Apprenticeships in the NHS

Chapters

This guide helps you embed apprenticeships into your workforce planning. It includes practical steps, examples, and resources to support implementation and maximise impact.

Introduction

The Government’s 10 Year Health Plan depends on a skilled, adaptable workforce. Apprenticeships give you a practical way to recruit, train, and retain staff across clinical and non-clinical roles. By using apprenticeships strategically, you can:

Develop talent aligned to service needs.
Create career pathways that support retention.
Make full use of the growth and skills levy.
Widen participation and improve workforce diversity.

Apprenticeships incorporate skills development, technical knowledge and practical experience through a work-based training programme. Apprenticeships enable learners to demonstrate competencies while gaining a nationally recognised qualification, ranging from level 2 (equivalent to GCSE) to level 7 (equivalent to a masters degree). They are available to both new members of staff, or they can be used to upskill existing staff.

An apprenticeship will include a minimum of six hours a week off the job training, although this can be considerably more for clinical degree apprenticeships. This time is likely to be in an education setting, so it is vital to create a strong working relationship with local further and higher education institutions. Fixed total hours per apprenticeship standard now replace the weekly calculation, giving more flexibility.

Assessment reforms introduced from late 2025 allow end-point assessments to be integrated into the training programme for updated standards, rather than delivered as a separate stage. This phased change aims to reduce duplication, streamline completion, and support a more flexible approach to assessment.

Functional skills requirements have been relaxed for adult apprentices. Apprentices aged 16 to 18 will still need to secure up to a Level 2 qualification in English and maths. The funding will continue to be available for English and maths qualifications for those over 19 if the employer deems it necessary.
The level 2 healthcare support worker standard has been chosen as one of the first shorter apprenticeships. The Department for Education has confirmed it will reduce the current minimum duration of this apprenticeship to eight months, to take effect from 1 August 2025.
The minimum duration for other standards may also be reduced where prior learning exists.
Apprenticeships can be tailored to meet business needs through flexible or accelerated delivery. Organisations with non-standard working patterns can adapt training schedules—for example, by offering block training early in the programme to build essential knowledge and skills.
A formal process for recognising prior learning has now been introduced, allowing employers and training providers to reduce programme length and cost where apprentices already have relevant skills or experience. This supports accelerated apprenticeships and helps avoid duplication of training.
Flexible apprenticeships offer an alternative to the single-employer model and benefit both employers and apprentices:
- Employers who are unable to offer full length placements can still support apprentices to meet government requirements.
- Apprenticeships can be shortened for individuals with existing relevant knowledge or skills.
- Rotational placements across different health and care settings (e.g. community, acute, ambulance, and social care) broaden apprentices’ experience and development.
The flexible apprenticeships in health and social care manual outlines how off-the-job training can be adapted to employer needs. It includes guidance and case studies on:
- Flexible training models – such as front-loading training at the start of the apprenticeship.
- Accelerated apprenticeships – adjusting training plans based on prior learning.
- Customisable approaches – enabling apprenticeships to flex around organisational requirements.
From August 2025, NHS organisations can offer the first foundation apprenticeship standard in health and social care, mapped to roles such as adult care worker, healthcare support worker, personal assistant, and mental health support worker.
As part of the government’s Youth Guarantee to improve opportunities for young people and strengthen the future workforce, foundation apprenticeships provide an employment-based training route for people aged 16 to 21, and up to 25 for those with an Education, Health and Care Plan (EHCP), care leavers, or prison leavers. They are fully funded for under-25s in SMEs. These programmes allow individuals to earn a wage while developing vital workplace skills and gaining entry-level competence in a foundation occupation. Skills for Care provide further information on implementing foundation apprenticeships in your organisation.

Explore the positive impact of utilising apprenticeships

Building apprenticeships into your workforce strategy

The government’s Post-16 education and skills white paper places apprenticeships at the heart of its strategy to build a high-skilled, employer-led workforce. It sets a target for 10 per cent of young people to be in higher technical education or apprenticeships by age 25 by 2040, nearly doubling current participation. NHS employers can contribute to this national ambition by expanding apprenticeship opportunities, especially in clinical and support roles. The paper also introduces level 2 occupational pathways and level 3 V Levels, which can feed into NHS apprenticeships and support early career development.

Identify where apprenticeships can be used to address workforce needs

The first step is to determine which apprenticeship standards align with your organisation’s current and future vacancies. Apprenticeships are available in clinical roles, including nursing and midwifery and allied health professions and non-clinical roles including, clinical coding, finance, administration and facilities management.

Explore the variety of apprenticeships on offer through Skills England’s list of approved apprenticeship standards.

Apprentices can provide support in hard to fill workforce gaps and provide current staff members the opportunity staff to upskill. Employers can work on a system level to identify workforce gaps and share resources.

