Spotlight On Staff

Health and Social Care: An Important and Changing Sector

Pamela Reid, Director

0845 120 6244





Health and Social Care: An Important and Changing Sector

The Health and Social Care sector makes a significant contribution to the Scottish economy, as a major employer, a driver for research and innovation and as a key purchaser of goods and services. There is just short of 200,000 people working in the health sector in Scotland and a bit more in social care. ekosgen’s  recent work for Skills Development Scotland highlights the importance of the sector as an employer in every local authority area.

A reasonable estimate of the economic contribution of the sector in Scotland is GVA of £9.05bn per annum.  Along with contributing to the economy and providing employment, it also has an important role to play in enabling participation in the workforce by supporting the health and well-being of the population. Scotland’s Economic Strategy underlines the importance of this to the economy, recognising that:

“a healthier and more active population with a longer life expectancy as well as improving overall wellbeing also further improves a  country’s productive capacity.”

The sector has undergone significant change in terms of the demand for services, the way services are organised and delivered, and changes in the policy environment. Many of the drivers stem from the demographic changes that Scotland is experiencing - population growth, a shifting demographic structure and an increasingly ageing population.  There is also a question around whether that population will be healthier for longer and at the moment, life expectancy is increasing at a faster rate than healthy life expectancy. Demonstrating the pressures that will be placed on it both financially and in terms of staffing needs, Scotland’s dependency ratio is expected to increase from its current rate of 60 per 100 to 68 per 100 by 2033 - a ticking time bomb.

Within the last decade there has been a considerable policy focus on health improvement in Scotland.  The new Integration Authorities came in to being on 1 April 2016 meaning that resources, including the workforce, will shift towards a more preventative, community based approach Roles and responsibilities of health and social care workers have expanded and changed considerably in the last five to ten years. The workforce now requires a much wider skill set and a shift in approach and practice to deliver person-centred care driven by the outcomes for individuals. 

The introduction of the Living Wage is undoubtedly a good thing but it will increase the wage bill for most employers in this sector. Compounding this, an inhibitor to growth and development is public sector budgetary constraints leading to the downwards pressure on fees.

The expansion of entitlement to free Early Learning and Childcare is driven by the commitment of the Scottish Government to improve the outcomes for Scotland’s children and no-one can disagree with that but how can we achieve this expansion, where will the workforce come from and how can we ensure that growth is not at the expense of quality?

Social care has a relatively old workforce and as this bulge of workers moves towards and reaches retirement it is by no means clear that there is a sufficient pipeline of new workers. There are also some skills gaps in the existing social care workforce and amongst some health occupations e.g. literacy, numeracy and digital literacy. Technological developments are already impacting on the IT skills required for information gathering, service delivery and providing information.  A lack of these core skills hinders the progression of individuals in the workforce as well as efficiency and quality of care.

There are lots of challenges facing the sector but also opportunities to shape it to deliver the care required for the 21st century. Quality of service is inextricably linked to the people delivering it so all the partners must carefully consider their role and commit resources to make sure that Scotland develops a highly skilled, sustainable health and social care workforce for the future.

To learn more about ekosgen’s work in this sector, including workforce development, contact Pamela Reid on 0845 120 244 or