interviews

NSA Health: Skills for the support workforce

Candace Miller, director of NSA Health, and skills minister Matthew Hancock MP speak to NHE about the launch of the new academy.

On Thursday September 12, the National Skills Academy for Health (NSA Health) was officially launched by skills minister Matthew Hancock MP.

Ahead of the launch, both Hancock and NSA Health director Candace Miller spoke to NHE to explain the priorities of the organisation and why a focus on the support workforce is particularly relevant now.

The National Skills Academies – there are 19 already operational – are important to target specific skills needs, Hancock said, and ensure Government support reaches all employers: “No matter the size or shape of the company you work for, if provision is needed and the support is available, then it can reach you.”

Miller said: “Our interest is in ensuring the workforce – a wide group of occupations – has access to the kind of high quality training and development that they require. To make sure the whole skill-set of an organisation is really up there and delivering the kind of care quality and productivity of care that we all want to see.”

The support workforce in the health sector consists of around 500,000 to 600,000 people, although this can be hard to gauge due to the wide range of roles included. Yet despite making up around 40% of the whole healthcare workforce, the sector only receives around 4% of the healthcare spend on education and training.

“One of the reasons why [counting] is so difficult is because unlike named professional roles there isn’t a simple and easy way of calculating numbers,” Miller said. It also encompasses a “whole range” of support roles, and this diversity can add to the challenge.

Equal access

While training in some places is “absolutely excellent”, it remains inconsistently accessible across the country. Smaller trusts can be dependent on local education providers rather than having the infrastructure available to undertake skills development in-house, for example.

Hancock acknowledged the training already in place for the support workforce, but added: “It’s clear that there is a need for more. This is about making sure there is better and easier access to training where it’s needed.”

Employers have raised concerns over training, and “one of the things they struggle to do is to consistently be able to give their staff the kind of skills they require,” Miller said.

There is a clear skills gap in the support workforce: with approximately 20% qualified to level 2 in the education framework, 10% at level 3 and then a jump to entry level for clinical professions at level 5.

One way to help fill this need is to offer higher level apprenticeships or foundation degrees, she said: “That’s not always equally available all around the country, and isn’t always as accessible as people might like it to be.”

Apprenticeships would play “an increasing role” in healthcare, Hancock said.

Listening to employers

NSA Health is an employer-led organisation, and Miller said it was really important for businesses to set out the requirements they have for their workforce.

“Whether that’s entry level, or part of an up-skilling process to take current staff who have demonstrated that they’ve got the right kind of values and expertise to progress and maybe go on to fill some of the more professional roles, it really should be employers who say ‘this is what we want’ and for the rest of the system to work out the best ways of delivering that.

“Part of our role is helping at a practical level to make sure employers can access those programmes of learning and that their own staff have access to the right information, advice and expertise they need to make decisions about what a good quality programme is. ‘Why should I go for an apprenticeship?’ ‘If I wanted to, how would I do it?’ ‘How would I navigate the funding maze for the vocational and education training world?’ Those questions are quite complex even for those who work within it.”

This complexity could explain why a number of employees “don’t get as involved as they could do,” she said.

Pockets of excellence

Practical support should help employers access the right information and advice, as well as opportunities to learn from others’ expertise, how to encourage reluctant learners or negotiate multi-agency arrangements to improve local skills infrastructure, to “build on those pockets of excellence and make them much more consistently available”.

Hancock agreed that it was “very important to take action” and said: “The whole skills system is being reformed to make it more responsive to the needs of employers, and that is a vital part of its job – being nimble-footed and flexible is the name of the game.”

Employer buy-in will be crucial to the new organisation, as members will determine the shape of support and activity by NSA Health. This means that they “won’t have everything available from day one, because we want employers to tell us what they want,” Miller said.

Support will evolve and develop depending on different priorities that arise, and the academy will also work to bring in additional investment to create new resources or take forward new initiatives.

“But what those will be one year from now I don’t know! It’ll only be by listening to our members and by working with them and learning providers, other agencies like the National Apprenticeship Service, to try to bring about the kind of changes that we want to see happen.”

Under the spotlight

The support workforce may have suffered from a lack of attention or understanding in the past, exacerbated by the difficulty in quantifying its members, but this year a number of high-profile reports have sought to change that.

The Francis, Berwick and Cavendish reviews all highlighted the importance of greater compassion in care, with the latter focusing specifically on healthcare assistants.

It launched a debate on the level of scrutiny for HCA training standards, and whether greater regulation is needed for the support workforce.

Discussing the Cavendish review, Miller said: “It sets the wider scene for what we will do.”

Hancock added: “It’s very clear from all of this that the need for care within the healthcare system is vital” and suggested apprenticeships could help to fill this shortfall, to strengthen the culture of compassion in the NHS.

‘A fundamental role’

While the exact nature of any response will depend upon Government, it is expected that the academy will have a significant role in helping to deliver this. 

One recommendation called for a new certificate in fundamental care, which could be one area the NSA Health provides practical support for its members.

Miller said: “Whether that’s in the form of resources, or putting on skills sharing events, running webinars – we’re still in discussion about how we address that.

“It’s not for us to say what that should look like; however we do expect that the NSA will play a fundamental role in that.

“[Government] take forward the design and development of that framework; we would ensure our members have the practical resources to deliver it, that learning providers know quality what it looks like and how it needs to be delivered.”

Gold standard

Miller said the academy “absolutely” agreed on the need for more of a quality consideration for learning and training for the support workforce.

With the Sector Skills Council, NSA Health will administer a new quality mark scheme, to “kite mark” high quality learning programmes.

The launch of the academy was “very timely”, she added, considering the huge reforms which have taken place – and still are taking place – in the healthcare sector with “all the expectations that have rightly been placed on making sure there is better training available to the whole workforce”.

It also dovetails with a push for greater appreciation of the value of apprenticeships and more work-based training.

Standardised quality, not delivery

Miller continued: “Apprenticeships offer a really effective way of making sure that training is of the highest possible quality because they set down a standard framework.

“You don’t have to deliver it in an absolutely standardised fashion but you do have to make sure you meet certain standards and deliver the content that has been developed by employers as the requirements that they have for different roles.

“Really we ought to have nothing but the best in apprenticeships programmes – that’s absolutely what we’re here to do.”

Miller said that while health sector employers do deliver a fair number of apprenticeships, it’s “probably fewer than they should” and there is “patchy” engagement across the country.

This is one area where the NSA Health can provide support to encourage and enable better take-up.

“We’ll be promoting apprenticeships, providing employers with access to resources and skills sharing programmes which will help them to learn from the best and make sure they too can make the best use of the apprenticeship’s framework as a way to recruit the workforce they will need for the future.”

Status of NSA Health

The NSA Health is a wholly owned subsidiary of Skills for Health, with an independent board. It differs from the sector skills board in that it focuses only on support workforce in England, but does cover all healthcare sector employers; the independent and third sector as well as the NHS.

Miller said the academy was building “strong relationships” with organisations like Health Education England (HEE), NHS Employers, and the Skills Funding Agency.