sector skills insights: health and social care
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Sector Skills Insights: Health and Social Care. Introduction. - PowerPoint PPT PresentationTRANSCRIPT
Sector Skills Insights: Health and Social Care
Introduction
The UK Commission is working to transform the UK’s approach to investing in skills to help secure jobs and growth. Key to our ambition is the need to encourage greater employer ownership of skills, working to secure long term sustainable partnerships.
This slide pack and accompanying evidence report present the case for more employers in this sector to invest in the skills of their people. It does so by presenting real-life, skill-based business solutions that have been used by leading employers to tackle the performance challenges they face and by drawing on examples of the investments being made by the UK Commission through its investment funds.
There are several determinants of employers’ skills needs and training behaviour including firm size, strategy and location but it is by sector which the strongest variations appear. Hence this work focuses on the Health & Social Care sector. Slide packs and reports are also available for a number of other sectors from: http://www.ukces.org.uk/ourwork/sector-skills-insights. Each of the sectors are important to the economy in terms of employment, productivity or their future potential.
For information about this slide pack and accompanying report please contact:Rebecca Jones, [email protected]
Source information can be found in the notes section of each slide
Storyboard
What key skills challenges are being faced in
Health and Social Care?
Performance challenge (1)
doing more with less
Performance challenge (4) management
capability
The importance of Health and Social Care sector today
Performance challenge (2)
attracting talented individuals
Tackling these performance challenges:
Growth through skills
Imagine where the sector could
be tomorrow
Performance challenge (3)
key skills shortages
Benefits to organisations
What services do the Health and Social care sector offer?
Hospital activities
and nursing homes
Residential care
Child day care
Dental practice
s
GP practice
s
Social work
activities
Specialist practices
What key skills challenges are being faced overall?
Doing more with lessThe NHS in particular is facing major restructuring including significant reductions in management and administrative costs and further efficiency savings are planned across all UK nations. Reduction in public spending is likely to result in significant cost pressures for the Health and Social care sector. Research has demonstrated that management skills are correlated with financial performance and better patient outcomes.
Attracting and retaining the necessary talent An ageing population, and an ageing workforce produce a combination of increasing demand for services coupled with high rates of retirement of existing employees.Almost 1.7 million job openings are expected across health and social care by 2020 (both new demand and the replacement of retiring staff). This includes 881,000 job openings for managers, professionals and associate professionals (160, 000 new job openings). Some parts of the social care sub-sector have high staff turnover and vacancy rates.
Reducing skills gaps among the existing workforce A lack of proficiency has been reported in the areas of strategic management, team-working andcommunication skills. Skills gaps can typically make it harder for organisations to meet quality standards, increase the workload of other staff and create additional operational costs. At the same time, new technology is expected to have wide ranging impact across the sector with assistive technologies shifting the delivery of care towards the home and local providers. Technology will increasedemand for high level skills, with potentially negative consequences for the skills gaps in the sector.
Health and social care matter: where the sector is today
6
• Growth in output in the sector is projected to increase by 2.4% a year to 2020. When taking qualitative measures into account, productivity has increased over the last decade
• Employment in health is dominated by the NHS (over 75%), whereas 47% of employment in adult social care is in the private sector
• There is strong female participation in the sector (79%) and high rates of part-time working (40%), compared to an all-economy average of 47% and 28% respectively.
• The influence of health & social care extends beyond the sector: it provides a large market for UK life sciences industry and other industrial supply chains.
• However, the health and social care sectors have relatively low rates of innovation and investment compared to other sectors.
• The health and social care sector is fundamental to the success of the economy as a major employer employing almost 4 million people.
• Data suggests approximately 1/3 of health and social care employees work within small organisations (under 25 employees) and 1/3 work in large organisations (500 or more employees).
• The importance of health and social care lies in its contribution to all other aspects of the economy: a healthy population is more productive, and more economically active.
• The health workforce is much better qualified than average. Almost a third work in professional occupations compared with a fifth in the labour market as a whole.
• Exporting innovative ideas and expertise, provides business opportunities for UK-based companies.
