New Anglia

Health and Social Care

Sector Skills Plan

The Health and Social Care sector is one of the fundamental foundations of our

economy.

It is the largest sector in New Anglia in employment terms and plays an essential role

in tackling poverty, driving employment and thus productivity. The sector covers

services delivered by the NHS and private providers including hospitals, GP

services, residential care homes, day services, homecare and care in the

community.

Economic Growth

A healthy population is more productive, and more economically active and is a key

building block upon which the growth and success of our economy is built.

Expenditure on Health and Social Care in the UK has increased by approximately

120% since 2000 to over £150bn a year, meaning that the sector now accounts for a

significant proportion of GDP (over 10%).

In New Anglia the sector accounts for an estimated 102,700 jobs across Norfolk and

Suffolk, some 13% of total employment, making it the largest sector by employment

in this region. The sector has also been the fastest growing with an additional 12,000

jobs in the region since 2009 (a 12.2% increase). This is more than any other sector,

with almost 30% of new employment since the recession in New Anglia in health and

social care.

Employment in the sector is split between the private sector (58%) and the public

sector (42%) with the majority of employment related to human health, 25% in

residential care activities and 22% in social work activities.

As well as being the most significant sector by employment, Health and Social care

has an estimated Gross Value Added (GVA) of £2.8 billion, making it New Anglia’s

third largest sector by economic output.

The sector is projected to grow steadily (2.4% a year) and employment overall also

continues to rise. A high proportion of this growth relates to the higher skilled

occupations (degree level and above), the proportion of which is expected to rise in

the sector to around 39% by 2020 (higher than the average of all other sectors).

As well as contributing to economic growth directly, health and care services are also

major contributors to the wealth of other sectors (such as construction, IT, finance,

insurance, pharmaceuticals, catering and food suppliers, healthcare equipment and

consumables) as a consumer of services and products. It provides the primary

market for the life sciences industry - one of New Anglia’s identified growth sectors -

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and is a source of exportable innovative ideas and expertise which can provide

business opportunities for Norfolk and Suffolk based businesses.

Increased demand

Growth in Health and Social Care is essential if the sector is to be able to respond to

an ever increasing demand for its services. The population of New Anglia is growing

and ageing at a rate above the UK average. This alongside other factors, such as

the continued rise of obesity, puts pressure on the sector. Across the country an

additional 6.5 million cases of heart disease and stroke, and between 492,000 and

669,000 additional cases of cancer are expected by 2030. The difference between

average life expectancy and healthy life expectancy continues to rise and is currently

15 years for men and 17 years for women.

We also know that demand is increasing and that simply maintaining existing levels

of employment in adult social care will not meet demand. The Centre for Workforce

Intelligence tells us that, nationally, the changes in population will bring a

33%

increase in demand for social care by 2030. We need to look at new ways of

meeting and managing that demand but there will still be a need to increase worker

numbers.

In short, Norfolk and Suffolk have:

•

A higher number of over 65s than the national average

•

A lower number of working age adults than the national average

•

An increasing number of years of ill health and disability before death

National data indicates that across adult social care in Norfolk and Suffolk 42% of

the workforce have no qualifications compared to a national figure for the sector of

32%. The data also indicates that the proportion of qualified staff in Norfolk and

Suffolk for levels 2, 3 and 4 and above is consistently 5 % lower than the national

figure.

This sector experiences high staff turnover, for Norfolk and Suffolk this fluctuates at

about 25%, with a vacancy rate of just over 4%.

It is clear that Norfolk and Suffolk needs an effective Health and Social Care sector

to support the growth of our local economy. It is therefore important to ensure that

there is a supply of the right skills for the sector in the local workforce.

Following extensive consultation across the health and social care sector, public

private and voluntary, the Health and Social Care Sector Skills plan project group

have identified 3 key areas of focus which are regarded as fundamentally important

to both health and social care. These are:

(1) Entrance and retention to the health and social care sector with a

particular focus on adult social care.

