Published: 02/06/2005, Volume II5, No. 5958 Page 4 5

With increasing demands for training and career development, these are crucial times for Skills for Health. Stuart Shepherd asks four board members about the challenges ahead

What is the biggest challenge facing the NHS over the next five years in the arena of skills and education?

AM: To match what is on offer with what individuals want from their career, at a time when the service is faced with major retention and recruitment problems. Managers need to think from the perspective of the employee or potential recruit who asks why they should work for the NHS. Ambitions need to be married to service delivery and too often this can seem a source of conflict. The challenge is achieving this to the benefit of all concerned.

SW: We know from the staff survey of 2003 that 46 per cent of the workforce gets only two days of training or less a year. This represents a substantial inequality when contrasted with the excellent training provision available to NHS professionals. Addressing this will increase confidence and raise expectations throughout the service. I want us to be sure that the opportunities of Agenda for Change become reality.

IT: Achieving volume implementation of NVQs across the NHS and independent sector is a huge challenge. There are tens of thousands of staff in positions that have traditionally required no qualifications and establishing their competences over the next five years will be a real test of time and resources.

Do you think the NHS has improved its attitude to and provision of skills development to all staff in recent years - and if so how?

DH: There has been recognition of the link between education and activity, and interactions with patients have changed as a result. In the past healthcare was something that was done to you, but thankfully that is no longer the case. And the skills base is now more about evidence and transferable competencies. This is a real benefit because it allows people to move seamlessly between care venues.

SW: Yes. The NHS plan gave all staff, including those without qualifications, entitlement to a learning account. The framework for lifelong learning, Working Together, Learning Together, is at the core of this important agenda. Evidence shows staff more readily coming forward to participate. Trusts are also being innovative and thinking how they might grow their own workforce - for example, by turning healthcare assistants into nurses.

IT: In a service that works so closely with people you need to have a workforce with proven competences at all levels of employment and responsibility. This has not been recognised in the past.

It is equally important that this new commitment doesn't detract from the educational obligations we have to our highly skilled staff.

How will you judge the success of Skills for Health?

AM: In terms of the responses garnered from its two major audiences, the service workers and employers. Ideally staff should find the new systems accessible and helpful, offering a clearly identifiable skills ladder along which they can see themselves progressing. The employers will want to see it inspiring their staff and also as a means of creating and retaining the quality and mix of staff they need.

DH: It should be possible to have some kind of measure of improvement in the sphere of recruitment and retention that reflects both quantitative and qualitative outcomes. And the relationship between employers, trainers and those on the receiving end of the training should be more comprehensive, efficient and effective.

SW: As a sector skills council we will need to develop an agreement to provide an over-arching framework for all healthcare training and development. All the good stuff That is happening with staff in trusts needs bringing together to avoid duplication and allow the exchange of ideas across the UK. The skills agreement is a vehicle for the spread of good practice.

What is the most useful piece of training or learning - informal or formal - that you have had in your career?

DH: You can go on management training courses and acquire an understanding of commercial methods. There you will learn about the best practice models for human resources, time and project management. And then you can return to health or education and use that learning to benefit the public interest. I like to call this public enterprise.

IT: What I learned 25 years ago about the theory of quality management. This was way before it arrived here in earnest, and the basic principles are still the same. I was working for a computer group in the UK and they were aware that our main competitors in the US were using the theory. It made good sense to know what they were up to.

AM: I started my working life as a primary school teacher and learned very early that no matter how much you might think you are the one giving instruction, your pupils are not mere passive receptors. You're actually much better off recognising every interaction as a potential learning experience. It took a schoolboy pointing out the obvious to me - that I couldn't walk properly in my heels - for that to really sink in.

What one skill would you like to learn?

IT: I always feel that I could enhance my people-management and motivation skills. These skills allow you to build a good management team and when that gets up and running it works together to overcome its own problems without the need for external intervention. Recruitment and retention is better, service delivery and consistency of work is better and turnover is lower. Everybody wins.

DH: Better communication. I try to find ways of enabling people to adapt their aspirations to the work environment and simultaneously modifying the environment to the people that work in it to better serve their needs. I would very much like to know how to best square that circle.

SW: I have been regularly holidaying in Italy for some time now and constantly feel embarrassed by the vast number of people who take the trouble to speak to me in English. So I started taking lessons in Italian and it would really mean a lot to me to reach some level of fluency so that I can repay a debt of gratitude. .


Chris Hannah took over as chair of Skills for Health in November 2004. She is also the chief executive of Cheshire and Merseyside strategic health authority and is one of four SHA chiefs who lead on workforce issues on behalf of the 28 SHAs in England. Ms Hannah has a long-standing commitment to workforce issues having spent 15 years of her NHS career in human resources management Ms Hannah feels the work of Skills for Health represents a unique challenge 'covering all aspects of the healthcare workforce across the NHS, independent and voluntary sectors on a UK-wide basis'. She adds: 'The work of Skills for Health is vital to improve skills and give UK employers a voice to influence the provision of education and training they require.

'The health sector workforce is rapidly changing and Skills for Health is central to producing an 'infrastructure' including qualification frameworks and career pathways to support a flexible, modern workforce.'


The four Skills for Health board members answering questions were:

Ann Markham Chair, NHS Education Scotland

Deian Hopkin Chief executive, London South Bank University

Ian Turner Vice-chair, Registered Nursing Home Association

Steve Williams Head of Unison Open College