HEALTH & SOCIAL CARE IN
GREATER MANCHESTER
NOVEMBER 2013
1
1
INTRODUCTION
The Health and Social Care sector employs 152,000 people in Greater Manchester (GM)
and generated £4.1bn of economic output for GM in 2011.
Within GM there is a high concentration of critical health and social care assets including
Manchester Science Park, The Christie Hospital, and UK Biobank. In addition, the
MediPark project, currently under development, looks to add to GM’s already substantial
life sciences presence.1
For the purpose of this report, Health & Social Care include the following sub-sectors:
 Hospital activities (SIC code 86)
 General medical practice activities (SIC code 86)
 Specialist medical practice activities (SIC code 86)
 Dental practice activities (SIC code 86)
 Other human health activities (SIC code 86)
 Residential nursing care activities (SIC code 87)
 Residential care activities for learning disabilities, mental health and substance abuse





1
(SIC code 87)
Residential care activities for the elderly and disabled (SIC code 87)
Other residential care activities (SIC code 87)
Social work activities without accommodation for the elderly and disabled (SIC 88)
Child day-care activities (SIC code 88)
Other social work activities without accommodation not elsewhere classified
(SIC code 88)
Industrial Strategy, BIS 2012
2
2
DEMAND FOR SKILLS FROM HEALTH & SOCIAL CARE
Business Base
The Inter-Departmental Business Register (2012) reports 5,400 health & social care
businesses within GM, with almost half of these dealing in human health activities
(including hospital activities, medical and dental practice activities and general and
specialist medical practice activities). Health and social care businesses account for 8%
of the GM business base.
Examples of key GM employers within health & social care are the NHS Foundation
Trusts; Bupa Care Homes; all local authority councils within the conurbation; HC-ONE
Ltd, a residential care organisation; and Greater Manchester Ambulance.
Table 1 - Number of GM businesses in health & social care, 2012
SUB-SECTOR
Human health activities
Social work activities without accommodation
Residential care activities
TOTAL
No OF BUSINESSES
2,336
1,935
1,134
5,405
Source: IDBR, 2012
In terms of the local authority split, 21% of health and social care businesses are located
in Manchester. Stockport has the second highest number of health and social care
businesses (11%), followed by Trafford (10%).
Health and social care businesses in GM tend to be large with nearly two thirds (65%)
employing more than 50 people, compared to only 6% for all businesses in GM. 43% of
these businesses employ 250+ people and 22% employ 50 – 249 employees. Only 8%
of health and social care businesses employ 1 – 9 people.
The sector has a relatively high proportion of part time workers, with 40% of employees
working part time compared to 28% across GM as a whole.
Key Employment Sub-Sectors
The Health and social care sector is the second largest employer in GM, employing
152,000 people in GM and representing 13% of total GM employment. Although the
majority of health employment is within the public sector, the specialist and high-value
biotechnology and life sciences sub-sectors have also seen strong growth.
Hospital staff represent over 40% of these employees, followed by other social work
activities without accommodation not elsewhere classified (12%), and other human
health activities (8%).
3
Table 2 – Employment in Health & Social Care sub-sectors in GM, 2011
SUB-SECTOR
Hospital activities
Other social work activities without accommodation n.e.c.
Other human health activities
Child day-care activities
Social work activities without accommodation for the elderly and disabled
Residential care activities for the elderly and disabled
Other residential care activities
General medical practice activities
Residential nursing care activities
Residential care activities for learning disabilities, mental health and substance abuse
Dental practice activities
Specialist medical practice activities
TOTAL
EMPLOYEES IN
GM
63,710
18,800
12,330
9,920
8,420
8,300
8,180
7,470
6,210
4,470
3,050
810
151,700
Source: Business Register & Employment Survey, 2012
Geographic Distribution
Manchester local authority has the largest concentration of health & social care
employees in GM, representing 27% of the sector. This is followed by Stockport (10%),
Salford (10%), and Wigan (10%).
Figure 1 – Health & Social Care employees across GM districts, 2011
TAMESIDE
9,250
6%
TRAFFORD
9,530
6%
OLDHAM
11,350
8%
BURU
12,770
8%
