THE HEALTH & SOCIAL CARE

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1 THE HEALTH & SOCIAL CARE SECTOR in greater manchester overview of skills ISSUES

2 1. INTRODUCTION This briefing summarises the findings of primary and secondary research in respect of the skills and training priorities for Greater Manchester s health and social care sector. The intention is for the information and data in each sector summary to be used by employers and skills and training providers to inform the development of new strategies and approaches to skills and training. 2. INSIGHTS Health and social care is the second largest employment sector in Greater Manchester, employing 152,000 people; Hospitals account for nearly half of the sector s employment base in Greater Manchester but total employment within all sub-sectors is not insignificant; Workers within the Greater Manchester health and social care sector are highly qualified, with 61% of the workforce qualified to NVQ Level 4 or equivalent compared to 34% across whole economy; High levels of regulation and significant public sector employment within the sector mean that rates of staff training are very high; Some 94% of the health and social care organisations we surveyed said that they felt engaged with training and learning providers. This compares to 79% across all nine sectors included in the survey; The sector relies on people motivated by caring considerations above monetary ones; It is also regarded as better suited to people aged over 18. According to the Skills Funding Agency (SFA), approximately 20,100 people aged over 19 began a course (30% at level 3, 29% at level 2, 22% entry and level 1) in 2012/13; Research suggests Greater Manchester-specific skills shortages in nursing and dementia care, as well as a perceived lack of young people coming into the sector; Some Greater Manchester training providers feel that the sector is under-sold to young people, with perceptions of low pay and limited opportunities common; Total Greater Manchester employment in the sector is forecast to be flat over coming decade but social pressures mean that skills needs are forecast to increase; Greater Manchester also faces a significant challenge in replacing the tens of thousands of sector employees who are expected to retire, move or change career. 3. PROFILE OF THE HEALTH AND SOCIAL CARE SECTOR IN GREATER MANCHESTER There are 5,400 health and social care organisations within Greater Manchester; These organisations employ 152,000 people making the sector second only to financial and professional services in terms of how many Greater Manchester residents work in the sector; Organisations within the sector are generally larger than those in other sectors in terms of numbers of employees; the average company size (84) is larger than that for all sectors (19); Workers within the Greater Manchester Health and Social Care sector are highly qualified, with 61% of the workforce qualified to NVQ Level 4 or equivalent compared to 34% across the whole economy; Some 55% of the workforce is employed in professional or associate professional roles personal care occupations are also more prevalent than across the economy as a whole but there are relatively few managerial posts; A total of 80% of employees are female, compared to 46% across the whole economy; Part-time working is more common in the sector than in the wider economy; The age profile of the workforce is slightly older than in other sectors; Some 13% of the workforce was born outside the UK; and The sector s workforce has continued to grow steadily as social pressures trump the economic demands of austerity. The health and social care sector encompasses hospitals, GPs and dentists together with residential care, child-care and other types of social work. Hospitals account for nearly half of the sector s employment base in Greater Manchester but total employment within all sub-sectors is not insignificant.

3 Table 2 Employment in Health & Social Care sub-sectors in Greater Manchester, 2011 SUBSECTOR Hospital activities 63,710 Other social work activities without accommodation n.e.c. 18,800 Other human health activities 12,330 Child day-care activities 9,920 Social work activities without accommodation for the elderly and disabled 8,420 Residential care activities for the elderly and disabled 8,300 Other residential care activities 8,180 General medical practice activities 7,470 Residential nursing care activities 6,210 Residential care activities for learning disabilities, mental health and substance abuse 4,470 Dental practice activities 3,050 Specialist medical practice activities 810 TOTAL 151,700 Source: Business Register & Employment Survey, 2012 EMPLOYEES IN GM The sector s employment is concentrated in Manchester, with the remaining workforce fairly evenly spread across the conurbation. Figure 1 Health & Social Care employees across Greater Manchester districts, 2011, by location of employment Source: Business Register & Employment Survey, 2012