Health and social care: imagine where we want to be tomorrow
•The sector offers w
orld-leading standards of care and public health supporting the w
ell-being and econom
ic activity of the population, so supporting the perform
ance of other sectors
•W
orld-class m
anagers drive continuous im
provemen
t and m
aximise
the contribution of em
ployees to deliver service excellence
•S
ervices are delivered in an efficient w
ay that m
aximise
value for m
oney
•The U
K
leads the w
orld in term
s of efficiency and innovation in the delivery of H
ealth and S
ocial C
are services
•The sector attracts the m
ost talented individuals for both training and practice
•The sector recognises talent as a source of com
petitive advantage
•Firm
s and individuals invest optimally in their skills
•E
mployers collaborate on, lead and ow
n skills solutions to the sector’s perform
ance challenges in pursuit of m
utual gain
The sector tomorrow: increasing demand for skills in Health and Social Care
•Em
ployment overall is projected to grow
by 1.3 per cent (social care +4.9%
, health -1.3%)
between 2010 and 2020 (below
all sector average of 5.1 per cent). H
owever, the expansion and
retraction for different occupations reveals a more
challenging picture.
•The m
ajority of employm
ent growth is
projected among highly skilled occupations
(9% across m
anagers, directors and senior officials, professional occupations, associate professional and technical) but this is low
er than across all sectors (16%
), therefore competition for
skills is likely to be high.
•E
mploym
ent among positions using higher level
qualifications (first degree level and above) is projected to increase from
28% in health, 26%
in care in 2010 to 39%
for both sectors in 2020. At
both time points this is higher than the all sector
average, 24% in 2020 to 32%
in 2020 across all sectors
•N
ew job openings due to retirem
ent and em
ployment grow
th is significant: 485,000 jobs in professional and 570,000 jobs in caring, leisure and other services occupations by 2020
•E
mploym
ent is also expected to increase among
caring, leisure and other services occupations particularly in S
ocial Care (12%
for Social C
are, but 9%
for Health w
hich is on a par with the all
sector average)
•P
ositions are expected to decrease among
administrative and secretarial (31%
) and skilled trade occupations (33%
), much m
ore so than across all sectors (11%
and 7% respectively).
The sector tomorrow: doing more with less
Doing more...• The UK population is growing and ageing which is likely to lead to a 20% increase in
demand for residential care, home care, day centres and meals per decade.• The number of children referred to Social Services is rising in England (613K referrals
year ending March 2011, 608K in 2010, 547K in 2009, 539K in 2008)• Obesity is steadily increasing across the UK, associated with an extra 7 million cases of
diabetes, 6.5 million cases of heart disease and stroke, and between 492,000 and 669,000 additional cases of cancer by 2030.
• Alcohol-related hospital admissions is rising as is the incidence of binge drinking
With less...• Targets of 5% in efficiency savings have been announced across the NHS, requiring
annual savings worth £20 billion by 2014/15.• The NHS is facing major restructuring (Health and Social Care Act 2012) including a
challenge to reduce bureaucracy, and reduce the resulting management and administrative costs.
• The pay freeze means salaries are under pressure, in the health sector especially: “the pressure to pay more in real terms will be immense; by 2012-13 GPs will have had their pay frozen for four years, consultants for three and everyone else for two years.” (John Appleby of the King's Fund)
9
The performance challenge Quality of management capability
Managem
ent practice in hospitals are strongly related to quality of patient care and better productivity. Im
proved m
anagement practices are associated w
ith:•
Significantly low
er mortality rates
•B
etter financial performance
•Q
uality patient careThere is a general perception of poor m
anagement skills in
the H&
SC
sector, however research* has show
n that the UK
delivers strong hospital-m
anagement practices relative to
health expenditure. That said, variation in the quality of m
anagement and outcom
es is evident; in that, better m
anagement scores can be found am
ong:•
Hospitals w
ith clinically qualified managers associated w
ith better m
anagement scores.
•H
igher-scoring hospitals give managers higher levels of autonom
y •
Larger hospitals are better managed.
•P
rivate hospitals (including not-for-profits) achieve higher managem
ent scores than public hospitals.
