What apprenticeships are and how to use them

Doctors transporting bed

This page provides an overview of apprenticeships. It includes information on the benefits apprenticeships can bring to your organisation, how they can be used to support your workforce plans, and links to useful resources.


In recent years the government has reformed the way apprenticeships are delivered and funded in England. As part of these reforms apprenticeships are more robust, better structured, and independently assessed to ensure apprentices gain the skills that employers need for their workforce. There is a wide range of apprenticeships now available, including higher and degree level apprenticeships. Not only can they support with addressing skills shortages, but they are an excellent means of attracting new talent, developing and upskilling existing staff, and retaining the full workforce within the NHS.

What is an apprenticeship?

The government defines apprenticeships as a job with training. They incorporate skills development, technical knowledge and practical experience through a work-based training programme. Apprenticeships are available to anyone over the age of 16 and enable learners to demonstrate competencies while gaining a recognised qualification. In a change to previous rules, individuals can undertake an apprenticeship at any level (this could be higher, equal or lower to a qualification they already hold), if it allows them to acquire substantive new skills.

Employment is a fundamental part of an apprenticeship and an apprentice must be employed in a job role with a productive purpose. In addition, the minimum duration for an apprenticeship is 12 months and the apprentice must spend at least 20 per cent of their time on off-the-job training. (For some roles such as nursing, the requirement may be more). Apprentices must be paid for time spent training or studying for the relevant qualification, whether this is while at work, attending college or a training organisation.

What is the apprenticeship levy?

As part of the reforms, the apprenticeship levy was introduced in April 2017. This levy is paid by all employers at a rate of 0.5 per cent for those who have a pay bill of more than £3million per year and is used to fund apprenticeship training costs (not employment) for apprentices. You can find more information about the apprenticeship levy, and how to use it on our apprenticeship levy web page

The key enablers to providing apprenticeship programmes

To deliver successful apprenticeship programmes, an organisation will need to develop a culture of work-based learning and an approach that embeds apprenticeships as a part of what they do. Achieving this may require a combination of actions with some behavioural change. We have identified five key principles that underpin a successful culture of learning in the workplace. These key principles are:

  • leadership
  • manager buy-in and understanding
  • workforce strategy and planning
  • infrastructure
  • relationships with education providers. 

Use our work-based learning infographic and view more detail on work-based learning to support with conversations around the five key principles.

Building apprenticeships into the workforce strategy

Apprenticeship qualifications or standards range from levels 2-7. This is the equivalent of GCSE level up to master’s degree level. Apprenticeships are also available in a range of subjects and can develop individuals in many occupational competencies. These include but are not limited to, clinical apprenticeships such as nursing, advanced clinical practice, and radiography, and non-clinical apprenticeships such as senior leadership, clinical coding and facilities management. The drop-out rates for apprenticeships are also far lower than many of the more traditional routes of learning.

Consider the following questions when developing your workforce plans:

  • How can a scaled-up apprenticeship offer act as an enabler of your workforce strategy?
  • Does your current apprenticeship offer align to the skills/talent pipeline you will need over the next five years?
  • How can the introduction/use of apprenticeships tackle your key workforce challenges?

The HASO website also shows the range of apprenticeships you could include as part of your workforce strategy.

There are a number of ways that apprenticeships can benefit your organisation:

Apprenticeships help develop clear career pathways and retain staff

Apprenticeship pathways are now being developed to provide higher-level technical skills and provide a great option for retaining the existing workforce and, building talent pipelines. For example, Leeds Teaching Hospitals NHS Trust has created a pathway from traineeship to registered nurse, which has enabled the trust to retain talent. You can view more about this and other examples in the using the apprenticeship levy resource. The HASO website also shares a wide array of potential pathways that you could develop in your organisation.

Apprenticeships can develop your existing workforce

Retaining the skills and experience of existing employers is vital if employers are to avoid future skills shortages. Many employers are now offering apprenticeships at all levels to existing staff across a wide range of roles and disciplines as part of their strategy. Find out how North Lincolnshire and Goole NHS Trust has done this to improve skills in its trust.

Apprenticeships can help you to reshape your workforce

When thinking about how they can redesign and shape the workforce in order to respond to, and anticipate service needs, many employers are ensuring that apprenticeships form a key part of their workforce supply strategy. Read how Chesterfield Royal Hospital introduced band 4 roles to help build a team around the patient. This case study can also help you think about what skills and activities you want your team to have and how apprenticeships can support with that.

