This briefing sets out the value of apprenticeships and how they are being used to upskill, upscale and widen access to the NHS workforce to support current and future demand.
In June 2023, the NHS Long Term Workforce Plan announced how the NHS will address existing and future workforce challenges by recruiting and retaining thousands more staff.
There are key actions for employers as apprenticeship ambitions feature heavily in the plan including aims to provide 22 per cent of all training for clinical staff through apprenticeship routes by 2031/32, up from just seven per cent currently.
Increasing training places for nursing associates (NAs) to 10,500 by 2031/32. By 2036/37, there will be over 64,000 nursing associates working in the NHS, compared to 4,600 today.
Plus introduce medical degree apprenticeships, with pilots running in 2024/25, so that by 2031/32, 2,000 medical students will train via this route.
This briefing is in support of NHS England's Long Term Workforce Plan, which prioritises apprenticeships as a valuable route to developing and retaining the workforce through creating innovative opportunities to increase access to roles through apprenticeships. The plan describes substantial growth of doctors, nurses, midwives, allied health professionals and support staff underpinned by significant investment in training and education opportunities. In this document, we have pulled together relevant resources, good practice, top tips and key actions to consider.
This brief aims to explain the significance of apprenticeships in NHS organisations and offer guidance to employers on identifying and recruiting for apprenticeships. Additionally, it highlights workforce factors that can determine the viability of a suitable apprenticeship.
From 2018 to 2022 the number of clinical and non-clinical apprenticeship standards used by health and social care increased from 86 to 196, with over 27,000 starts in 2021/22.
According to the Department for Education (DfE) (2022) take up of degree apprenticeships is growing. In 2018/19 degree apprenticeships represented just two per cent of all apprenticeships, by 2022 this has increased by more than ten per cent of all apprenticeships being degree-level.
Evidence also shows that apprentices studying through the degree route are the most satisfied (91 per cent) of all apprentices and 80 per cent of them continue to work for the same employer when they complete their apprenticeship. Demonstrating that apprenticeships are a credible and reliable option to retain your workforce.
What are apprenticeships?
The government defines apprenticeships as a job with training. They incorporate skills development, technical knowledge and practical experience through a work-based training programme. An apprenticeship will include a minimum of six hours off the job training weekly. However, for some clinical degree apprenticeships, this can be considerably more.
Apprenticeships are available to anyone over the age of 16 and enable learners to demonstrate competencies while gaining a nationally recognised qualification. An apprentice can be a new joiner, or they can be used as a way of upskilling existing staff, with apprenticeships ranging from level 2, GCSE equivalent to level 7, equivalent to a master’s degree.
There is no agreed national pay rate for apprentices in the NHS, employers should follow the agreed Staff Council Guidance.
We recommend that you discuss apprenticeship pay at a system level to provide consistency for your local communities and explore the possibility of paying a real living wage in support of good work as an anchor institution.
By engaging with other organisations within your Integrated Care System (ICS) you can reduce recruitment costs through joined-up recruitment campaigns.
Lincolnshire Partnership NHS Foundation Trust offers a three-year mental health nursing apprenticeship to strengthen traditional supply. This forms part of the trust’s grow your own approach which is committed to offering at least five healthcare assistants each year the opportunity to undertake the mental health nursing apprenticeship.
Benefits of offering apprenticeships
Apprenticeships can offer numerous benefits to your organisation.
- Support with addressing skills shortages in the organisation.
- An apprenticeship can provide a great return on investment. Use this costing tool to work out the potential cost of delivering apprenticeships and calculate the return on the investment.
- Apprenticeships can encourage internal development opportunities and improve staff retention.
- They offer staff the opportunity to reskill, develop their careers or support them with training for hard to fill job roles.
- Opportunities to provide degree level training across a wide range of roles within your organisation.
- As staff are developed into roles there is, in some cases, a reduced need to hire agency staff saving costs.
- Apprenticeships allow employers to flexibly meet workforce demands, as gaps in the workforce can be addressed by training apprentices.
- Apprenticeships can increase diversity in the workforce and support the organisation in being more representative of communities and the wider population.
- Apprenticeships can help guide young people into an NHS career that is right for them and improve their employability.
- Employers receive £1,000 for each apprentice that is 16-18 years old or 19-25 years old that has left care or on an education, health and care plan to support any associated costs.
- Employers can adapt apprenticeship programme training to meet the needs of the organisation and system objectives.
- Apprenticeships can upskill the workforce by building the learners digital, analytical and functional skills.
- Delivering apprenticeship programmes collaboratively means local health and care organisations can meet shared goals and ensure sufficient apprentice numbers are achieved.
The Black Country and West Birmingham ICS has taken a collaborative system-wide approach to people and the workforce in the ICS. They created a system-wide apprenticeship prospectus to promote all the apprenticeships available in the ICS’s NHS trusts, West Midlands Ambulance Service and other local authority organisations.