BOLTON
13,650
9%
ROCHDALE
9,170
6%
MANCHESTER
40,510
27%
TOTAL GM
HEALTH &
SOCIAL CARE
EMPLOYEES:
151,670
WIGAN
14,290
10%
STOCKPORT
15,730
10%
SALFORD
15,420
10%
Source: Business Register & Employment Survey, 2012
4
Growth forecasts
Growth forecasts for the health & social care industries in GM are drawn from the
Greater Manchester Forecasting Model (GMFM) produced by Oxford Economics. The
model gives an overview of the sector’s overall growth potential over the coming decade.
While employment is forecast to remain relatively level to the 2022 period, economic
output (GVA) is expected to increase by 17%, equating to approximately £700m of
additional economic contribution to GM. Over the same period the total output of the GM
economy is forecast to increase by 31%.
An increase in GVA whilst total employment remains stable implies increased
productivity within the section and an associated need for more highly skilled workers.
Indeed, forecasts indicate that of the 10,000 jobs due to be created over the next decade
in GM’s health & social care sector (due to the need to replace people who move or
retire, as well the creation of new jobs), about half will require skills equivalent to NVQ
Level 4. However, it is clear that the forecast also suggests that the sector will continue
to offer significant numbers of lower skill jobs.
Table 3 – Net requirement per annum in health & social care by skill level in GM, 2012-22
NVQ0
Health and Social Care
Total in GM economy
Source: Oxford Economics (2011)
3
NVQ1
NVQ2
NVQ3
NVQ4
TOTAL
547
1,070
2,056
1,907
4,948
10,528
11,307
13,901
22,897
22,641
21,388
92,134
SUPPLY & PROVISION OF SKILLS
This section reviews data on the number of apprentices, further education and higher
education students who live in GM and who are studying Health & Social Care sector
related courses. It aims to give an indication of the potential supply of skilled labour to the
sector. However, when reviewing the following data the following caveats should be
noted:
1. a person’s subject of study is not necessarily an indicator of their future
employment occupation;
2. many GM learners are studying for academic qualifications (e.g. history,
geography) which could make them suitable for employment in a range of sectors
– these learners are not included in the analysis;
3. across the relevant datasets up to 10% of learners have their study subject listed
as unknown – these learners are not included in the analysis;
4. the latest available data on 16-19 year old and Higher Education students is less
current (2011/12 vs. 2012/13) than the latest available data on 19+ and
apprenticeship students; and
5
5. there is no official line on which subjects of study are directly relevant to which
sectors of the economy, therefore New Economy has had to make a judgement
on which subjects and apprenticeship frameworks map to which sectors – detail
on this mapping exercise is provided in an appendix to this report.
Thus the figures presented are indicative of the pool of labour from which the sector
could recruit.
16-19: Further education (FE) and school sixth forms
During the 2011/2012 academic year, there were a total of 10,300 starts in health &
social care related subjects across FE and sixth form colleges in GM. About half of these
FE starts were made at Level 1 or below, while the other half were at Level 2 or 3.
The number of EFA-funded GM starts on health and social care courses increased by
65% from 2009-2011. Over the same period the total number of all EFA-funded starts
increased by 13%.
70% of EFA-funded starters in 2011/12 were female compared to 49% across all
subjects.
The EFA data identifies the largest providers of Health and Social Care related courses
in GM. Four FE and sixth form colleges accounted for over half of EFA-funded starts in
the 2011/12 academic year. In order, these were:




Ashton Sixth Form College
Trafford College
Oldham College
Hopwood Hall College
Table 4 – Number of Health and Social Care relevant learning aims funded by EFA to GM
learners, 2011/2012
Health and Social Care
Health, Public Services
and Care
TOTAL
Entry
Level
50
Level
1
3,698
Level
2
1,719
3,678
Level
4
-
198
922
-
10
248
4,620
1,719
3,688
Level 3
Other Level
TOTAL
-
9,145
-
-
1,130
-
-
10,275
Source: Education Funding Agency, 2012
6
Adult Skills Funding Agency (SFA)-funded provision (excluding apprenticeships)
In 2012/13 the SFA funded approximately 20,100 health & social care training starts by
GM residents aged 19 and over. Two sector subject areas account for the lion’s share of
these learner starts:

