Change is everywhere in the labour market, but sometimes it helps to focus down on one sector to get a sense of the kinds of influences that bring about change. Sara Bosley, Research fellow, Health Sciences Research Institute, University of Warwick has provided the following mini study to illustrate what's been going on in the National Health Service. What do you make of the observations here?

Changing careers in the NHS

Healthcare delivery is changing as a result of government policy which aims to:

• increase patient choice
• expand the number of independent and voluntary sector providers
• promote joined-up health and social care provision; contain costs
• shift funds and delivery from the acute sector to primary care and from treatment to health promotion and illness prevention

Despite current funding shortages in the NHS and media reports about redundancies and unemployment among newly qualified nurses, the demand for healthcare workers is likely to increase over the longer term in response to patient demand, developments in health technology and the needs of an ageing population.

In terms of healthcare careers, the intention of the Career Framework and Agenda for Change is to facilitate progression for staff at all levels within the NHS. In theory some professionals such as nurses and allied health professionals can become consultants, and support workers will be able to attain professional status.

Although it is too early to assess how this will operate in practice, some healthcare professionals have already extended their practice by taking on roles which were traditionally the preserve of doctors. As the healthcare professionals take more responsibility for diagnosis, care planning and treatment, supervising staff and monitoring practice, so more tasks are delegated to an increasing number of healthcare assistants and support workers. Indeed healthcare assistants who support nurses are the fastest growing staff group in the NHS. Such developments are likely to reduce the role of healthcare professionals in delivering direct patient care and blur the distinction between 'professionals' and those who assist them.

Together these changes are impacting on, and have implications for, current and future healthcare workers in respect of

• entry
• job roles and satisfaction
• work activities
• staff practices
• career pathways
• occupational and organisational boundaries
• the range of work environments and value systems available to them

This state of flux presents challenges to information and guidance workers who endeavour to gather and present up-to-date careers information and help clients understand the demands and opportunities of different options in the healthcare sector.

For more on changing skills mix in the NHS see:

• Hewitt, C., Lankshear, A., Maynard, A., Sheldon, T. and Smith, K. (2005) Health Service Workforce and Health Outcomes: a scoping exercise. Report for the National Co-ordinating Centre for the NHS Delivery and Organisation. York: University of York.
• Sergison, M., Sibbald, B. and Rose, S. (1999) Skill mix in primary care - a bibliography. Manchester: National Primary Care Research and Development Centre, University of Manchester.
• Sibbald, B., Shen, J. and McBride, A. (2004) Changing the skill-mix of the health care workforce. Journal of Health Services Research and Policy 9: S1: 28-S1:38.

A guide to Labour Market Information and Intelligence for NHS Workforce planners

Preview Info - LMI-Guide revised[1].pdf - 1.55 Mb

(mirrored - for original see http://www.healthcareworkforce.nhs.uk/index.php?option=com_content&task=view&id=56) ... This guide aims to help workforce planners in the National Health Service understand where labour market information and intelligence can support them in their role.