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The turnover of some parts of our sector is extremely high. Some home care

providers, for example, report in excess of 50%. However the data also suggests

that, once in the sector, people are more likely to move around to other parts of the

system (other adult social care providers, children’s or health services) than to other

sectors. The negative perception of the industry (low pay, zero hours, low skilled,

limited career progression, media reports which report failing services) is more likely

to be held by those who have never worked in the adult social care or those advising

possible future workers than amongst the workers themselves.

We also know that demand is increasing and that simply maintaining existing levels

of employment in adult social care will not meet demand. The Centre for Workforce

Intelligence tells us that, nationally, the changes in population will bring a

33%

increase in demand for social care by 2030. We need to look at new ways of

meeting and managing that demand but there will still be a need to increase worker

numbers.

There is a ‘public relations’ battle to be won - re-framing the way in which care is

perceived and the enormous opportunities for a lifelong skilled and valued career in

a sector that employs over 71,000 people in Norfolk and Suffolk. There is also work

to be done to reduce the waste in the system that comes from unnecessary turnover,

employing and re-employing the same individuals in different parts of the system.

For example, the Care Certificate (a requirement for all new health and social care

workers) presents an opportunity to standardise induction processes.

Within this priority we also need to consider how the proposed changes to the

apprenticeship system are likely to impact on entry into the sector and ensure the

sector is suitably prepared.

(2) Recruitment and retention of registered nurses in nursing homes

The need for high quality nursing homes and the problems for the health and social

care system when a lack of nursing care results in additional demand on emergency

services, or delays in discharging people from hospitals are well documented.

The importance of nurses to the social care system and the wider healthcare system

has recently been highlighted by the pressures on Accident and Emergency

Departments in hospitals across England. It has been reported that on the 30th

November 2014 there were 5,200 patients in hospital who were ready for discharge

but were not able to because there were not suitable care arrangements in place.

Some of this pressure on the health and social care system has been attributed to a

shortage of nursing staff e.g. in “reablement‟ and “step down‟ services including

residential care with nursing. Representatives of independent social care providers

have recently commented that whilst nurse workforce planning may be taking place

in the NHS it has not been sufficient with respect to the independent sector.

(“Registered Nurses in Adult Social Care”, 2015, Skills for Care)

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There is a consistently high annual turnover of registered nurses in nursing homes (c

40%) with no single identifiable reason why nurses leave. There are also issues of

‘perception’ within the profession. Despite the fact that nurses in nursing homes are

effectively nurse unit leaders, the role does not have high status, is felt to be highly

pressured

(with higher ratios of patients to nurses than elsewhere) and quite

isolated. Career progression is seen as limited.

We have an opportunity to draw on the resources and intelligence supporting the

current range of initiatives encouraging people into and returning to the nursing

profession. We need to enable nurses in nursing homes to access more easily the

range of professional development opportunities open to others to improve career

pathways between health and social care.

(3) Leadership and succession planning for registered managers and owners

of adult social care businesses

Leadership is regarded as pivotal to the quality of care and the working environment

of Care Quality Commission (CQC) registered providers, of which there are almost

1,000 in Norfolk and Suffolk.

Adult social care businesses: need to be agile, commercially minded and able to

respond to changing demands. The care provided must be high quality and safe (as

measured by CQC reports); and the working environment needs to be one in which

people feel well led and supported.

In Norfolk the turnover of Registered Managers is 16% and in Suffolk it is around 7%

so turnover is also a concern.

Our focus on this area is on both ensuring we have a good cadre of aspiring

Registered Managers and that the managers and owners are themselves effectively

supported both on appointment and subsequently.

Ownership and governance

Details of representation on the Health and Social Care Sector Skills plan project

group can be found at Appendix 1.

To ensure clear ownership of the actions included within this sector skills plan an

Executive Board and governance framework has been established and can be found

at Appendix 2.

Supporting data

The sector skills action plan development was based on an analysis of local data

which is summarised in Appendix 3.

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PRIORITY 1

Entry and Retention in the Health and Social Care Sector

A cross-region, multi-media campaign to increase the number of quality individuals

Action 1

recruited by the health and social care system

Description

The nature and size of the New Anglia workforce needs to respond to increasing demands

for health and social care services. By working in partnership across Norfolk and Suffolk

the sector will plan, prepare and deliver coordinated and targeted local promotional

campaigns to ensure there is awareness of the breadth of career opportunities within the

sector, including career pathways between health and social care.

