Published: 22/07/2004, Volume II4, No. 5915 Page 21 22 23

The world of workforce education and skills development can seem a complex and even arcane place - with its language too often removing it from any practical reality that people recognise and understand.

However, the licensing last month of Skills for Health, the sector skills council for the UK health sector, marks the beginning of a new era in the way workforce education and training is planned and delivered.

For the past two years most of its work has been sponsored through the UK's four health departments. Now with its SSC licence signed, it can greatly expand the scope and effect of its work.

Chief executive John Rogers explains: 'SSCs can seem quite technical, but at the heart of our work we are simply looking to ensure we have a skilled workforce to meet future sector demand.We all know that this means working differently - and a great deal of progress has already been made.

'Skills for Health will work in partnership across the sector to provide a common skills framework to underpin a more flexible and skilled workforce.'

He adds: 'What is different is that we start from what services we need to deliver. That leads us on to questions about what the workforce needs to look like, what individual skills are required, how we measure that competence and what the existing knowledge base is.'

At its core will be the creation and maintenance of a national workforce competence framework - a model of the different skills at different levels that go to proving competence in a particular area. This can then be used to measure individual and group skills, as well as different types of development programmes.

The world of training and education organisations is complex, but at a local level it is based around regional skills partnerships. These are made up of the regional development agency, major sector skills councils in the area, learning and skills councils and Jobcentre Plus.

Other SSCs will have a greater or lesser effect on health. For example, Skills for Care, covering personal and social services, is in the process of being set up (there is already close partnership between the two bodies) and the e-skills SSC, which covers IT training, will also have a presence.

Mr Rogers says: 'It is natural to feel you are the only one to have certain problems. But, in fact sectors tend to have the same problems - and joint working can be very productive.'

As far as Skills for Health is concerned, one of the main expressions of its strategy will be through a national sector skills agreement. This is expected to be finalised next year and will set out the overall priorities for skills development and how Skills for Health plans to work with other organisations to fulfil them.Although the system works slightly differently in each of the four UK countries, the principle will be the same.

However, the organisation does not have to wait for the sector skills agreement to be signed to start work.

Hundreds of competences have already been created in a series of care groups; Mr Rogers estimates about half the total so far.Most of the 'core group' has been completed.

Conveniently, because each of the unit competences is a building block, much of the substance for new areas can be transferred from existing ones.

The work programme includes topics as diverse as emergency care access, coronary heart disease, cancer services, pharmacy and complementary medicine.

For the most part they are based on clinical care but competences involving support functions exist and elements from them can be transferred into specific care-related competences.

For instance, a drugs and alcohol support worker's competence framework might contain units from more generic administrative and management competences.

Mr Rogers comments: 'Part of the trick is to make the frameworks accessible to different types of people with different needs, rather than work being delivered in a great pile of paper that no-one knows what to do with.'

Skills for Health is developing an online tool to guide users to the units of a framework most relevant to them.

In the case of the drugs and alcohol competence, for example, a specialised support worker might work closely with the whole framework, an interested GP might look at particular levels and a teacher might consider one or two units.

Different types of organisations will interact with Skills for Health frameworks in different ways. For instance, strategic health authorities are likely to use the frameworks to define the specification for the education/training courses they purchase. This gives greater clarity of commissioning and ensures transferability.

For their part, education providers such as universities and colleges will be encouraged to mould the curriculum of new and existing courses to the frameworks. Awarding bodies and royal colleges could also take account of them when designing qualifications and assessing standards.

Alternatively, a directorate manager in an acute hospital might use the broad headings of a competence framework when looking at workforce needs and skill-mix during a service redesign project.

And, finally, an individual employee might use units in a framework as part of their personal development plan.

Mr Rogers says: 'There is nothing inherently mandatory about the competence frameworks.However, there is a general consensus that multiple frameworks and 'reinventing the wheel' across the UK is not good for the sector as a whole.

'Skills for Health has the backing of the four UK health departments and the major sector stakeholders to bring cohesion to this area, with the ultimate benefits of a flexible UK-wide workforce with recognised, transferable skills and competences.'

The frameworks have been used across a wide range of qualifications - public health specialists, assistant practitioners (breast screening services), short modular CHD programmes (Sunderland University) and operating department practitioners to name but a few.

Another common use has been as the basis for NVQs.

Mr Rogers admits NVQs have a 'variable' image. Some organisations have embraced them and some have not. Skills for Health is just completing a major overhaul of the current NVQs (in partnership with social care workforce development body Topss).

The revamped awards have been designed to meet the sector's needs, with smaller units and a more flexible structure.

Similarly, modern apprenticeships have had a mixed reception in the health sector. 'It is something we will be looking at - what employers need and also how they might be delivered, ' says Mr Rogers.

Higher education - and foundation course development, degrees and continuing professional development - is complex. 'But again the competence frameworks can provide the 'common language', so that it does not matter what the title of the qualification is if the competence units that it is made up of are recognised and transferable, ' explains Mr Rogers.

Foundation degrees are becoming more important and better funded as part of the government's drive to get 50 per cent of young people into higher education. Influencing the design of new and existing degrees will be a key part of Skills for Health's role.

