Financial barriers and placement capacity issues are limiting the use and growth of nursing apprenticeships, new research has warned.
And it suggested that planned funding cuts to Level 7 apprenticeships – which cover nursing specialties such as general practice nursing and district nursing – risk ‘reducing opportunities for career advancement’.
The report, from the University Alliance and the University of Derby and published during National Apprenticeship Week, highlights several financial constraints and disincentives and issues with capacity and support, as well as coordination challenges between employers and education providers.
It draws on existing evidence, a survey and in-depth qualitative interviews of current and former apprentices, alongside employers and staff at higher education institutions.
And it explores the targets and ambitions set out in the 2023 NHS Long Term Workforce Plan – which suggested the number of registered nurses qualifying through apprenticeship routes should increase from 9% to 20% by 2028/29.
Level 7 apprenticeship changes
Significantly, the report noted plans by Prime Minister Sir Keir Starmer to move Level 7 apprenticeships outside the scope of levy funding, meaning individual businesses would be required to fund more of these apprenticeships – such as GPNs – themselves.
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‘These changes could impact sectors reliant on level 7 apprenticeships, potentially reducing opportunities for career advancement within the apprenticeship framework,’ the report warned.
As a definitive policy change around Level 7 apprenticeships is yet to be confirmed, researchers warned the situation was impacting commercial decision making and recommended that Level 7 apprenticeships are retained for ‘skills and roles in demand’.
Last year, nurse leaders and educators warned the proposed funding change would majorly impact specialist nurse training and risked derailing recruitment.
Financial and capacity constraints
Researchers found that financial barriers were ‘a major issue’ that was ‘limiting the wider use of apprenticeships in healthcare’.
It claimed that ‘many’ NHS trusts ‘can’t fully support apprentices due to budget limits and the lack of funds to cover staff backfill’.
‘Employers also struggle to balance apprenticeship costs with keeping their workforce operational, as apprenticeships require resources that are already stretched,’ it added.
In addition, the report found that capacity issues, especially around the provision of ‘quality’ clinical placements, was limiting the ‘growth’ of healthcare apprenticeships.
‘With limited apprenticeship placement opportunities, choices must be made on which students to prioritise,’ the report said, adding that employers also struggled to ‘accommodate apprentices due to the shortage of suitable learning environments’.
Technology was also cited as another barrier, ‘with many employers lacking the tools to manage apprenticeship programmes efficiently’.
The Royal College of Nursing’s executive director for England, Patricia Marquis, said: ‘The reality is that in order to recruit the highly skilled nurses we need at scale and speed, the government must deliver new investment in nursing education, in both apprenticeships and traditional degrees.’
Ms Marquis said this should include changes to the apprenticeship levy to ensure it covered the ‘full cost’ of providing a nursing apprenticeship.
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Dr Denise Baker, chair of the University Alliance Deans of Health Network, and pro vice-chancellor and dean of the College of Health, Psychology, and Social Care at the University of Derby, said: ‘Our new report highlights that there are still significant challenges that are hindering their expansion: whether it be a lack of capacity for delivering placements, or an off-putting number of burdensome regulations and financial disincentives for employers and educators.
‘As one of the authors of the report, I hope policymakers who wish to make the most of the [NHS Long Term] Workforce Plan’s promise to expand the healthcare workforce take heed of the report’s insights and recommendations,’ she said.
Key policy recommendations from the report:
- increasing flexibility in the apprenticeship and skills levy to cover backfill, supervision, and other related costs for healthcare organisations;
- fairer distribution of apprenticeship funding across regions and specialties;
- retaining level 7 apprenticeships for skills and roles in demand.
For better employer-education partnerships, by:
- fostering early collaboration between employers and education providers to define roles, expectations, and responsibilities;
- designating a dedicated Higher Education Institution (HEI) contact to streamline communication with and support for employers;
- improving communication and collaboration between employers and higher education institutions to focus on providing conjoined support for apprentices.
Increased capacity building, including:
- investment in infrastructure to increase clinical placements and dedicated support roles for apprentices;
- streamlining regulations and offering clearer guidance to reduce the administrative burden on employers and providers;
- increasing resources for clinical supervisors to enable effective mentorship while managing workload;
- upgrading technology and platforms within higher education institutions and employer partners to support apprenticeship management and placements.
Improved public awareness and perception of degree apprenticeships, including through:
- promoting apprenticeships as valuable healthcare career pathways through public and media campaigns;
- partnering with schools to present apprenticeships as viable alternatives to traditional routes, and including successful apprentices in outreach efforts to build credibility and inspire new entrants.
Improved policy coordination, by:
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- improving coordination between government departments in healthcare, education, and employment for cohesive policymaking;
- aligning apprenticeship policies with government workforce plans or strategies to address future workforce needs;
- promoting a sustained and long-term plan and commitment towards growing apprenticeships, rather than short term plans.