How to use apprenticeships
When considering the suitability of apprenticeships for your organisation the following prompts are useful for integrating apprenticeships into your workforce plans.
Consider giving apprenticeships equal weighting when deciding on recruiting for vacancies or new job roles. This blog by the North West Ambulance Service NHS Trust showcases how a consideration of apprenticeships led to the recruitment of a Junior Energy Manager apprentice.
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 or this webinar on supporting learning difficulties and disabilities apprenticeships.
Recruiting apprentices from the local community can improve representation and foster positive engagement with patients. 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.
With so many apprenticeships on offer, you can start training the employees of the future now. 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.
Apprentices can provide support in hard to fill workforce gaps, alleviate the pressure of recruitment in other areas and provide current staff members the opportunity staff to upskill. Employers can work on a system level to identify workforce gaps. This could involve sharing resources and approaching apprentice recruitment together.
Skills for life are a fundamental element to your workforce and their development prospects. Not only will developing functional skills upskill the workforce, by developing these skills it improves social mobility, population health, and outcomes for patients through a more competent skilled workforce. These skills for life can be developed through apprenticeships but you should also ensure that you have an appropriate pre-apprenticeship offer for your workforce to gain these 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.
Great Ormond Street Hospital (GOSH) used a range of apprenticeships to become an inclusive employer in the local area. They recruited over 200 clinical apprentices, including ten entry roles which required no prior experience. By placing emphasis on internal recruitment in the community, they have championed inclusivity, staff development, and increased retention rates.
At least 95 per cent of apprenticeship training costs are funded by the government, the remaining five per cent can be covered by the apprenticeship levy which all NHS organisations can access through their pay bill or transfer from a levy paying organisation.
The levy is payable for anyone with an annual pay bill of three million or more charged at 0.5 per cent of an employer’s total payroll.
The levy can’t be used on other costs associated with your apprentices (such as salary or travel costs) or for other types of training.
Up to 25 per cent of unspent levy can be transferred and received by other employers.
Explore the options and opportunities for transferring apprenticeship levy funds to or from another employer on our apprenticeship levy transfer guide.
An employer may wish to transfer a percentage of its levy to another trust or health provider including primary care, social care and the third sector. Employers/systems can also get in touch with their local council and Local Enterprise Partnerships for transfer opportunities.
As there is an off the job training element to employing an apprentice, this means that employers should factor in salary and backfill costs for the learner. In health and care, this is acknowledged as a barrier to upscaling the apprenticeship offer however when compared to the long term return on investment and the benefits already outlined it is a worthwhile initial investment.
There are several ways employers can consider alleviating some of the 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.
Flexible apprenticeships can provide an alternative to the single-employer apprenticeship model and can benefit employers and apprentices in multiple ways.
- Flexible apprenticeships can support employers who want to offer apprenticeships but are unable to offer a long-enough placement for apprentices to meet the government's minimum twelve month requirement.
- They allow an apprenticeship to be reduced (less than twelve months) where an individual has existing relevant knowledge or skills.
- They provide apprentices with the opportunity to broaden their skills, training and development working in different health and care organisations and settings (often referred to as rotational placements), i.e. community, acute, ambulance00 and social care.
The flexible apprenticeships in health and social care manual explains how off-the-job training can be flexed to meet individual employer needs. It includes information and case studies about:
- Flexible training models – options for delivering off-the-job training, including ‘front-loading’ blocks of training at the beginning of an apprenticeship.
- Accelerated apprenticeships – approaches to adjusting the content and duration of apprenticeship training plans through recognition of prior learning.
Derbyshire Community Health Services NHS Foundation Trust has piloted rotational apprenticeships across health and social care settings for the health care support worker apprenticeship and are exploring options for advanced practice training. The ambition is that the apprentice experiences the whole patient pathway.
Use any established relationships with further/higher education institutes and experience a service may have from supporting clinical placements for pre-registration students to think about what you can offer and where.
Link in with ICS colleagues and assess your workforce development need to identify the skills gaps within your system. Look at your workforce plan and think about vacancies that could be considered as a future apprentice role and what resources you can pool/share to save on infrastructure costs.
Engage with NHS England regional leads to gain technical and expert knowledge on apprenticeships and what is going on within your area through the Talent for Care team.
Encourage existing staff to consider an apprenticeship to aid their development and career progression or to get family and friends interested in an apprentice role. Use our apprenticeship opportunities in your organisation poster to promote opportunities available.
Build on your existing pre apprenticeship base offer to think about the pipeline of workforce you can bring in on apprenticeships. These could be volunteers, work experience, industry placements or supported internships.
Provide ongoing support for apprentices by having a robust induction, having a mentor, planning workload to provide necessary opportunities to complete practical training tasks. Build in time for the apprentice to receive regular assessment reviews.
Evaluate the benefits of apprenticeships in your organisation by regularly analysing the performance and outcomes of your apprentices, this will allow you to see the current and future benefits to your business.