Across both sectors the skills levels and training of senior staff are strong:
•B
oth sectors fare very well w
hen compared to the all sector
average for Managers and professional w
ithout L4 or above qualification (H
ealth 15%, C
are 30%, all sector
average 39%)
•E
qually, employees receiving training at M
anager, Director
and senior Official O
ccupations is well above the all sector
average of 45%. (H
ealth 61%, C
are 60%)
But, w
hile on the whole skills shortage vacancies are low
er than the U
K average, the occurrence of skills shortage
vacancies as % of all vacancies is concentrated in the
managerial and professional occupations (for health, 42%
of all vacancies for m
anagers are SS
V’s, and in care this is
24%)
.
A key outcome of the Health & Social Care Act is a reduction in bureaucracy and a consequent reduction in management and administrative costs. The challenge to do more with less means
what is good now will need to be better.
The performance challenge Quality of management capability
Looking ahead at demand for management skills: • Small growth is expected in the workforce in health and care sectors between 2010-2020.
However, the share of the workforce made up from the top three occupation levels plus caring occupations is expected to grow while others are expected to retract.
• Demand for skills at level from degree level to doctorate level is expected to increase during 2010-2020 across all sectors including health and care
– But, demand for higher degree and doctorate level in expected to increase above the level for all sectors. In 2010 the share of employment at QCF 7-8 is around 9-10% for health and social care, in line with the all sector average. By 2020 this is expected to increase to just over 15% for health and social care and just under 15% for all sectors
• Meanwhile, the demand from other sectors for skills at the top three occupational levels is also set to increase, competition to attract these skills will be high which increase the need to nurture and promote from within the sector.
Meanwhile, if we look at High Performance Working in the sectors the role of good management is important in enabling the execution of the four indicators used to measure HPW. Here both health and social care have variable strengths and some weaknesses in relation to the sector average
– Identifying talent is a strength for both sectors ( 20% health, 28% care and 214% all sectors) – For both variety in work and discretion in tasks, health is lower than the all sector average
(variety - 51% health, 59% care and 55% UK) (discretion – 42% health, 53% care and 52% UK)– Flexible working is lower for both sector than the all sector average (27% health, care and UK)
The increased demand for higher levels across the economy will mean increased competition to attract talent and nurture these skills. Key outcomes of HPW are effective skills utilisation and
progression – this could help to nurture talent and meet future the demand for higher level skills from growth and replacement demand.
12
The problemMacIntyre found that managers in the Care sector were often lacking key management and leadership skills and also lacking confidence in the role.
The approachThe National Skills Academy for Social Care developed the Leader’s programme, designed for those working or leading to develop the language and values of leadership and peer learning. The course helped first-line managers respond to high rates of attrition (40% in first year, 60% in the second year).
The benefitsThe programme helped managers better manage their role and gave them the confidence to cope effectively with the tougher, more personal aspects of the role. Feedback from attendees has been very positive generating high levels of enthusiasm, helping participants learn and think about themselves and their roles differently.
Case study - Front-line leaders programme
The performance challenge Key skills shortages
•In the H
ealth sector, the over-whelm
ing response from
employers in regard to skills requirem
ents was for
greater levels of job specific skills (77% of health
employers identified this as a need com
pared to 54% in
Care and 66%
across all sectors)
•In S
ocial Care sector, em
ployer skills requirements
were highest for job specific skills. In addition to this
employers reported sim
ilar levels of needs across: planning skills, com
munication skills (w
ritten and oral), custom
er handling, ability to work in team
s and problem
solving (all at higher levels than the all sector average for the skill type)
•D
espite generally high proportions of well qualified staff
overall (61% qualified to N
QF Level 4 and above,
compared to 36%
in whole econom
y) there are still significant pockets of low
qualified employees (e.g.
16% of em
ployees in the sector have either no qualification, or are educated to N
QF Level 1 or
equivalent compared to a 19%
economy average).