Health & Social Care – 18,300

Health, Public Services & Care – 1,500
The ‘Medicine and dentistry’ and ‘Nursing and Subjects and Vocations Allied to Medicine’
sector subject areas account for a few hundred starts per year each.
SFA funded provision to the sector has declined by 19% over the past five years with
noticeable falls in the numbers of health & social care starts. Over the same period total
SFA funded starts in GM have fallen by 8%.
Looking in more detail at the types of residents on these courses shows that:

SFA funded learners in health & social care are mostly female (75%) – compared
to a more even balance across all sector subject areas (53% female/47% male);

Just under a third (31%) are studying at Level 3 and above – this is higher than
the all sectors figure of 21%.
Table 5 - Level of study by GM residents of SFA funded health & social care courses,
2012/13
Level
Level 1 & Entry
Level 2
Level 3
Level 4+
Health & Social Care
22%
29%
30%
1%
All sectors
20%
20%
21%
-
Source: SFA, 2012/13
The largest providers of the health & social care sector training in GM by number of SFA
funded starts include:






The Manchester College
Oldham College
Ashton Sixth Form College
Hopwood Hall College
Trafford College
Bolton Council
7
Apprenticeships
In 2012/13 there was a total of 4,035 Greater Manchester residents started an
apprenticeship framework that is related to the health & social care sector. This
compares with 769 starts in 2008/09 – reflecting a fivefold increase.
The vast majority (88%) of these starts are in apprenticeships labelled ‘health & social
care’, with other areas like dental nursing, pathology support or pharmacy representing
only a tiny fraction of overall starts in the sector.
There has been strong growth in the number of health & social care sector GM
apprenticeship starts – up by 430% since 2008, compared to the rise of 124% seen
across all sectors in GM.
Almost half (42%) of health & social care GM apprenticeships starts are at the advanced
level (Level 3).
In terms of gender, similarly to SFA funded provision, apprenticeship starts were
overwhelmingly made by females (85%); across all GM apprenticeships 54% of starts
are by females.
With regards to apprenticeship providers, ESG, GP Strategies Training, Elmfield
Training, and Economic Solutions are the largest providers.
The demographic characteristics of apprentices of health and social care courses has
dramatically changed over the last five years with the largest age group to take up
training in health and social care being 31 to 49 year olds in 2012/13. Just over one third
of apprenticeship starts were by under 25 year olds (with 8% under 19 years, and 26%
between 19 and 24). This reflects a considerable number of starts by 31 to 49 year olds
and a decrease of the proportion of under 25 year olds – which made up three quarters
in 2008/09.
Age Groups
Apprenticeship
starts 2012 / 2013
(total number)
Under 19
19-24
25-30
31-49
50-64
65+
Total Number
303
1043
677
1557
450
5
4035
8
Higher Education (HE)
GM is home to four universities (the University of Manchester, Manchester Metropolitan
University, University of Salford, and the University of Bolton) who collectively have more
than 100,000 students and almost 30,000 graduates each year.
In the 2010/2011 academic year, there were a total of 6,410 GM HE students studying
health & social care related subjects, with just over half of these studying subjects allied
to medicine.
Table 6 – Number of students studying health & social care-related subjects in GM HE
institutions, 2010/2011
SECTOR
UNIVERSITY OF BOLTON
UNIVERSITY OF MANCHESTER
MMU
UNIVERSITY OF SALFORD
TOTAL
Medicine & dentistry
Subjects allied to medicine
Biological sciences
TOTAL
0
250
195
445
900
1,335
870
3,105
0
505
695
1,200
10
1,320
330
1,660
910
3,410
2,090
6,410
Source: HESA (2011)
Data on the destination of leavers suggests that following the 2010/11 academic year,
2,640 graduates (41%) were working in the health & social care sector six months after
graduating.
Table 7 – Destination of leavers employed in Health & Social Care, 2010/11
SECTOR
UNIVERSITY OF BOLTON
UNIVERSITY OF MANCHESTER
MMU
UNIVERSITY OF SALFORD
TOTAL
Human health & social work activities
TOTAL
280
280
1,150
1,150
580
580
630
630
2,640
2,640
Source: HESA (2011)
4
SECTOR SKILLS ISSUES
Current skills issues
Whilst the health and social care sector has a highly qualified workforce, with 61% of the
workforce qualified to Level 4 or equivalent, there remain a range of skills gaps, skills
shortages and occupational shortages that are highlighted as an immediate priority.
These priorities are evidenced through the UK Health Sector Skills Assessment 2011,
analysis of NHS vacancy data and the Migration Advisory Committee (MAC) ‘Skilled,
Shortage and Sensible’ shortage occupation list for the UK and Scotland.
The skills gaps demonstrated by sector staff include:


