Action plans for each UK country are building up the formal recognition for people seeking to enhance their work prospects, and this includes the rebirth of apprenticeships

The qualifications available to the health sector are under review. The process is prompted both by a wider government-led programme of reform, and changes in the sector as a result of new policies, priorities and roles. At its heart is the desire to ensure qualifications meet the needs of UK health employers for a skilled and flexible workforce.

The Sector Qualifications Strategy, a national document completed in 2007 following lengthy consultation with partners and stakeholders, sets out the approach to developing and improving qualifications to meet those changing needs. These are described in annual action plans for each UK country, written by Skills for Health on the basis of what the sector tells it and taking account of local differences.

Deriving from the direction set by the sector skills agreements and the Skills for Health strategic plan, the strategy focuses on qualifications for staff in NHS bands 1-4 or equivalent.

"This is about how people gain entry into the sector and then progress, sideways or upwards, through it," says Vicky Yearsley, programme manager, qualifications development. "The part we as a sector skills council play is setting out priorities on behalf of the sector, so that health employers are able to influence what the qualification and education providers offer."

Ms Yearsley says: "There are a huge number of qualifications aimed specifically at this level of the workforce. Many qualifications cover the same ground and it makes it very hard for people to distinguish one from another and decide which is best. So as part of the strategy action plans we have been working with the awarding bodies to facilitate the development of common units, as a means of improving transferability and transportability of qualifications."

It is not Skills for Health's intention to get rid of much-valued existing qualifications. Rather, it seeks to make sure that those available are fit for purpose. Staff should be able to build up a portfolio of units towards a qualification that supports employability and is recognised by higher education so that they can progress if they want into higher level roles or go into higher education.

The strategy supports a number of different established and new developments in training and education.

Apprenticeship opportunities

Skills for Health is responsible for the management and development of four apprenticeship frameworks - healthcare support, dental nursing, pharmacy support and health and social care.

As well as doing an NVQ - at level 2 or 3 - in their chosen sphere, apprentices also take technical certificates, which underpin the NVQ, and key skills in the application of numbers and communication.

Known as modern apprenticeships in Scotland, traineeships in Northern Ireland and apprenticeships across England and Wales, as a training option they have traditionally been available to 16 to 24-year-olds. Adult apprenticeships are becoming increasingly available in England, however, while the programme in Wales is open to all ages.

"There are a number of potential benefits to healthcare organisations that can offer apprenticeships," says Dawn Probert, programme manager, (qualifications provision). "Adult apprenticeships are a good means of providing training and support for existing members of the workforce and offer them a progression route into higher education. Many apprentices move to nursing or health professional roles."

"Bringing in apprentices in the 16-24 age range could help many trusts currently facing the challenges that come from having an ageing workforce," says Ms Probert. "It is also good for succession planning. Statistics show that retention levels are better with people who have done apprenticeships."

There are several flexible models already being successfully delivered in the UK. While apprentices drawn from the workforce tend to be placed on individually tailored programmes, younger apprentices often undertake training at a local college, as one of a cohort of 15 or 20, with placements in the health sector.

"A Level 3 apprenticeship - the advanced apprenticeship in England - lasts two years. Once achieved it can be a route into a number of specialised healthcare roles, such as assistant in physiotherapy, clinical imaging or radiotherapy," says Ms Probert. "It can also be a route to a range of diploma courses and foundation degrees."

Diploma entitlement

Teaching for the diploma in society, health and development starts in September at 39 teaching consortia across England, with numbers of centres to rise to 110 in 2009. It is one of 17 different diplomas to be offered by 2013, at which time it will be a national entitlement.

The diploma is targeted at 14 to 19-year-olds and is available at foundation, higher and advanced levels, the higher level equating broadly to GCSE qualifications.

Three core elements exist in any diploma - generic learning, which includes functional or key skills of language, literacy and numeracy, personal learning, and thinking skills such as communications, team work and reflective learning and a project; principal learning, which is sector related; and specialist learning, a choice for learners to further specialise or choose another qualification that supports their progression into the sector.

"When we consulted with employers about what they wanted in the diploma," says Sharon Ensor, programme manager (14-19), "their primary focus was almost always employability skills, the features that will bring people with maturity into the health sector."

Ms Ensor says the diploma offers a route for young people to make an informed choice about coming into health and equips them with the skills and learning in context to be able to work effectively once they arrive. "An 18-year-old with an advanced diploma would, if they wanted, be a good candidate for an advanced apprenticeship and in the long term this will have a positive impact on retention. The three core elements also mean that young people doing other courses would not be ruled out from joining the sector as well," she says.

The diploma covers four sectors - health, social care, children and young people's workforce, and community justice. National occupational standards in those four areas were used as one of the resources for the core principle learning.

At diploma level 3, principle learning also has a UCAS higher education entry tariff. A young person choosing to do the diploma with chemistry A-level as an element of it, for example, would be well prepared for a higher education dietician programme.

Higher education

The Sector Qualifications Strategy and the Higher Education Strategy were developed as distinct approaches to tiers of education meeting different levels of workforce need.

Steps are now being taken to merge the two strategies to ensure a seamless approach to educational pathways including progression into professional awards.

Skills for Health has been looking at ways of improving the interface between employers, further and higher education through its work at a number of funded demonstration sites.

"These pilot projects study how we can most effectively bring key stakeholders in higher education and employment together into partnership to use competences in the construction of award pathways at higher education level," says Paul Blakeman, divisional manager (qualifications).

"We facilitate the partners' use of our awards/qualifications process document in order that employers can express workforce needs through roles and underpinning competences," Dr Blakeman explains. "As a result, higher education can better understand the need and match it to the educational requirement.

"The awards/qualifications process document itself sets out a strategic vision based around learning design principles. Degree courses are set around a three-year programme but these principles break learning down into smaller units that make it easier to feed learners along educational pathways and mean it is much harder to lose them to the system."

Skills for life

Another strategic objective is to improve participation in learning and employability through better language, literacy, numeracy, and information and communication technology skill levels. These skills are fundamental in ensuring the healthcare workforce is competent, flexible and able to deliver safe and effective healthcare.

Skills for Health works closely with a number of key stakeholders and external agencies, including the Department for Innovation, Universities and Skills and the National Institute of Adult Continuing Education and health departments across the UK on encouraging organisations to engage with these aims.

The sector skills council is developing resources, including tools to assess skills and identify language, literacy and numeracy requirements, the adoption of a whole organisational approach to skills for life and building capacity through continuing professional development.