•D
espite high instances of formal and inform
al training in both sectors
•In the H
ealth sector, employees in skilled
process, plant and machine operative roles
were the only occupational category less likely to
experience training than the sector average•
Whereas in the C
are sector, employees receiving
training was low
er than the all sector average for professional occupations, associate professional and custom
er service occupations
•A
cross the three main im
plications of skills gaps em
ployers in both health and care report similar
experience of these implications as for all firm
s
•Increased w
orkload for other staff (82 per cent for both health and care, 78%
across all sectors), increased operating costs (40%
health, 33%
care, 45% all sectors), and difficulty in m
eeting quality standards (39%
health 38% care and 40%
all sectors)
•H
owever, a particular issue for health and care
employers is difficulties introducing new
working
practices (44% health and 48%
care compared to
38% of all firm
s).
The health of the workforce skills and experience of training is variable across occupations. The repercussions are felt more widely. In health and social care, new working practices and their consistent adoption are a fundamental to effective delivery. Investment in skills is key.
Case study – Creating new roles to reduce emergency hospital admissions
The problemO
ver 75% of 999 calls to the am
bulance service result in adm
ission to an emergency departm
ent. This is resource-intensive and creates traum
a for patients. S
kills for Health developed a com
petency framew
ork for em
ergency, urgent and unscheduled care to devise a new
role and learning programm
e for E
mergency C
are Practitioners (E
CP
s)The approachE
CP
s are up-skilled to assess and treat patients at the scene, provide clinical support and advice, support prim
ary care staff in home visits or out of
hours cover and work in m
inor injury units.
The benefitsE
CP
s have reduced emergency adm
issions: almost a
third of patients avoided transfer to an em
ergency departm
ent when treated by an E
CP
at the scene. A
lmost a half of elderly patients suffering a fall and
seen by an EC
P did not need to be adm
itted. P
atient satisfaction is higher; as generally patients prefer to be treated close to or in their ow
n homes.
The new com
petency framew
ork provides staff with
the opportunity to develop and progress.
.
ECP attendance costs less than sending an ambulance in response
to a 999 call.
The performance challenge Attracting talented individuals
In Health
•H
owever, there is a concentration of S
kills Shortage
Vacancies reported among professional occupations
in Health (47%
compared to 16%
for Social C
are and 18%
across the economy).
•There are skills shortages reported am
ong Pharm
acists, Dental Practitioners, Specialist
nurses occupations and in other physiological sciences and respiratory physiology sectors.
•The share of skills gaps by occupation in health is higher for professionals 8%
compared to 4 %
for both care and the all sector average)
Reliance on international recruitm
ent is lessening, how
ever employers need to think about alternative
recruitment channels.
In Care
•There are particular S
kills Shortage Vacancies in
personal service occupations in Care, of all the skills
shortage vacancies in care 52% are in the caring
occupations (compared to 29%
for health) and 11%
across the economy.
•S
kills gaps** are also higher than average in skilled trades (8%
compared to 4%
in care and 5% all sector
average) and caring occupations (6% versus 4%
for health and 5%
economy average).
•S
ocial care also has a high staff turnover rate, of 18%
in the private sector, and 11% am
ong local authorities).
Enhancing the attractiveness of jobs for new
recruits im
proves employer’s ability to recruit and retain
talented individuals. * S
kills shortage vacancies are hard to fill vacancies caused by a lack of applicants with the skills, qualifications or experience
needed** S
kills gaps are a lack of full proficiency amongst existing staff ie not able to do the job to the required level
The share of all vacancies which are Skills Shortage Vacancies* are lower in Health (12%) and in Care (9%) compared to the (16%) average across all sectors, but on closer inspection the need
to attract talent for specific occupations becomes apparent.
16
The ProblemAs a healthcare recruitment company, specialising in recruiting and supplying care assistants, support workers and nurses, Caledonia Healthcare Limited wanted to attract, recruit, retain and motivate high calibre professionals and saw Investors in People (IiP) as a fundamental part of becoming an employer of choice and leveraging human capital.
The ApproachIiP helped Caledonia Healthcare understand what made their people happy through implementing a staff consultation process. The results revealed innovative solutions for business planning and new ways for senior managers to communicate with staff.
