The training of more junior staff has been neglected in the past. But an initiative that provides match-funding for investment in their skills is a big boost for those in bands 1-4, reports Stuart Shepherd

Anyone interested in improving workers’ skills – and in healthcare that rules more people in than out – will be curious to know how plans to boost the skills of the UK workforce set out in the 2006 Leitch review will work in practice.

There is no need to wait to find out. Norfolk and Waveney Mental Health Partnership trust is just one of several organisations in NHS East of England region already benefiting from a new skills initiative called the joint investment framework.

This enables health organisations to get extra government funds to deliver programmes that provide staff with accredited and transferable qualifications.

The framework is effective for three years from September 2007. It promises up to£50m from the Learning and Skills Council – the national training funding body for England – to match equal investment by the health sector. Agreed by the strategic health authorities, Skills for Health and the LSC, the framework will support skills development and qualifications at levels 2, 3 and 4 in staff bands 1-4.

Investment in training for bands 1-3 has been scarce in the East of England, the English region with the largest deficit. But over the next three years the joint investment programme will bring in£22.2m for training in bands 1-4. A regional sector skills agreement launched in November 2007 has already set out skills gaps in the local health sector and how to tackle them, giving further direction to the programme.

The NHS East of England is helped by local “brokers” from the LSC’s Train to Gain service who help to identify and plug skills gaps. Funding for certain types of training is also available through the service. NHS East Of England pre-professional workforce lead Jane Winter says: “The strength of what we and the trusts have already been able to do in a short space of time comes from our close working relationships with Train to Gain skills brokers, and the lack of bureaucratic barriers. Now we meet up with managers, discuss the training issues, come up with solutions and allocate the funding resources to get things done as we talk.”

In Norfolk and Waveney’s case this approach has helped the trust to bring together two
pre-professional health courses – the national vocational qualification and the vocational related qualification – so they can be studied in combination. The VRQ, which is more academic, does not attract funding through Train to Gain. Delivered in the workplace, it is well regarded for those wishing to move up into professional nursing, social work or therapy training.

Ms Winter said NHS East of England and Norfolk and Waveney agreed it was “nonsense” that staff had to do two separate qualifications to progress their career, “so we combined them.” “Train to Gain pays for the NVQ and the [framework] pays for the VRQ. For an extra£200, learners are made much more fit for purpose, getting all the practical aspects of the NVQ and a reflective understanding of mental health conditions from the VRQ.”

Managers are being encouraged to identify workforce skills gaps and then to work creatively with strategic and Train to Gain colleagues.

“They just have to think through what the issues are and what might need to happen to solve them,” says Ms Winter. “Then the brokers, who know the elements of the training programmes and qualifications inside out, can help them pick the most suitable combinations and get what they want. So many opportunities, with no conditions – it’s making a lot of people step back and take a good look.”

Framework funding is open to all health employers who sign up to the government’s Skills Pledge – a promise to improve the skills of all workers to a level equivalent to five GCSEs. For instance, the manager of a nursing home or respite centre could use the funds to develop a workforce that is more responsive to diverse care pathways and business opportunities.

“The joint investment framework is now rolling out across the regions,” says John Rogers, chief executive of Skills for Health, the national healthcare skills council and one of the bodies behind the framework. “In the North West more than 6,700 additional training places have been agreed as a result of the funding received.

“In close consultation with healthcare sector employers, Skills for Health has also created a range of tools to assist [them] in measuring what skills they have and identifying those they need,” he says. “They include a UK-wide framework of competencies and competence application tools to help employers identify what competencies teams have and what they may be lacking.”
The UK healthcare workforce is large and complex, a place where the most academically qualified rub shoulders with people who have had little or no chance to acquire qualifications or training. Skills development can have an impact on them all.

“The only way we are really going to be able to meet the demand for what you might call high-level skills is by making best use of all our other staff,” says Skills for Health UK strategy and networks director Brian Payne. “You cannot look at any one group in isolation.

“The philosophy and direction that Skills for Health espoused, and to which Leitch gave a clearer recognition and added impetus, starts with what the patient needs. We now have a greater opportunity to design flexible services and roles around the needs of that individual.”

In April the NHS National Workforce Projects, which supports workforce development, will merge with Skills for Health, simplifying arrangements and making it easier for health organisations to access help with skills.

Such steps are broadly welcomed, although some experts warn against getting over-excited about Leitch. “Leitch is not a revolutionary review in any way,” says Chris Barrett, academic adviser at the NHS Workforce Review Team. “It links with much of what has come before and puts the emphasis on continuity, improving what we already have.”

Nonetheless, she says, the policy in the Leitch implementation paper (see below) is “very good”, and that the workforce review team agrees fully with the Leitch aims. “What we might have concerns about though is how, with the development of foundation trusts and the fragmentation of the healthcare workforce, we might work across employer boundaries.”

Dr Barrett adds: “There do also seem to be certain areas of the specialist workforce, such as screening and genetics, where there are no specific incentives for employers to invest.”

What Leitch said
Prosperity for all in the Global Economy: world class skills, published in December 2006, known widely as the Leitch report, was a government commissioned review of the UK’s long-term skills needs.

The report made clear that while the UK economy is strong and educational standards are rising, the
country cannot afford to stand still in a climate of rapid change. Leitch recommended that the UK should become a world leader in skills by 2020. To do this it would need to equip 95 per cent of
working-age adults with basic skills and 90 per cent with level 2 (GCSE equivalent) qualifications, provide more than 500,000 apprenticeships a year, more level 3 (A-level equivalent) skills and 40 per cent of adults skilled to graduate level or above.

The responsibility for delivering these radical ambitions should, said Leitch, be shared by employers, individuals and the government with a strong focus on demandled economically valuable and transferable skills. Efficiency improvements should be achieved through structural and institutional simplification with sector skills councils playing a key role. The report estimated the potential net benefit of boosting skills in this way to be at least£80bn over 30 years.

The Government's repsonse
In July 2007 the new Department for Innovation, Universities and Skills published its first significant paper, World Class Skills: implementing the Leitch review. The document set out plans to start the “skills revolution” in England and meet the targets outlined in Leitch.

Public funding for demand-led adult training is to be substantially increased with the Learning and Skills Council funding for its Train to Gain service, which advises on and provides funding for employee training, rising to more than£650m in 2008-09. A new UK Commission for Employment and Skills will strengthen employer voice in skills programmes, advise the government on strategy and oversee the sector skills councils, responsible for training for each industrial sector.

The councils will have a sharper focus, highlighting future needs and encouraging employers to develop workers’ skills and qualifications. Employers are encouraged to make a Skills Pledge – to support employees, guiding them to level 2 qualifications. In return, they will get Train to Gain support.