agnostic. If the proposed solution offers the opportunity to solve the Challenge in question, we will consider it.

Much is currently being made of the potential of advanced AI. In truth, just about all the products CivTech has developed over the past few years have AI as part of the tech stack but there is no obligation on your part to go down this route – either with componentry such as machine learning and pattern recognition, or indeed LLMs.

We are looking for the best solution, whatever technology is used.

While not limited to the following technologies, the Challenge Sponsor is particularly interested in proposals that explore the following:

• Internet of Things (IoT) and wearables - wearable sensors to monitor physical activity, posture, or pain levels will be useful for people recovering from musculoskeletal conditions to track recovery safely

• Assistive and accessible technology – tools that helps those with fatigue, pain, or cognitive limitations engage gradually in the workplace

• API Integration with NHS/Employer systems – to cater for a unified platform to pull in data from different services for example sick notes, and employer support forms

• Digital Twin for Return-to-Work Planning – will result in stimulated phased return-to-work scenarios based on job type, health status, and workplace adjustments to allow clinicians and employers to collaboratively plan safe, personalised pathways

• We would not like to see a mobile application that gives personalised guidance based on predictive modelling, as this will not meet the nuanced requirements of the Challenge.

What is the commercial opportunity beyond a CivTech contract?

The commercial opportunities associated with solutions to this Challenge include other health and social care sectors nationally and internationally. There is a global need to reduce economic inactivity and improve occupational health, therefore a potential exists to roll out this solution to employers - particularly in countries with similar health and employment systems (e.g. Nordic countries, Canada, Australia, NHS England).

Innovation may translate into other aspects of health-related inactivity and could be applied to mental health, long COVID, chronic fatigue or pain conditions.

We are aware of large and growing markets for workplace health platforms and services, occupational health technology solutions, and employee wellbeing and retention tools.

Who are the stakeholders?

The specific service areas involved in the Challenge will include:

Scottish Government:

• Employability Division, Claire Renton, Deputy Director for Employability

• Population Health Strategy and Improvement, James Wilson, Unit Head, Population Health Strategy and Improvement

City Councils:

• Frankie Barrett, Glasgow City Council

• Lynne Burgess, Dumfries and Galloway City Council

Public Health Scotland:

• Rachel McAdams, Service Manager

Who’s in the Challenge Sponsor team?

The Challenge Sponsor team will be made up of staff from the following Scottish Government Divisions;

• Employability Division, Scottish Government

• Population Health, Strategy, and Improvement Division, Scottish Government

• Glasgow City Council

• Dumfries and Galloway City Council

What is the policy background to the Challenge?

Economic Inactivity is a priority for the Scottish Government. Commitments on the health side of Economic Inactivity have been included in the Programme for Government 2025-26:

• Evaluating the impact of improved health and work services committed to in Programme for Government 2024, which will support up to 1,000 additional people in 2025-26 and beyond, and work with Public Health Scotland to galvanise employer action towards healthy workplaces.

Scotland’s Population Health Framework was published on 17 June 2025, as part of broader Health and Social Care reform set out by the First Minister in January 2025.

Co-developed with COSLA in partnership with Public Health Scotland and Directors of Public Health, the Framework takes a cross-government and cross-sector approach to improve the key building blocks of health with a focus on whole system preventative action, towards improving life expectancy and reducing the gap in life expectancy noted between the 20% most deprived areas of Scotland, and the country as a whole.

Within the Framework’s key driver of improving the social and economic factors that support better health and reduce inequalities, it sets out:

“To grow economic activity, we will improve the support employees receive to remain in work when facing poor health or with caring responsibilities, as well as continue to help employers support mentally healthy workplaces.”

This includes an initial action to develop an action plan focusing on health and work, to include improving support for people with ill health in work, and those with ill health who wish to return to work, especially those with mental health and musculoskeletal conditions.