Apprenticeships have lower attrition rates

National dropout rates for many university courses tend to be relatively high, particularly within the first six months. Northumberland, Tyne and Wear NHS Foundation Trust introduced a nursing apprenticeship programme as part of their ‘grow your own’ approach and reported 100 per cent retention after six months. The scheme is referenced in the King’s Fund report, The courage of compassion: Supporting nurses and midwives to deliver high-quality care.

Attract and recruit from a wider pool of people in your local community

Apprenticeships present a genuine alternative to full-time college or university study to anyone aged 16 and over. They can widen access to employment to all areas of your local community. For example the nurse degree apprenticeship, which leads to the same qualification as the traditional route, can be offered to new or existing staff. Barking, Havering and Redbridge Trust has used this approach to strengthen its nursing supply.

Flexibility and innovation to open the doors for future nurses

Employers can open doors for the existing and future nursing workforce in their local community by building a nursing partnership with their providers. The Open University (OU) has worked with Kent Community Health NHS Foundation Trust to develop the local nursing workforce through the registered nurse degree apprenticeship and nursing associate higher apprenticeship, through the use of the innovative Nursing Academy. This allows apprentices to earn while they learn and the OU can give flexibility as a distance learning provider.

Recruit a diverse and representative workforce

Widening your recruitment to better reflect the community you serve is a key message of the NHS Five Year Forward View and inclusive apprenticeship recruitment can also lead to better retention rates and improved workforce supply. The benefits of establishing and maintaining a diverse and representative workforce are well understood. Teams are more innovative and creative. It is also found that patients have better experiences of care when the workforce mirrors the patient population.

Taking positive action during the recruitment process can enable you to diversify your workforce, and deliver against actions in the We are the NHS People Plan, Workforce Race Equality Standard (WRES) and the Workforce Disability Equality Standard (WDES).

According to gov.uk ‘positive action provisions mean that it is not unlawful to recruit or promote a candidate who is of equal merit to another candidate if the employer reasonably thinks the candidate:

  • has a protected characteristic that is underrepresented in the workforce; or
  • that people with that characteristic suffer a disadvantage connected to that characteristic.

However, positive action does not allow an employer to appoint a less suitable candidate just because that candidate has a protected characteristic that is under-represented or disadvantaged.’

Protected characteristics include age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief (or lack of), sex, and sexual orientation.

Most fundamentally positive action can support employers under the Equality Act 2010 to recruit and promote people from under-represented groups to help them overcome disadvantages in competing with other applicants.

This positive action in recruitment guide from gov.uk outlines all of the steps throughout the recruitment process where positive action can be taken, from shortlisting through to interview, and provides examples of tie-break scenarios. Your recruitment team can also provide you with data throughout the recruitment process on the protected characteristics of applicants, to support you with taking positive action during the process or to understand where barriers in the process may occur.

Ensure that your recruitment processes are accessible to all. Ask whether reasonable adjustments are required and if so provide them. This may be including hearing loops, accessible software for any computer-based activity, a wheelchair accessible space for all activities, papers in large print and colour filters available, or access to a computer for any written task for those who struggle with paper-based activity. 

When Royal Berkshire Trust identified a gap in black and minority ethnicity (BAME) senior leaders at the trust they specifically invited and encouraged BAME staff to take up the offer of a senior leadership apprenticeship. View the briefing.

For more information about how you can build a diverse workforce visit our pages on recruiting from your community, diversity and inclusion and accessible recruitment. This section includes schools and community engagement, and recruiting from underrepresented community groups include care leavers, carers, people from different cultural communities and LGBT+ people. We also have dedicated web pages for supporting disabled apprentices, young people and those choosing to work longer

Return on investment

A costing tool has been developed to help work out the potential cost to your organisation of delivering apprenticeships and shows a breakdown of the annual salary costs and levy spend, enabling you to calculate a return on the investment made. The costing tool is part of the Apprenticeship Toolkit found on the HASO website.

Further information

  • Stay up to date with apprenticeship policy, sign up to our education and training newsletter
  • Information about employing apprentices, funding and an employer’s guide to apprenticeships available on the gov.uk website
  • The HASO website also has information on the apprenticeships available in healthcare, and a range of tools and resources to support you with implementing apprenticeships in your organisation including apprenticeship pathways and a procurement toolkit

Why Register?

Great reasons to register with NHS Employers

  • A personalised website
    Manage your profile and select topics of interest to you
  • Access your dashboard
    Bookmark useful content to help you quickly find what you're looking for
  • Get involved
    Contribute to our Talking Points discussions, comment on and rate our webpages
  • Keep up to date
    Receive the latest newsletters and media summaries

Log In