Recruiting apprentices from the local community can improve representation and foster positive engagement with patients, as discovered by Great Ormond Street Hospital in this case study on diversifying apprenticeships. This also enhances the trust's reputation and offers development opportunities to locals. Building relationships with HR directors, employer networks, and transformational leads can promote change and develop staff through apprenticeships.
Recruiting apprentices can help increase the diversity of the staff across your system by providing supportive development opportunities for those that may not have entered the health and care workforce. Apprenticeships can facilitate the recruitment of individuals who otherwise might not have the opportunity to join the workforce, as displayed in this case study on refugee and asylum seeker community recruitment.
New apprenticeship standards are constantly being developed to target emerging workforce challenges. As apprentices will be in training, they will be bringing new ideas and ways of working into the organisation. Consider your pre-employment offers to see what opportunities can lead to training as an apprentice within your organisation.
T levels offer routes into NHS careers by preparing learners with the technical knowledge and practical experience needed for health and care roles. These qualifications can serve as stepping stones into apprenticeships, helping to build a future-ready workforce and diversify entry pathways.
Apprenticeships are a powerful tool for upskilling and retaining your workforce, enabling staff to gain new competencies while continuing in their roles. They support career progression and help build a more capable and confident team.
Skills for Life are a fundamental element to developing and retaining staff. Developing these skills improves social mobility, population health, and outcomes for patients through a more competent skilled workforce. These skills can be developed through apprenticeships but you should also ensure that you have an appropriate pre-apprenticeship offer for your workforce to gain the relevant skills needed to progress.
The Higher Development Award offers a personal development programme for support workers that enables them to build on their knowledge and give them the tools to increase awareness of their important roles.

Conversations with your board

Senior leaders across your organisation and system play a vital role in delivering successful apprenticeship programmes. Securing their support helps embed apprenticeships into your workforce strategy. Use the following key messages to engage each board member:

Funding and pay

Funding apprenticeships through the growth and skills levy

The Growth and Skills Levy replaced the apprenticeship levy in April 2025, giving employers greater flexibility to invest in both apprenticeships and shorter training courses.
The levy is paid by all employers who have an annual pay bill of three million pounds or more. The rate of the levy is set at 0.5 per cent of the total pay bill and is paid to HMRC through the PAYE process.

Levy-paying organisations can access funds via an online account, which are paid each month. The levy funds are used to pay for training costs only, not salaries. Any funds that are not used expire 24 months after they enter the account. To help minimise the risk of funds expiring, payments are taken from those funds that entered the account first. From April 2026, funds will expire after 12 months.

Employers can transfer up to 50 per cent of their contributions to another organisation, such as local councils or partners, to support apprenticeship delivery. Explore the options and opportunities for transferring apprenticeship levy funds to or from another employer on our levy transfer page.

Level 7 funding is ending for most learners over 21.

From 1 January 2026 levy funding for level 7 apprenticeships will be restricted to those aged 16-21 (or up to 25 for care leavers or those with an Education, Health and Care Plan (EHCP). From April 2026, mitigation funding will be available until 2029 for the following five apprenticeships at level 7:

Advanced clinical practitioner
Specialist community public health nurse (SCPHN)
District nurse (Community Specialist Practice Qualification)
Clinical associate in psychology (CAP)
Population health intelligence specialist (PHIS)

Apprenticeship pay

Apprentices must be paid at least the national minimum wage for apprentices, which will rise to £8.00 per hour from April 2026. Many NHS organisations choose to pay above this rate, aligning with Agenda for Change pay scales. Pay should reflect the apprentice’s role, responsibilities, and progression throughout the programme.

NHS staff undertaking formal apprenticeships as part of agreed career development should not experience a reduction in their basic pay. If the apprenticeship leads to a role at the same or higher band, the employee’s basic pay will be preserved at either the apprenticeship rate or their previous pay step—whichever is higher. This includes eligibility for pay progression during the apprenticeship.

For detailed guidance and FAQs, visit NHS Employers apprenticeship pay guidance.

Managing salary and backfill costs

Employers must factor in salary and backfill costs for the learner when employing an apprentice, due to the off the job training requirements. In health and care, this cost is often seen as a barrier to scaling up apprenticeship programmes, however when compared to the long term return on investment and the benefits already outlined it is a worthwhile initial investment.

To secure internal funding and leadership support, you may need to develop a business case outlining the strategic value of apprenticeships. This should include anticipated benefits such as improved retention, reduced reliance on agency staff, and alignment with workforce planning goals. The case should also highlight return on investment, levy utilisation, and how apprenticeships support national policy priorities. Consider including examples from other NHS trusts and systems that have successfully scaled up apprenticeship programmes through business case approval.