Our intention is to re-frame and enhance the image of the sector and attract a more diverse

local workforce The campaign will include the support and recruitment of I…Care

Ambassadors and Health Ambassadors to work with schools and colleges and those who

provide careers guidance.

Such a coordinated approach will also help to address the recruitment challenges present

when there is a diverse adult social care provider market with 1,000s of independent

providers by presenting the career opportunities as part of a unified pathway.

This action will build on work already being undertaken in the sector including the delivery,

by Suffolk Brokerage and Norfolk and Suffolk Care Support, of the I…Care Ambassador

scheme, the NHS Health Ambassador Scheme and the recently established Care Careers

Suffolk brand. It will also capitalise on opportunities arising from ongoing skills activity such

as the local economy online platforms in both counties and the New Anglia Youth Pledge

This action will contribute to the New Anglia Skills Manifesto by:

Strategic Links

• Linking to the New Anglia work inspiration offer to ensure that all young people

have access to the information they need to make informed decisions about their

future.

• Supporting employers to better communicate their current and future skills needs to

schools, colleges, universities and government.

• Helping to increase the supply of high level apprenticeships

Start Date

May 2016 -

Individual organisations and partnerships already undertake a wide range of work in this

area. This action is about co-ordination of existing initiatives, identifying and meeting gaps.

Expected End Date

Progress review November 2016

Estimated costs and

£45,000 funding already secured from Better Care Fund, Health Education England (East),

resource implications

Norfolk & Suffolk County Councils to provide a Project Officer will significantly contribute to

this priority.

Estimated campaign costs £40,000

It is also expected that financial and resource commitments will be required from a wide

group of stakeholders including Local Authorities, CCGs, health and care providers,

NALEP and Health Education England (East).

Potential funding source:

New EU Calls to Overcome Gender Stereotypes in Education & Workplace

Action grants to support transnational projects to promote good practices on gender roles

and to overcome gender stereotypes in education, training and the workplace

Ownership and

Christine Futter - Norfolk & Suffolk Care Support

Accountability

Louise Whitley - Suffolk Brokerage

Reporting to the Health & Social Care Skills Sector Executive Board

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Milestones

Date

Project Steering Group Established

June 2016

Existing initiatives and new work identified

June 2016

Key Activities

Co-ordinated campaign begins

September

This will include a coordinated approach to use of cross-sector initiatives

2016

such as ICanBeA and the New Anglia Youth Pledge.

Further milestones will be detailed in the campaign plan

Measures of Success

• There is an increased supply of good quality applicants interested in working in the

sector. (evaluation of campaign)

• Vacancy rate across all social care providers has reduced - especially in home

care

• Increase the number of new apprenticeships aged 16 to 24

• Increase the number of higher apprenticeships in the sector.

PRIORITY 1

Entry and Retention in the Health and Social Care Sector

Action 2

A sector-owned and branded ‘recruitment centre’ for adult social care

Description

The ‘recruitment centres’ will be established as a business model. They will source suitable

candidates (apprenticeships and workers), deliver pre-entry training (linked to the Care

Certificate) and explore opportunities for an Apprentice Training Agency for rotational

apprenticeships across health and social care.

They will also work in support of local or place-based initiatives in the recruitment initiatives

This action will help reduce turnover rates which are particularly high in some sectors (such

as home care) by helping ensure that candidates are appropriately prepared and

understand the requirements of the working world they are choosing to enter

Given the geography of Norfolk and Suffolk, initial work will look at piloting a ‘recruitment

centre’ in both counties.

This action will build on work already being undertaken in the sector including the

development of rotational apprenticeships by Health Education England (East) and the

existence of funded apprenticeship co-ordinator by Suffolk County Councils. Both Suffolk

Brokerage and Norfolk and Suffolk Care Support, funded by the Norfolk and Suffolk County

Councils already provide of support on recruitment and retention to the sector including

signposting, advice and recruitment events.

Strategic Links

This action will contribute to the New Anglia Skills Manifesto by:

• Linking to the New Anglia work inspiration offer to ensure that all young people

have access to the information they need to make informed decisions about their

future.

