20 August 2021
Could apprenticeships in the healthcare sector be used further as a key business tool? Was the NHS public sector apprenticeship target unrealistic from the outset?
The answer to both questions is probably yes. Those healthcare employers who embrace and use apprenticeships, largely as a way of acquiring and nurturing talent, have had really positive results. Nearly eight in ten apprentices who complete the apprenticeship remain in employment, proving they are a sustainable and long term investment.
However, many businesses, including NHS Trusts, are failing to spend all the money allocated to them through the Apprenticeship Levy, and funds have been returned to the government. While it is too late to spend that money, there are still many opportunities to use apprenticeships further within the business across both clinical and non-clinical roles.
Apprenticeships are not a new tool for the healthcare sector, and many employers are long-standing advocates for their positive impact. But with only 25 per cent of healthcare sector employers currently offering them, and only 13 per cent planning to offer them in the future, what more can be done to support the industry?
When the levy was introduced in 2017, the economic, employment and workforce landscape was very different. The Public Sector Apprenticeship Target (PSAT) required public sector bodies in England with 250 or more staff to employ an average of at least 2.3 per cent of their staff as new apprentice starts over the period 1 April 2017 to 31 March 2021. When the levy came in, there was debate as to whether it was possible for NHS institutions to ever reasonably achieve this target.
The 31 March 2021 deadline date has been extended to 31 March 2022. According to Health Education England, this has been welcomed by the NHS, where apprentices ‘make a huge contribution to the delivery of essential services across the NHS in frontline clinical and non-clinical roles’. The most recent available data identifies only 12 per cent of NHS organisations as currently achieving or exceeding the PSAT, although 45 per cent of organisations demonstrate an improvement compared to previous years.
Should apprenticeships be central to current and future workforce needs?
The healthcare industry invests significantly in training, and more than 76 per cent of its workforce benefits from an annual spend of more than £5.9bn.
But the sector continues to have trouble recruiting the skills that it needs, with over 44 per cent of vacancies marked as ‘hard to fill’ and 16 per cent of employers continuing to report skills gaps in the workforce.
Apprenticeships are an important vehicle for the development of existing staff or recruiting new talent to plug skills gaps. Regardless of how mature your apprenticeship programme is, it is vital to ensure that you have taken the right steps and considered the risks and opportunities to your business.
The critical starting point is to have a clear vision and ambition for how apprenticeships can be embedded into your organisation. Setting clear targets and objectives, and having an action plan and key performance metrics, will ensure that your strategy helps you to achieve your ambitions.
Apprenticeship strategies should not focus on ‘how to spend the apprenticeship levy’, but be far broader, aligned to talent, workforce, and people strategies.
The NHS People Plan for 2020/21 highlights the need to foster a culture of inclusion and belonging as well as action to grow the workforce, train people and work differently to deliver patient care. Much of the sector was struggling to cope even before the pandemic took hold, with retention, staff stress, turnover and large numbers of vacancies across the health and care system.
Apprenticeships could address some of these issues, with many apprenticeship strategies focused on:
- Addressing misconceptions about apprenticeships
- Ageing workforce
- Agile and ways of working
- Becoming a training provider
- Demands on service provision
- Developing career pathways
- Employability skills
- Growing your own talent
- Increasing opportunities
- Invest in a local workforce and your workforce
- Management apprenticeships
- Partnership working
- Recruitment and resourcing
- Retaining talent
- Return on investment
- Skills gaps
- Staff retention
- Succession planning
- Supporting apprentices into employment
There are several positive examples of collaboration within the sector particularly linked to Nursing Associate Apprenticeship where reciprocal collaborations arrangements relating to placements with other likeminded partners were in place and working well.
It is also important to align involvement with other national initiatives such as those aimed to increase the number of trainee nurses and health professionals: kickstart, traineeships and work placements.
What happens if the strategy costs more than the funds in your levy account?
Prioritising the objectives and business areas where apprenticeships are the right option is critical. And you should be already negotiating fees with your procured and chosen training provider to ensure value for money, and already have measures in place to ensure that apprenticeship monies spent are having a positive impact. However, if this is still going to cost more than you have in your levy pot, many employers who are unable to spend their own levy are looking to benefactors to donate unspent levy monies to.
Additionally, alternative support is available for those business who have spent up to and over their levy, with the government co-investment rate set at 95 per cent. Also, local authorities and Local Enterprise Partnerships have regional funding and grants available so it is worth checking with them to see if any additional incentives may be available.
