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
overview
Skills
drivers
Current
skills
challenges
Mixed-methods
research examined five
occupations in depth:
- care assistants
- care home managers
-
Future
skills
The role
of NOS
Implications
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 highlycomplex 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
Social and political
factors – including the
push for resource
efficiency and structural
reform.
Demographic change
– increasing overall
demand for the
services delivered by
the sector.
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.
Skills and
performance
challenges in
the health and
social care
Each key occupation has a specific skills dynamic
Care 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 singleowned 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 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 selfmanagement (which may reduce
demand)
• New technologies create new service
opportunities
A set of future trends will have implications for the sector’s
workforce
Integration of services will
impact on skills needs
and may make some
traditional distinctions
between occupations
redundant
There is likely to be an
increasingly diverse
health and social care
employer base
Pressure on resources
will lead to further redesign of roles and an
increased focus on
outcomes
The skills mix of the
workforce will evolve as
more care is delivered
in community locations
Implications
on the sector
and key
occupations
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
NOS are relatively well known in the
sector
They are seen as informing
training
Professional and service regulatory
standards are important too
• 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 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 set “the minimum baseline for the professions”
• The Royal Colleges / chartered societies / professional associations’ standards
tend to be more “aspirational”.
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
https://www.gov.uk/government/organisations/uk-commission-for-employment-and-skills
[email protected]
@ukces
Images sourced from Shutterstock