• Helping to increase the supply of high level apprenticeships

Start Date

October 2016 - Business proposal for consideration

Expected End Date

Established by April 2017

Estimated costs and

Start up funding to support detailed business plan approximately £300,000

resource implications

Ownership and

Christine Futter - Norfolk & Suffolk Care Support

Accountability

Louise Whitley - Suffolk Brokerage

Reporting to the Health & Social Care Skills Sector Executive Board

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PRIORITY 2

Recruitment and Retention of Registered Nurses in Nursing Homes

Actions 1

Improving the perception and career opportunities for nurses in nursing homes.

Description

• Supporting and developing nursing homes in order to be able to provide

placements to pre-registration Nurses and other pre-registration health care

students, ensuring that the placements meet the necessary regulatory

requirements and enable the students to meet their learning outcomes during all

years of their programme (across health and social care sector)

• Implementation of practice based learning models using a coaching method to

support pre-registration students in practice

• Developing and supporting the sharing of CPD opportunities within Norfolk and

Suffolk allowing cross organisational and cross sector learning.

• Development and implantation of career framework/pathway ensuring leadership

development is embedded throughout.

• Implementation of a preceptorship package and minimum offer for newly qualified

nurses. This includes CPD opportunities and a preceptor during their first year of

Qualification.

• Advertise, actively recruit and support Return to Practice students.

• Increase the awareness of education and student support within the sector

• Increase the number of qualified mentors and practice educators within the sector.

• Piloting rotational and secondment opportunities across NHS, Private and social

care sectors to support staff with their development.

• Support NMC revalidation of Nursing within the care sector

Health Ambassador Schemes

Directors of Nursing

Health Education England (East)

Suffolk Association of Independent Care Providers (SAICP)

Strategic Links

Norfolk Independent Care (NIC)

This action will contribute to the New Anglia Skills Manifesto by:

• Ensuring there are clear and complete training pathways for each sector that

enable people to get into and progress within their chosen career and develop the

higher level skills needed.

• Aligning collective effort to meet the skills needs of the sector

Start Date

September 2016 - this will need to link with the Norfolk and Suffolk Workforce Partnership

Group work programme.

Expected End Date

August 2019

Estimated costs and

Appointment of a clinical Educator to support pre-registration placements and

resource implications

implementation of practice based learning model including the role of peripatetic mentor

£495,000 over a 3 year period (3 eqv band 6 afc)

CPD funding to support preparation for mentorship and practice education development

costs would need to be ascertained after TNA has been completed.

Ownership and

Laura Mallett - Health Education England (East)

Accountability

Reporting to the Health & Social Care Skills Sector Executive Board

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Milestones

Date

Project Plan produced

Sept 2016

Training needs analysis of mentorship completed

Dec 2017

Funding secured

March 2017

Key Activities

Clinical educators appointed

May 2017

Development of new placement areas

June 2017

Further activities will be detailed in the project plan

Measures of Success

• Reduction in loss of nurses from the nursing home care sector

• Increased number of applications for advertised posts

• Decreased vacancy rate

• Uptake and evaluation of preceptorship

• Post impact evaluation of CPD

• Increased available CPD portfolio

• Student feedback from HEI

• Mentor feedback

• Increased number of pre-registration placements

PRIORITY 2

Recruitment and Retention of Registered Nurses in Nursing Homes

Action 2

To develop and implement programmes that enables nursing homes to “grow their own”

nurses and other health care professionals to deliver holistic care to service users.

Description

Research suggests that the shortage of registered nurses in nursing homes and the level of

‘churn’ (c40%) is not attributable to any one specific cause. Due to the national and global

shortage in nursing the contribution of other healthcare professionals and generic workers

needs to be explored further.

The actions proposed in this work strand will link with the range of existing initiatives and

work streams, supported by Health Education England and our local Higher Education

Institutions.

•

“Grow your own” schemes to help care assistants progress to a career as a health

care professional e.g. through developing a higher level apprenticeship

• Active exploration of other healthcare roles that can support the existing nurse

resources e.g generic workers and Allied Health Professionals

• Engage with and pilot the nursing associate role following the publication of the

consultation.