There are several ways employers can help reduce backfill costs:

Build a business case – influence your board by pulling together a business case to have organisation funding to cover the relevant backfill costs. Speak to other employers/systems who have done this already and learn from their experience
Upskill existing staff – apprenticeships can be used to develop and upskill staff, so their salary is already funded whilst they train.
Embed a permanent apprenticeship vacancy – make the business case to hold a permanent apprenticeship vacancy within the structure so that is supernumerary to establishment.
Provide rotational and reciprocal placements – work with local employers in your system and training providers to rotate placements or offer reciprocal placements to gain equivalent learners at those times.

Apprentice recruitment and support

The apprentice recruitment process

To start the recruitment process, you can use the government’s list of apprenticeship providers and recruit an apprentice service to advertise apprenticeship job vacancies and manage applications.

Your chosen apprenticeship provider may share details of interested and relevant candidates for you to review and sift to check suitability.

Treat the apprentice recruitment process as a traditional job role, conduct interviews and consider including a practical task.

Ensure every apprentice has a contract of employment that lasts long enough to complete their apprenticeship. Many employers also plan for a permanent role at the end of the programme. Assign a job role (or roles) that allows the apprentice to gain the knowledge, skills, and behaviours required to meet the apprenticeship standard. You can offer employment on either a fixed-term or permanent basis.

Keep in mind this may be the applicant’s first experience of a professional interview. The National Careers Service provides clear advice and guidance to support apprenticeship applicants prepare for an interview. You may wish to share this with applicants.

Attracting and supporting disabled apprentices and those with learning difficulties and disabilities

NHS organisations are encouraged to actively attract disabled applicants to apprenticeship roles to build a sustainable, skilled, and inclusive workforce. By creating accessible recruitment pathways and offering tailored support, employers can unlock the potential of individuals with disabilities and learning difficulties.

The UK government’s Spring Statement 2025 outlines new measures to support disabled people into employment. These include:

Investing £1 billion annually by 2029/30 in personalised employment support.
Expanding employment programmes to help individuals overcome barriers to work.
Reforming Universal Credit and PIP to encourage employment while maintaining support for those with the highest needs.

These reforms aim to reduce economic inactivity and promote inclusive employment across sectors, including health and social care.

Use the NHS Employers guide How to recruit and support disabled staff in the NHS for practical guidance on inclusive recruitment, reasonable adjustments, and workplace support. The Department for Education (DfE) has published guidance on how to support apprentices with a learning difficulty or disability, including the funding options available. Employers can receive up to £150 a month for additional learning needs where evidence of costs can be provided. There is also funding available which can go directly to the apprentice. There is more information about the funding available on the UK government website.

The government’s Access to Work scheme helps staff with physical or mental health conditions or disabilities, including learning difficulties and disabilities. It enables them to access the support they need to thrive in the workplace, such as specialist equipment, job coaching, support workers, or travel costs.
Staff, including apprentices, apply for Access to Work themselves, but employers can signpost to the application process and offer support. Find out more about the scheme on the Access to Work web pages.

Consider giving apprenticeships equal weighting when deciding on recruiting for vacancies or new job roles.

"Before now, we’d never considered adding a role with an explicit sustainability focus to our estates and facilities team. However, the team proposed that having a staff member tasked explicitly with focusing on sustainability would support the trust's ambitions to make sustainability a priority.

For the junior energy manager apprenticeship, we were able to hire a fantastic apprentice. The estates and facilities team are seeing many benefits from having recruited for this role. The apprentice has been able to focus on data analytics, which has been key in obtaining data and calculating heat loss from our ambulance stations.

Apprenticeships can widen the skillset within our organisation. Their manager is impressed by the passion and enthusiasm the apprentice brings to the role, and the positive experience it has been to have a fresh pair of eyes that can support the team in moving in a sustainable direction."

Lisa Hill, widening access development manager at North West Ambulance Service NHS Trust

Checklist for getting started

Use this checklist to guide your organisation through the phases of planning and implementing your apprenticeship programme.

Further resources

The Skills for Health apprenticeships resources include free tools, guidance, and frameworks to help healthcare employers develop and deliver high-quality apprenticeship programmes across clinical and non-clinical roles.
Skills England’s Occupational Maps provide a visual guide to technical education routes, showing how apprenticeships, T Levels, and other qualifications connect to real occupations and career progression.
The government’s Road to a Quality Apprenticeship resource provides step-by-step guidance for employers on how to design, deliver, and support high-quality apprenticeship programmes that meet business needs and benefit learners.
NHS England provides information on using apprenticeships as an entry route into allied health professions, and as a tool for career development and workforce sustainability.
Read about real-life examples of how NHS organisations have successfully implemented healthcare science apprenticeships to support workforce development and improve service delivery.