From a government policy perspective though, apprenticeships are here to stay. They remain an integral part of the white paper Skills for jobs: lifelong learning for opportunity and growth, and post-16 education and training consultations.
Accommodating off-the-job training requirements
All apprenticeships standards have been developed under the guidance that they must be sufficiently stretching. Off-the-job training must account for at least 20 per cent of the apprentice’s normal working hours over the period of the apprenticeship, and be for the purpose of achieving the knowledge, skills and behaviours required. It reinforces practical, work-based learning with technical and theoretical learning.
It is important that all employers think about how they can tailor the delivery of off-the-job training to suit their needs, and work with providers and apprentices to achieve the right blend of on- and off-the-job training to achieve high-quality outcomes.
The traditional regular day release models, where time in the workplace is frequently interspersed with training (eg one day a week), are not the only option. Other models include:
- block release, which provides longer periods in the workplace interspersed with concentrated periods of training (eg one week); and
- front-loaded models deliver a block of training at the beginning of the apprenticeship to embed core skills, knowledge and behaviours.
The increased use of technology further increases the ability for agile, blended and online learning techniques.
Apprenticeship training plans need to be aligned to business needs so that the timing of training fits to the peaks and troughs of the business cycle, enabling managers to plan resource requirements.
Are you ensuring your apprenticeship programmes are high quality?
The proportion of apprentices who complete the apprenticeship and achieve is not as high as you might think, being only 65 per cent. This figure is low when compared to full time education training programmes such as A-levels and university degrees, which have pass rates of around 90 per cent.
Appointing the right training provider is crucial to running an effective apprenticeship programme. It will determine, in large part, the quality of training provided and in some cases the level of apprentice engagement.
The Apprenticeship Standards website is useful in identifying training providers. It is important to have a clear selection process and to consider aligning levy spending to existing internal financial regulations re tendering and contracts monitoring to ensure effective corporate governance.
An unmonitored apprenticeship programme has the potential to become unwieldy, ineffective, and misaligned to business objectives. Establishing key performance indicators and a monitoring framework to assess the performance of the programme is essential, and will provide much reassurance that the programmes are progressing as expected.
Real value from apprenticeships comes from mutual benefit between the organisation and the apprentice. This can only be assured if the organisation and the apprentice know what they are working towards and can demonstrate that value.
Considering becoming an apprenticeship training provider and delivering apprenticeships yourself?
The Register of Apprenticeship Training Providers (RoATP) has recently reopened for new applications, and for existing providers to reapply. There are three types of provider:
- Main providers – Directly deliver apprenticeship training to employers who use the apprenticeship service to pay for training. Providers that meet this requirement can also provide apprenticeship training to their own employees, or to those of connected companies, and act as subcontractors for other providers.
- Employer providers – Employer providers pay the apprenticeship levy and deliver training directly, either to their own employees or to those of connected companies. They use the apprenticeship service to pay for apprenticeship training. Providers that meet this requirement can also act as subcontractors.
- Supporting providers – These providers deliver apprenticeship training under subcontracts with main providers and employer providers.
There are more than 2,000 providers from a wide range of sectors approved on RoATP for the delivery of apprenticeship training. Whilst not all are currently delivering apprenticeship training, there are 62 providers on the register associated with NHS organisations. The majority of these are in the form of employer or supporting providers.
As the health sector continues to explore workforce and training needs, could more organisations explore the possibilities of becoming an apprenticeship training provider? It is important to complete a business case to fully consider the risks and opportunities of doing so.
There are many benefits to becoming a provider and using the skills within your business, keeping the skills in house, customising the training to meet your needs and using your own funding or generating further income from others.
However, there are risks to consider, particularly in relation to the costs associated with establishing yourselves as a provider, compliance with the funding regulators, responding to changing requirements, and satisfying agencies such as Ofsted.
For further information, please see the Education and Skills Funding Agency guidance.
Questions to consider
- Have you calculated correctly, and are paying, the right amount of apprenticeship levy?
- Do you have a clear governance and advocacy structure for apprenticeship development?
- Has an apprenticeship strategy with defined objectives and business impact been developed?
- Are you making the most of the levy and ensuring that you are using the funds available?
- Are colleagues aware of how apprenticeships can be used to develop and support the business?
- Is your training provider delivering the training you really need, and to the right level of quality?
- If you can’t use the levy yourself, could you help your local community by letting another organisation use it instead?