This action will build on work already being undertaken in the sector (eg Flexible Nursing

Schemes, Talent for Care, Assistant Health Practitioners and Clinical Apprenticeships).

Skills for Health

Skills for Care

Higher and Further Education Providers

Health Education England

Strategic Links

NMC and HCPC

This action will contribute to the New Anglia Skills Manifesto by:

• Helping to ensure there are clear and complete training pathways for each sector

that enable people to progress

• Helping to increase the supply of high level apprenticeships

April 2016 V6

Start Date

September 2016- linking with the Norfolk and Suffolk Workforce Partnership Group work

programme.

Expected End Date

August 2019

Estimated costs and

Additional funding quantified by Higher Education establishments will be required to

resource implications

develop new courses that are structured appropriately to ensure accessibility for health

social care trainees. It is currently unclear how much is required and no further information

will be available until the completion and publication of the consultation for the

comprehensive spending review.

Employer contributions to support students whilst learning on a ‘grow your own approach’

in the form of salary support, back fill costs and education training costs.

Apprenticeship Grants for Employers (AGE) accessed

We will look to investigate the potential of using Employer Training Incentive Pilot funding

for level 3 apprenticeships as well as the possibility of New Anglia Skills Deals Programme

co-funding.

Ownership and

Laura Mallett - Health Education England (East)

Accountability

Reporting to the Health & Social Care Skills Sector Executive Board

Milestones

Date

Project Plan produced including securing of start-up funding

January 2017

Training needs analysis to enable the development of a workforce

March 2017

transformation plan

Key Activities

Full funding secured

May 2017

Development and validation of educational pathways to meet the needs

September

of the workforce

2017

Further activities will be included in the project plan

Measures of Success

• Enhanced patient outcomes e.g. reduction in avoidable admissions, incidence

of pressure ulcers and improved satisfaction surveys & CQC ratings

• Increased capacity of nursing beds across Norfolk & Suffolk

• Reduction in waiting times for admission to nursing home care

• HEI feedback

• Student feedback

• Mentor feedback

• Good return on investment i.e. good completion rates, low attrition, low staff

turn over

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PRIORITY 3

Leadership and succession planning for registered managers and owners

• Develop a “Registered Managers’ Academy” for aspiring and Registered Managers

Action 1

and Adult Social Care Private Voluntary and Independent Sector Owners

Description

The purpose of an ‘Academy’ a virtual concept rather than a physical building is that it will

be a place where:

Aspiring and existing managers and owners can access:

• management/leadership qualifications and on-going continuing professional

development;

• on-going in-setting support to enable the embedding of leadership behaviours that

deliver cultural change;

• peer to peer support through networks and other fora

This priority directly links to the preceding two priorities since registered managers and

owners set the culture that enables excellent practice or otherwise. We need to develop

the quality of leadership and management in the adult social care provider system and

ensure that aspiring managers are adequately supported to take on these roles.

Suffolk Brokerage, Norfolk and Suffolk Care Support and Norfolk Independent Care are

commissioned through Suffolk and Norfolk County Councils and Skills for Care to provide a

range of support for Registered Managers including networks, master classes, action

learning and coaching activity.

Strategic Links

Skills for Care provides Registered Managers programmes and a wide range of online

resources to support both owners and social care managers in their roles.

This action will contribute to the New Anglia Skills Manifesto by:

• supporting the development of emerging leaders and innovators

Start Date

October 2016 business proposal developed, with a funding plan

Expected End Date

Academy established by April 2017

Estimated costs and

Management and administration £70,000

resource implications

Initial Training and resources costs £150,000

£220,000

Ownership and

Emma John - Suffolk Association of Independent Care providers

Accountability

Nigel Carlton - Norfolk Independent Care

Reporting to the Health & Social Care Skills Sector Executive Board

Milestones

Date

Project Steering Group Established

June 2016

Business proposal prepared with funding plan

October 2016

Key Activities

Academy launched

April 2017

Further detail and milestones will emerge from the Project Plan

Measures of Success

• CQC inspection ratings improve (especially against the domain ‘well led’)

• Staff turnover reduces

• A range of high quality applicants for Registered Manager positions.

April 2016 V6