Another area where it will be delivering value to the health sector will be in labour market intelligence. It is unique in compiling health information across the whole of the UK and has already published a sector workforce market analysis, which local organisations will find useful.

Its reach across the NHS, independent and voluntary sectors is also crucial.Mr Rogers says: 'There have always been two-way streets between the different parts of the health sector, but future models of care seem likely to make skill transferability more important.'

Skills for Health: facts and figures

As an organisation Skills for Health is hosted by United Bristol Healthcare trust but is run independently and with its own board.Former North West London strategic health authority chief executive Professor Sir Ron De Witt is chair and John Rogers is chief executive.

Its board includes representatives from the four UK health departments, NHS, independent and voluntary sectors, and staff-side and professional bodies.

In numbers

The health sector is the second-largest purchaser of higher education in the UK - England alone accounts for nearly£3bn a year.

Skills for Health employs about 30 people although it plans to expand this to 75 in the next 12 months.

It has a board of 23 people.

It has an annual budget of£6m.

It is supported by all four UK health departments.

It has created almost 700 competence units.

What is Skills for Health?

It is the new sector skills council for health. It was granted an official licence from the government on 1 June, although it has been running for about two years. Its key role is to be the focus for the development of skills across the NHS, the independent sector and voluntary organisations providing healthcare.

Where do sector skills councils come from?

The plan to reorganise education and training in the UK was originally announced in November 2001, and a white paper on the subject was published by the Department for Education and Skills last summer.

What does Skills for Health do?

It provides a whole health sector voice to identify sector skills needs and influence provision. It does not provide training directly to individuals or organisations, or publish training materials. In this respect it is a partner to a range of education and training providers rather than a competitor.

What geographical areas does it cover?

Skills for Health covers the four UK countries, and has separate agreements with each health department. Its structure will be based on eight regions, working closely with regional development agencies and learning and skills councils.

So what is a learning and skills council?

These 55 regional organisations determine how funding for post-16 education and training is allocated, amounting to£9bn a year.They replaced the training and enterprise councils.

And the Skills for Business Network?

This is a network made up of the 23 SSCs, ensuring a profile for skills development across the UK economy.

And the Sector Skills Development Agency?

The SSDA is an agency of the DfES. It regulates and supports sector skills councils.

What came before?

SSCs replace the old national training organisations, which tended to be small limited companies.There will be fewer SSCs with a wider and more strategic brief, and a greater emphasis on being representative and employer-led.

Independent sector view: Sally Taber, responsible for policy at the Independent Healthcare Forum and Skills for Health board member

'There has always been a strong sense of seeing skills development across both the NHS and independent sectors, so it is good that is still the case.

'There are not real differences between the two although there has been an increasing recognition in the independent sector over the past few years of the value of education and training at all levels.

'I definitely want to see awareness of the council rise - communication is the key. I would give the example of the substance misuse competence framework: I was thrilled to hear a minister talk about it.That shows it is having an impact and I would want to see that in future competences.The danger is that the good work will sit on a shelf and not be used.'

'Voluntary sector view: Janet Fleming, Voluntary Sector National Training Organisation head and Skills for Health board member

'The great thing about Skills for Health is that it is a strategic body for skills development and learning across the whole sector.

'I would estimate that, of the voluntary sector's 263,000 paid employees, more than half will come under either Skills for Health or Skills for Care, so it will affect a lot of people.There are 24,000 people alone who work in a hospital setting.

'Transferability is important to the voluntary sector but problematic as well.People tend to move away from us rather more than towards us, but we do hope better skills development will make the sector more attractive.

'I would judge the success of Skills for Health by its ability to make professional standards more nationally available and uniform.At the moment it can be very variable. In one London area, for instance, a strategic health authority makes its courses available to voluntary organisations, but many other SHAs do not.So access can be very patchy.

'I would also like to see colleges providing training in a form that better suits voluntary organisations.They are less likely than, say, the NHS or independent providers to want rigid courses calling for perhaps a day a month off work for two years; people want to progress at their own speed.

'We are developing occupational standards for managing volunteers in health and public health, and that is something we would like to see promoted.'

www. voluntarysectorskills. org. uk

'The launch of the coronary heart disease competence framework (which has been successfully piloted across the NHS and local communities) heralds an exciting time for all those involved in three key areas: prevention, rehabilitation and heart failure.

'It is only by working together that we can promise our patients the very best advice, treatment and care.Already, the response to the framework has been positive.Skills for Health appointed a CHD champion to work with local services to help them best use the framework and one-day workshops have been organised.'

Roger Boyle, national clinical director for heart disease

'Change is a constant feature of the healthcare landscape and it is critically linked to the continuous improvement in the delivery of care.This requires flexible frameworks to help staff improve continually and modify their skills to meet the challenges that the sector faces.

'Skills for Health will influence and capitalise on a range of UKwide health and educational initiatives in order to ensure a 'joined-up thinking'approach to improving the delivery of skills within the healthcare sector.As a sector skills council, we are focused on the requirements of employers, but we realise we can only do this effectively by involving the professions, staff, patients and regulators.'

Professor Sir Ron de Witt, Skills for Health chair