The benefitsIn using a consistent approach to staff development, the firm experienced higher levels of staff engagement and retention. Gaining and retaining IiP has provided Caledonia Healthcare with a powerful way of demonstrating that they are a great company to work for – more people want to work for the organisation and more clients have provided positive feedback on the service they have received.
Case study - Caledonia Healthcare: Improving recruitment and retention
Case study- A new foundation degree to improve recruitment and retention
The problemA rising elderly population led to increasing pressure on com
munity nursing services to deliver routine care such as
dietary monitoring, support for those w
ith diabetes, wound
dressing and other routine procedures. At the sam
e time,
care staff were not qualified to carry out these procedures
leading to a resourcing issue for both time-pressured
comm
unity nurses and care staff whose capabilities w
ere being underutilised. For C
arers, lack of suitable progression routes m
eant that retention was low
.
The approachA partnership betw
een Skills for H
ealth, Foundation D
egree Forward,
University C
ampus S
uffolk and MO
VE
Lifelong Learning N
etwork
devised a new Foundation D
egree to enable care staff to becom
e qualified to offer basic care through a blend of w
ork-based and theoretical learning. C
redits can be accumulated and
easily transferred via a structured pathw
ay for career progression.
The benefitsC
are homes recruit and retain the volum
es of staff needed to m
eet future dem
and, benefitting from greater efficiency and
reduced staff turnover. P
atients would experience m
ore timely treatm
ent and greater continuity of care. The w
ider health sector experiences reduced pressure for com
munity nurses and through
reduced hospital admissions because of a lack of capacity
in care homes to provide appropriate care.
Growth through skillsSecuring future success
• Across the sector, raising skills is key to raising performance, but while there is no silver bullet, a mix of actions which push and pull in the same direction can help.
• Employer leadership in the development of solutions and then taking ownership of those solutions is fundamental to their success and sustainability.
Sources of investment are available to support the implementation of solutions led by business on behalf of the sector.
• The Employer Ownership pilots offers employers in England direct access to up to £250 million of public investment over the next two years to design and deliver their own training solutions.
• The Growth and Innovation Fund (£9 million invested so far, £29 million to invest in 2012-13) gives priority to solutions for the sector e.g.:• Employer commitment and investment in Apprenticeships• Creation of employer networks to overcome skill problems• Employer-backed proposals for other skills solutions such as: management and leadership;
professional standards; high performance work practices incorporating people development (e.g. Investors in People).
• Information and business advice is also important as a solution.
Ultimately this is trying to catalyse sustained investment in the development of the sector’s workforce led by employers which lies at the heart of an enterprising and dynamic nation.
Growth through skillsSecuring future success
Strong links between employers and colleges and universities have been cemented through the National Skills Academies.
The National Skills Academy for Social Care offers leadership training to:• Recent graduates through a National Management Trainee Scheme which seeks to
attract people into the sector and develop future leaders.• Front-line leaders which focuses on how the values and behaviours of leadership at the
front line are crucial to excellent care delivery.• Senior managers of the future An Aspiring Leaders programme focuses on leadership
within the commercial reality of day-to-day operations.• New Directors working with the Association of Directors of Adult Social Services
(ADASS) to run a programme to support senior managers when they’re newly promoted to lead local authority adult social services.
The social care academy also aims to raise the quality of provision by offering quality marks for organisations and individuals through awarding:• Centres of Excellence: who demonstrate exemplary commitment to meeting the needs
of learners, compliance with the social model of care, and understanding and measuring impact of provision on lives of service users.
• Recognised Providers: who demonstrate a professional approach to education and training in adult social care.
• Endorsed Practitioners: 'sole-trader' training providers who demonstrate a professional approach to education and training in adult social care.
