Strengthening the NHS frontline through apprenticeship training

Our health service has faced an onslaught of demand over the last few years, putting pressure on services and staff. NHS employers have been actively designing new apprenticeship standards for clinical roles, but to what extent are these new pathways helping to meet employers’ demand for skilled staff?

The Covid-19 pandemic has exacerbated the pressure on our health services. In our article Expecting the Unexpected, we considered how building skills and resilience within our workforces can help us to better prepare for the unexpected. But what would a fortified frontline look like if we utilised apprenticeships across all areas of the NHS?

Harnessing apprenticeships within the NHS

The use of apprenticeships in clinical settings is gaining traction, with a growing number of NHS trusts using apprenticeships to train staff within frontline roles. Apprenticeship standards have succeeded in creating new pathways to careers in healthcare, however, recent experience suggests that not all standards are proving to be a hit with employers. 

NHS organisations pay over £200 million in Apprenticeship Levy contributions annually, but anecdotal reports indicate that most employers are not making full use of their available funds. So, if employers have available apprenticeship funds and have been involved in designing a host of new apprenticeship standards, why does uptake of apprenticeships in some clinical occupations remain low?

£200 million Apprenticeship Levy

Over the last three years, more than 4000 learners have enrolled in a Nursing Associate apprenticeship programme. Over 1500 people started the Registered Nurse degree apprenticeship between August and October 2021 alone. In stark contrast, there were only 11 starts onto a Midwife degree apprenticeship last year. So why do apprenticeships work so well to in nursing and related roles, but not in other occupations?

Certainly one of the key differences in nursing and midwifery appears to lie in the investment being made. Nursing apprenticeships have not always been so popular. Only 30 learners enrolled on a nursing degree apprenticeship in 2017-18, prompting the Commons Education Committee to declare in 2018 that nursing apprenticeships were ‘not sustainable’. To reach their pledge of recruiting 50,000 more nurses into the NHS, an additional £172 million Government investment has been used by several trusts to recruit clinical educators to support apprentices’ on the job learning. This extra funding has allowed NHS providers to rapidly expand the number of nursing apprentices, suggesting a similar investment would be beneficial for midwifery.

£172 Million Government Investment

Midwifery is a popular occupation but chronic understaffing issues, financial constraints on trusts, and staff burnout are adding to pressures. For example, a recent inspection by the Care Quality Commission (CQC) of Basingstoke and North Hampshire Hospital’s maternity unit highlighted that understaffing was affecting workers’ ability to complete training in key skills for their roles, including identifying and treating sepsis.

The Royal College of Midwives has emphasised that maternity services across the UK face similar hurdles. There are apprenticeship standards approved, written, and available to train workers within the sector… but engagement with some of these new standards is minimal.

A challenging environment for training

High pressure on frontline NHS services can leave little room within operations to train and develop staff. Whilst the number of doctors and nurses working in the NHS has risen since this time last year, retention issues mean that severe pressures on staffing remain. Notably, analysis of people leaving NHS trusts in July to September last year highlighted that over 6700 staff members left the health service due to concerns over work-life balance (the highest figure since records began in 2011). In a survey by NHS Providers, 94% of leaders said they were extremely or moderately concerned about staff burnout. The Chief Executive of NHS Providers, Chris Hobson said “It is incredibly difficult to remedy the conditions creating these concerns without a significant and sustainable increase in staffing numbers in the NHS.”

But the NHS is making moves in the right direction to tackle the pressures on staff and services in some areas. Starts on the Advanced Clinical Practitioners apprenticeship has increased by nearly 1000 in the last year. A further 271 learners started the Paramedic degree apprenticeship, and 224 began the Occupational Therapist degree apprenticeship. While these numbers are not huge, they are encouraging because they show that learners and employers in the NHS are starting to use apprenticeships to fill vital frontline roles outside of nursing - attracting and retaining staff, ultimately strengthening the quality of care.

Advanced Clinical Practitioners

Bringing apprenticeships into the NHS’s culture of learning

The NHS is built on the foundation of protecting, treating, and restoring the health of our population, which includes the workers on the frontline. Creating a work culture within the NHS where staff are valued, encouraged to grow their skills, and provided with ample opportunities to do so will improve workforce resilience, staff retention, and the quality of care for patients.

Many trusts already make good use of apprenticeships outside of clinical roles (such as within management, IT, administration, and HR) to strengthen hospital and department performance and resilience. Service providers to NHS trusts also make extensive use of apprenticeships - Sodexo’s social impact pledge has committed them to consider every job role and vacancy as an apprenticeship opportunity.

The team at Think works with employers to strengthen workforce planning and development. We are the architects, site surveyors, and ground workers; helping you to make sense of your landscape and build strong, resilient approaches for workforce skills and development. 

And when population health outcomes are directly impacted by the skills, experience and resilience of our health care professionals, we can help NHS employers devise and implement strategies that deliver the skills their organisations need to succeed. In our society this rarely matters more than when it comes to the NHS.