The Careers Adviser: How do I get into NHS management?

Do I need extra training to earn more and move on?

Q. I'm a medical secretary and in the current climate need to earn more and move on in my career. Is it possible to progress into NHS management? Would I need training for this?

A. Working in the job you already have means you have some of the skills you will have to demonstrate – organisation, verbal and written communication skills, possibly the ability to lead a small team. Maybe you're also managing resources and co-ordinating people from various disciplines. So go for it – opportunities are many and varied, from running a GP surgery to managing in a range of areas: financial, IT, information, clinical or personnel.

Then ask an existing manager to be your mentor and offer advice and coaching. If you have the time to take on some additional responsibilities which help you towards your goal, all the better – it will pay off in the long run. If you work in the NHS, consult your line manager (are you due for a review?) and apply for secondments. Don't forget that volunteering outside work counts. Being a parent governor, charity fundraising or organising self-help groups mean you have project management capabilities. And employers can be willing to fund relevant training – there are many recognised qualifications in management. The Health Learning and Skills Advice Line (www.careers-advice.org/hlas or freephone 08000 150 850 ) has coaches who can give you feedback on your CV and help you with your skills assessment.

Q. I am 50 and interested in getting into arts administration, if possible working in the classical music field. Most vacancies expect A-levels or a degree – I left school after O-levels. I do have 10 years' administrative and practical music experience but this doesn't seem to count.

A. There is no one route or qualification that is a magic ticket here, but you do need to do a lot of research, and be willing to search people out and talk to them directly about a way in. Start with identifying where you want to work and find out what they need. Are you interested in the charity sector, in work with children or adults, for example? Then you can start to work out which qualifications would be appropriate. Work experience will be vital to help you find routes in, whether or not you take up a course of study. It will help you single out organisations and roles that match your interests and skills; build confidence and contacts, and work out where your skills need updating or developing.

New courses in this area spring up all the time, and lack of qualifications need not be a barrier – talk to course tutors about credits you may be able to acquire based on previous experience or learning (Accreditation of Prior Learning or APL). Check programme content – what skills does it develop? Who accredits the course, and vitally, how well is it connected to the industry? Check the background of lecturers and guest speakers. Courses are designed for those working for organisations, setting themselves up in a business or aiming to work freelance.

Careers adviser: Lorna Dallas-Conte, faculty of media, London College of Communication