Sector insights Skills and performance challenges in health and social care

Strategic Labour Market Intelligence - 2015

This project examines skills and performance challenges in the health and social care sector. Findings are reported in six main sections:

Sector overvie

w

Skills drivers

Current skills

challenges

Future skills

The role of NOS

Implications

Mixed-methods research examined five occupations in

depth:

- care assistants

- care home managers

- physiotherapists

- doctors

- nursing auxiliaries

The health and social care workforce today

The health and social care sector:• Largest UK sector – employing over 4 million

people • Provides care and support services ranging from

highly-complex acute care in hospitals through to personal care and support in people’s homes

• Predominantly female workforce - just over 20 per cent of the workforce is male

• Older age profile older and more highly-qualified than the economy as a whole

• Average weekly earnings lower than the economy average (despite the higher level of qualifications).

Four main factors drive skills demand in the sector

Skills and performanc

e challenges

in the health and social care

Demographic change –

increasing overall demand for the

services delivered by the sector.

Social and political factors – including the push

for resource efficiency and

structural reform.

Technology and innovation –

including advances in treatment

modalities and use of technology to support self-care.

Changing user expectation of

care – more person-centred,

compassionate, and integrated care.

Each key occupation has a specific skills dynamicCare Assistants

• Core skills are the provision of personal care; although a degree of specialisation is possible within the occupation based on the care needs of users. Skills challenges stem from structural issues such as the relatively low pay, poor working conditions, and growing demands of the role.

Care home managers and proprietors

• A complex occupation which can combine a regulatory role of assuring the quality of care with a commercial imperative of running a business. Current skills challenges derive from these twin roles. Promotion to the role from within is typical (particularly in single-owned homes); as a result, developing leadership and management skills is often required.

Physiotherapists

• An occupation operating across the health and social care economy; an integral part of multi-disciplinary care teams, offering support for patients with numerous care needs. Skills challenges differ depending on whether the role is community or acute-based. Employers report relatively few applicants for jobs, and a flattening out of career progression.

Medical practitioners

• Doctors have oversight over all aspects of medical care. Skills development is characterised by increasing specialisation (with key debates relating to the degree of specialisation required). Predicting future supply of, and demand for, specialist medical services is a key challenge facing employers and policy makers.

Nursing auxiliaries

• The nursing auxiliary occupational group is large and varied in its function and level of seniority. It provides support to clinical professions across the health and social care sector. Nursing auxiliaries influence how patients experience services .Recruiting for values is therefore a key issue. New / adapted roles are emerging within the occupation responding to patient need.

There are sector-wide challenges too, among them, recruiting sufficient staff to meet service demand

• The sector is growing – increasing by over 6 per cent in the five years up to September 2014

• It is forecast that over 2 million new workers will need to be trained and recruited into the health and social care sector by 2022

• Greatest demand anticipated for nursing auxiliaries and care workers/home carers.

• Retaining staff with the right values is crucially important – employers are looking at how best to recruit for values and to retain their staff.

Supporting progression in the sector is a common goal for employers

• Enabling progression is important for addressing high staff turnover

• In lower-level occupations• Employers support development within role (to

address increased patient demand). Training and competency frameworks will be important.

• In registered occupations progression often relates to specialisation – there is debate over the degree to which this model fully meets patient needs.

Forecasting (in terms of numbers and skills) is a long-term challenge within the sectorSupply: • Personal choices of staff (work-

life balance, part-time working, predictable hours) affect length of training, career and retirement decisions

• Choice of professional specialism (acute or community; medical specialism)

• Policy decisions (e.g. relating to wages; reform of training structures)

• Changing regulation (of professions and services)

Demand: • Changing patient expectations

(so that they are ‘enabled’ to care for themselves)

• Greater policy focus on prevention, improved health behaviours and self-management (which may reduce demand)

• New technologies create new service opportunities

A set of future trends will have implications for the sector’s workforce

Implications on the

sector and key

occupations

Integration of services will impact on skills

needs and may make some traditional

distinctions between occupations redundant The skills mix of the

workforce will evolve as more care is

delivered in community locationsThere is likely to be

an increasingly diverse health and

social care employer base

Pressure on resources will lead to further re-design

of roles and an increased focus on

outcomes

There will be a growing focus on prevention and population-level

health

These implications are already evident across the key occupations

• New intermediary roles, related to current more traditional occupations (e.g. physician assistants)

• An amplification of the existing challenge of workforce planning following the increasing fragmentation of the employer base

• Greater specialisation / fragmentation of occupations (such as nursing auxiliaries) – regulation may follow

• Existing occupations may expand to take on new responsibilities, such as physiotherapists in a public health role, and care home managers overseeing integrated health and social care facilities

• Occupations will take on more of an ‘enabling’ role, supporting people to live independently.

In the context of these current and future challenges, occupational and professional standards have a role to play

• Over half (55 per cent) of health and social care employers have some awareness of NOS

• This compares favourably to 40 per cent of employers across the entire economy.

NOS are relatively well known in the sector

• “They can be used to turn into an educational currency”• “We need some sort of basis and Skills for Care, Skills for Health and

NOS are as good as anyone [for this]”.They are seen as informing

training

• They set “the minimum baseline for the professions”• The Royal Colleges / chartered societies / professional associations’

standards tend to be more “aspirational”.

Professional and service regulatory standards are

important too

The sector could take a number of steps to address current and future challenges

• Design dual route training opportunities and qualifications for new entrants to the sector, which would allow staff to pursue a health or social care career path

• Capitalise on opportunities to share learning on recruitment and workforce planning to aid the delivery of personalised and integrated care

• Undertake exploratory scenario planning to examine the future shape of health and social care support jobs

• Share learning on how to engage lower skilled workers in workplace learning

• Move away from a narrowly-defined, task-orientated NOS and encourage greater use of NOS by national and sector bodies when developing training across the sector

Recommendations:

info@ukces.org.uk

@ukces

https://www.gov.uk/government/organisations/uk-commission-for-employment-and-skills

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