Technical, practical and job-specific areas;
Problem solving skills;
9




Oral communication skills;
Customer handling skills;
Team working skills; and
Management and leadership skills.
The MAC list contains 35 occupations with distinct shortages. Of relevance to the sector,
traditionally one with significant reliance on migrant labour, include:




Consultants within certain specialties;
Pharmacists;
Dental practitioners; and
Specialist nurses and therapists in certain roles.
Research has demonstrated that management skills are correlated with improved
financial performance and better patient outcomes. Both Skills for Health and Skills for
Care and Development sector skills councils have highlighted the relative importance of
up-skilling health and social care sector management and leadership for the future
wellbeing of the population.
Investment in training within the health and social care sector is relatively high, with over
80 per cent of employers arranging training for their staff compared to 59 per cent in the
economy as a whole, and the proportion of the workforce receiving training (66 per cent)
is also above average (54 per cent) but declining in line with all sectors.
UKCES2 concludes that to meet the skills gaps and occupational shortages listed above
there is a need to:





change working practices and roles by reworking traditional approaches to
provide greater flexibility, embrace new technology and deliver more appropriate
patient care;
develop new entry routes into the sector for example through apprenticeships;
encourage innovation and use the opportunities afforded by technology to
develop new services and ways of working;
raise engagement to maximise productivity, retention and minimise absence; and
Develop management and leadership capability.
Future trends, barriers to growth and opportunities
2
UKCES Sector Skills Insights : Health & Social Care, available at
http://www.ukces.org.uk/publications/er52-sector-skills-insights-health-and-social-care
10
The key challenge facing the health and care sector is to meet increasing demand for
services whilst operating with constrained resources in a rapidly changing operational
environment. A market research report by MBD concluded that there will be a significant
rise in the use of private healthcare in the coming years, with a 5% increase in 2011,
followed by increases of 5-7% until 2015. This is likely to be driven by reforms
encouraging competition between private providers and the public sector as well as
increasing outsourcing by the NHS.
There is also the issue of the UK’s ageing population, which is likely to create new
challenges for the sector, both in terms of health and social care. There will be an
increasing demand for services, with employees being required to do more with less and
be more attuned to the needs of elderly patients.
11
Appendix A: Definitions used to produce this report
SIC Codes
 Human health activities (SIC code 86)

Residential care activities (SIC code 87)

Social work activities with accommodation (SIC Code 88)
Tier 2 sector subject areas
 Health and Social Care

Health, Public Services and Care

Medicine and Dentistry

Nursing and Subjects and Vocations Allied to Medicine
Apprenticeship Frameworks
 Dental Nursing
 Allied Health Profession Support
 Health and Social Care
 Clinical Healthcare Support
 Emergency Care
 Healthcare Support Services
 Maternity and Paediatric Support
 Optical Retail
 Pathology Support
 Perioperative Support
 Pharmacy Services
 Pharmacy Technicians
12