4 4. DEMAND FOR SKILLS AND TRAINING FROM THE SECTOR The health and social care sector is highly regulated and public-sector dominated for these reasons, training activity within the sector is strong; Some 95% of the health and social care sector organisations we surveyed said that they carried out in-house training (compared to all-sector figure of 85%); The proportion of the sector workforce receiving training (66%) is above average (54%) but has been declining; Some 57% of health and social care sector organisations have a dedicated training budget, compared to 28% across all-sectors; Where sector organisations don t train their staff a lack of money is the most often cited reason - about 15% of organisations cite this factor, with care organisations are more likely to cite this than health organisations; Research has found the sector faces skills gaps in relation to: - Technical, practical and job-specific areas; - Problem solving skills; - Oral communication skills; - Customer handling skills; - Team working skills; and - Management and leadership skills Training most in demand from the sector relates to NVQs in health and social care and Level 5 in management, as well as degrees in nursing. Other compulsory training includes health and safety, CRB checks, food hygiene, manual handling, IT skills and first aid. Some 90% of sector organisations said that apprenticeships were suitable to their industry (84% is the all-sectors rate). Businesses regard apprenticeships as an ideal way for people to develop the necessary skills and knowledge on all aspects of health and social care. But Greater Manchester training providers feel there is a general lack of understanding of what areas of work a health and social care apprenticeship can cover - many careers advisors will focus on elderly care, when there is also working with young adults with learning disabilities, addictions or mental health issues - more generally, they question the quality of careers advice offered in relation to the sector; Occupations that the sector struggles to recruit to include: - Consultants within certain specialties; - Pharmacists; - Dental practitioners; and - Specialist nurses and therapists in certain roles When discussing the health and social care sector Greater Manchester training providers report continual increases in the demand for learning in the sector, as well as increased demand for higher level skills at Level 3 and above. Many noted the NHS priority to increase levels of competence, particularly for non-medically qualified staff as a key driver for this. In terms of recruiting skilled workers, our research has found little evidence that the health and social care sector faces skills shortages and recruitment difficulties not seen elsewhere in the UK. Some 13% of health and social care sector respondents said that their sector faced specific skills shortages within Greater Manchester which were not seen elsewhere in the UK. Across allsectors those responding yes to this question was 26%. The main issues cited were a shortage of qualified staff, particularly in nursing and dementia care, and a shortage of young people coming into the care sector. However, looking at sub-sectors within health and social care, there does appear to be a divide between the experiences of health organisations and social care organisations. In the former, vacancies and skills gaps are relatively rare; in the latter they are relatively common. It is also interesting to note that both sub-sectors feel they struggle to retain staff. Combining this with earlier points suggests that the large potential workforce available to the sector means it does not struggle to recruit but also that wages and working conditions within the sector can make it difficult to retain staff. 5. SUPPLY OF SKILLS AND TRAINING TO THE SECTOR Numbers of starts amongst those aged have been increasing, whilst the number of starts by residents aged 19+ has been falling; In 2011/12 10, year olds began courses relevant to health and social care (about half were level 1, half levels 2 and 3) 1 ; Over the last five years, Skills Funding Agency (SFA) starts have fallen by 19%; 1 At the time of writing, data for EFA funded starts for 2012/13 were unavailable

5 In 2012/13, 20,100 adults aged above 19 began courses; Just under a third of SFA funded starts are at level 3, with similar numbers at level 2 (29%) and slightly fewer at level 1 (22%); Some 50% of starts at age are at level 1, with the other half split between levels 2 and 3; Health and social care (18,300) and health and public services (1,500) are the most popular learning areas; Some 75% of learners are female; A total of 94% of the health and social care organisations we surveyed said that they felt engaged with training and learning providers. This compares to 79% across all nine sectors included in the survey; Some 90% of health and social care sector organisations surveyed said that training providers were able to respond to their skills needs; A total of 79% of health and social care sector survey respondents said that they felt that training providers gave enough support to help their company grow and expand, primarily by being knowledgeable about what support (and funding) was available to organisations. The all-sectors figure was lower at 70%; and Some 81% of the health and social care organisations we surveyed felt that the current supply and quantity of recruits met their needs. The satisfaction rate across all-sectors was slightly lower at 77%. Organisations within the sector feel that training providers are generally able to respond to their skills needs. However, to improve this responsiveness, it was suggested that training providers should: Provide more information on what qualifications and courses are available including grants and financial support; Offer better funding, especially for those aged over 24 and for those that have already achieved baseline qualifications; and Keep costs low. In response to questions about employing young people, comments received related to a young person s lack of workplace experience meaning that they lacked attributes/behaviours such as confidence when dealing with clients and communication skills. Employers also felt that young people lacked motivation and enthusiasm for roles in the care sector. The majority of young people are just not job ready Young people often need support to develop communication skills. Young people lack enthusiasm and motivation. There is also a lack of advice and guidance within the schools to understand the role of a carer. The more sector specific responses to this question focused on the fact that legislation dictates that only those aged 18+ can work unsupervised in the care sector. Several employers said that they only recruited people over a certain age due to the nature of the job roles. Two employers said that the sector just isn t attracting young people and suggested that this was in part due to low wages. Further comments received demonstrate that rigorous pre-recruitment screening and post-recruitment induction processes are key to ensuring new recruits are of the necessary quality. 6. OPPORTUNITIES AND CHALLENGES Net employment growth within Greater Manchester s health and social care sector is forecast to be flat over the coming decade. However, high total employment within the sector and its relatively old workforce means that Greater Manchester faces a significant challenge in replacing the tens of thousands of employees who are expected to retire, move or leave; This challenge will be faced at a time when the UK s aging population, concomitant demand on services, continuing or increasing resource constraints and rising use of private healthcare will require new skills and approaches within the sector The sector s future skills requirements are forecast to be related to shifts in resource constraints, increases in the use of private healthcare and the aging population of the UK, all of which will create challenges for the sector - from patient needs changing to increasing demand for services; It is striking that many of the learners in the sector are also from a relatively more mature cohort. For example, approximately half the apprenticeship starts in 2012/2013 were aged over 30.

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