Insights into Health and Social Care Skills and Performance Challenges

1. Sector insightsSkills and performance challenges in health and social care Strategic Labour Market Intelligence - 2015

2. This project examines skills and performance challenges in the health and social care sector. Findings are reported in six main sections: • Mixed-methods research examined five occupations in depth: • - care assistants • - care home managers • physiotherapists • doctors • - nursing auxiliaries

3. 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).

4. Four main factors drive skills demand in the sector Technology and innovation – including advances in treatment modalities and use of technology to support self-care. Social and political factors – including the push for resource efficiency and structural reform. Changing user expectation of care – more person-centred, compassionate, and integrated care. Demographic change – increasing overall demand for the services delivered by the sector. Skills and performance challenges in the health and social care

5. Each key occupation has a specific skills dynamic

6. 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.

7. 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.

8. Forecasting (in terms of numbers and skills) is a long-term challenge within the sector • Supply: • 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

9. A set of future trends will have implications for the sector’s workforce Pressure on resources will lead to further re-design of roles and an increased focus on outcomes 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 locations There is likely to be an increasingly diverse health and social care employer base Implications on the sector and key occupations There will be a growing focus on prevention and population-level health

10. 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.

11. In the context of these current and future challenges, occupational and professional standards have a role to play • NOS are relatively well known in the sector • 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. • They are seen as informing training • “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]”. Professional and service regulatory standards are important too • They set “the minimum baseline for the professions” • The Royal Colleges / chartered societies / professional associations’ standards tend to be more “aspirational”.

12. The sector could take a number of steps to address current and future challenges • Recommendations: • 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

13. info@ukces.org.uk • @ukces • https://www.gov.uk/government/organisations/uk-commission-for-employment-and-skills Images sourced from Shutterstock