Source: Constructed from data presented in Skills for Health 2005 (figure 2.3).  Based on 2004 Labour Force Survey.

For a list of the range of jobs available in the health sector see:

Over the past decade, the strongest employment growth has been in:

• personal services occupations (nursing assistants, ambulance staff excluding paramedics, dental nurses, residential wardens and care assistants)
• managers and senior officials (in hospitals, health care practices, social services and residential and day care centres)
• professional occupations (such as medical practitioners, pharmacists/pharmacologists, opticians, dental practitioners and veterinarians)

Employment has declined among administrative and secretarial, plus elementary occupations, such as hospital porters. 

There has also been slow growth in employment among associate professional and technical staff, which includes: nurses; midwives; paramedics; radiographers; chiropodists; dispensing opticians; pharmaceutical dispensers; medical and dental technicians; physiotherapists; occupational therapists; youth and community workers; and housing and welfare officers.

Source: Skills in England 2004 (Volume 3)

For more data on occupational trends and future composition of the health care sector workforce see:

Managers and senior officials as well as professional occupations (including doctors) are forecast to grow faster by 2014 than associate professional and technical occupations, and the personal services occupations. 

Total requirement is in excess of 60% of current employment levels for managers and senior officials, plus professional occupations.  These occupational groups are forecast to grow strongly over the next decade in both levels and shares of total employment in the sector.

To replace staff leaving the sector due to retirement and other reasons, recruitment will be approximately 45% of current staffing levels for associate professional and technical staff, and 66% for managers and senior managers.

A significant occupational shift is expected over the next 10-15 years to achieve a more flexible workforce.  For example:

• more tasks will be delegated from doctors to nurses, then nurses to health care assistants
• continuing changes in the overall career structure have been needed to accommodate newly created job roles and to facilitate career development.
• the introduction of two new levels: associate health professionals (extended roles for health care assistants) and advanced practitioners (extended roles mainly for degree level trained non-medical staff)
• decline in demand for nurses and degree level trained non-medical staff
• increase demand for associate health care professionals
• more public health specialists will be needed to deliver the public health agenda 

Source: Working Futures 2006, Skills for Health 2006 and Skills for Health 2005

For more data on total workforce requirements by occupation see:

Over the next 5 to 10 years, employers and other stakeholders believe that future skills requirements are likely to be driven by a growth in demand for vocational qualifications, specifically in those qualifications that will provide the health sector workforce with the capacity to fulfil new roles and competency requirements. 

The traditional roles of nurses and health care assistants are also expected to change in response to the pressures for improved health service delivery.  These pressures are likely to increase the demand for generic and basic skills as well as specialist skills.

Source: Skills for Health 2006

Following local pilots and accelerated development programmes a range of new roles have been developed to:

• match changes in health care delivery
• increase productivity and efficiency
• increase workforce flexibility
• alleviate current and future workforce shortages

These new roles include jobs requiring a broader range of skills (e.g. health care practitioners, bringing together knowledge from nursing, professions allied to medicine and medicine) and those demanding more specialised skills (e.g. nurse specialists, GPs with special interests).

There are two new career levels within a newly established 9 level career framework:

• associate practitioners (level 4) – will need to have a foundation degree, BTEC or HND, and will take on tasks previously only provided by state registered professionals
• assistant practitioners (level 7) – will need a high level of skills, knowledge and experience, and will be given more responsibility in terms of decision making and caseload

Although current numbers are still relatively low, new roles are expected to grow, underpinned by newly developed accredited courses.

Source: NHS website 2006

For more information new roles and job specifications at Trust level go to the NHS Modernisation Agency website.

For a list of sources and research on the impact of these new roles and sources of occupational information see:

• In 2004, the average annual basic salary for all staff directly employed in the NHS was £22,300 and average total earnings (including allowances, overtime etc.) were £26,300.
• The average annual basic salary for all qualified nurses was £22,700 with average total earnings of £26,400.
• The lowest paid staff group surveyed were Ancillary staff with an average salary of £10,900. 
• Of all NHS staff sampled 30,200 (6.5%) have an full-time annualised salary of less than £10,900.
• The highest paid staff group are consultants with an average annual basic salary of £74,500.

Source: Health and Social Care Information Centre 2005

For more data on average earnings in England for all NHS staff and by staff group go to the NHS Earnings Survey.

Major occupational groups

The enumeration lists single occupational groups relevant to the health care sector:

• Associate professional occupations include nurses, paramedics, medical radiographers and therapists (physiotherapists, occupational therapists and speech and language therapists)
• Personal services occupations include nursing auxiliaries and assistants, ambulance staff (excluding paramedics), dental nurses, house-parents, care assistants and home carers
• Professional occupations include medical practitioners, psychologists, pharmacists/pharmacologists, ophthalmic opticians, dental practitioners and veterinarians

Sub-major occupational groups

The enumeration lists single occupational groups relevant to the health care sector: 

• Health professionals include medical practitioners, psychologists, pharmacists/pharmacologists, ophthalmic opticians, dental practitioners and veterinarians
• Healthcare and related personal services include nursing auxiliaries and assistants, ambulance staff (excluding paramedics), dental nurses, care assistants and home carers
• Health and social welfare associate professionals include nurses, paramedics, medical radiographers and therapists (physiotherapists, occupational therapists and speech and language therapists)