Growth through skillsSecuring future success
The National Skills Academy for Health seeks to raise skills in the sector by offering:• Specialist Careers Advice and Information• Brokerage for employers matching training providers to need• Learning consultancy• Apprenticeship, Youth and Pre-employment Programmes, including the management of
the Joint Investment Framework• Partnerships with various organisations delivering the 14-19 diplomas, acting on their
behalf, and providing a comprehensive menu of employment engagement activities • Support to organisations on how to maintain standards both occupationally and through
qualification requirements via our Skills for Health approval process• Career development for those supporting learners with language, literacy and numeracy
development needs
Skills for Health are improving the talent pipeline of new entrants into the sector through: • The Skills Passport will provide a framework for statutory and mandatory skills. to
reduce training costs, improve productivity and increase quality of services. With investment from GIF, Skills for Health are offering to implement the framework within 60 organisations
• Skills for Health run a Cadet training programme to help young people start a career in the NHS, whilst continuing to study an academic or vocational qualification, a 14-19 diploma and young apprenticeships.
Growth through skillsSecuring future success
Apprenticeships and Workplace learning – social careCase study research reports that employers believed that Apprenticeships and WPL, often alongside mandatory training, delivers a number of benefits: • staff understanding of what care entails and consistency of standards; • helping to develop staff confidence and capability to deliver a good standard of care; • investment in training particularly beyond Level 2 offers (personal) development opportunities
help to support staff motivation and retention• when senior posts become vacant, a pool of suitably trained internal candidates for promotion
will be ready to take up the opportunity to progress.*In addition, this study of 8 sectors the net cost of WPL in social care was found to be lower than in many other sectors for both L2 Apprenticeships and L2 NVQ .
Partnerships with employers – Health • Skills for Health worked with Whittington Hospital NHS Trust to pioneered a competence
based leadership programme for front line managers. The benefits included: managers able to deal with issues without dependence on senior support , more proactive and raised confidence and morale.
• NHS Nottingham City and University of Nottingham have developed a ‘competency matrix’ to support staff development for End of Life Care. This has reaped benefits for: patient centred care, multidisciplinary approaches and increased competence and confidence in clinical practice.
Benefits of training to organisations
•E
vidence across a number of sectors
suggests that employers w
ho invest in training are m
ore likely to survive than those w
ho don’t .....
–Training im
proves organisational survival rates. N
on-training organisations in the Health
sector are 1.2 times m
ore likely to close com
pared to training organisations in Health*.
•A
nd, what is m
ore, the productivity gains for firm
s from investing in
training are seen to be higher than the increase in w
ages experienced by em
ployees
•D
evelopment of com
munication skills
results in a demonstrable shift in staff
behaviours towards patients. S
taff show
greater empathy, greater
responsiveness to patient cues and better style of questioning. The evidence show
s that change is sustained over the long term
.
•G
ood people managem
ent practices are strongly related to low
er patient m
ortality rates. The extent and sophistication of appraisal is particularly strongly related, but there are links too w
ith the level of training for staff, and the w
ay work is organised, for exam
ple the proportion of staff w
orking in teams.
Benefits of training to organisations
In the Social C
are sector, better perform
ing Care
homes have:
•H
igher proportions of staff w
ith relevant qualifications including m
anagerial and supervisory staff, senior care w
orkers and care workers
•G
reater proportions of w
orkers with higher level
qualifications (including care w
orkers at level 3 and m
anagers with professional
and managerial qualifications)
•M
ore experienced staff on hand.
Key messages
The health and social care is a major sector in
employm
ent and economic term
s now and dem
and for services is projected to grow
over the next decade. A
gainst a backdrop of fiscal constraint, several challenges exist w
hich threaten the sector’s perform
ance:
• attracting talented individuals to the sector
• overcoming skills gaps am
ong pockets of low-
qualified employees
• improving the quality of m
anagement capability
across the sectorE
xamples exist of w
here these challenges are being tackled successfully through em
ployer-led skills solutions. If the sector is to realise its potential, this action m
ust be scaled-up and employers m
ust play a greater role in developing the skills needed by their respective w
orkforces. B
y providing training and skills development in the
context of an employm
ent relationship which
recognises the importance of career progression, there
are benefits to both employer and em
ployee .
Work w
ith employers to transform
the UK
’s approach to investing in skills of its people to secure grow
th and prosperity. The U
K C
omm
ission is looking to w
ork with em
ployers to transform the U
K’s approach
to investing in the skills of its people to secure grow
th and prosperity. More inform
ation about the UK
C
omm
ission’s investment funds is available here.