Proposals to dramatically expand the use of apprenticeships to train nurses and other health workers in England’s NHS have been met with caution by nursing leaders.
NHS England chief executive Amanda Pritchard has revealed that apprenticeships will play a greater role going forwards in trying to address current staffing shortages in the health service.
“Anything else will risk jeopardising the position of registered nursing as a graduate profession”
While appearing to promise an increase in traditional nurse university places, she also said that apprenticeships would be used to train potentially “tens of thousands” of nurses and doctors over the coming years.
Ms Pritchard said it formed part of a “radical new approach” that would be outlined in the upcoming and long-awaited NHS workforce plan, due to be published this summer.
Further investigation by the PA news agency has suggested that up to one in 10 doctors and a third of nurses could be trained through the apprenticeship route in future.
Ms Pritchard’s comments come after Unison head of health Sara Gorton told Nursing Times in April that she was “expecting the [upcoming NHS long-term] workforce strategy to lead to a rapid expansion of degree-level apprenticeships”.
Speaking during a school visit last Friday, NHS England leader Ms Pritchard said: “One thing is clear, the NHS is nothing without its staff.
“That is why with more than 124,000 vacancies across the workforce, we know we need to increase training places in universities so more of our brightest and best can train to become doctors or nurses.
“But university isn’t right for every school-leaver and some young people want to start earning straight away, while others may decide on a career in health care later in life,” she said.
“So the NHS is looking to expand apprenticeship schemes over the coming years, offering a different route into the NHS where students can earn while they learn, instead of going through the university route.
“This radical new approach could see tens of thousands of school-leavers becoming doctors and nurses, or other key healthcare roles, after being trained on the job over the next 25 years,” she added.
However, responding to Ms Pritchard’s comments, Professor Nicola Ranger, director of nursing at the Royal College of Nursing, called for caution over expanding nurse apprenticeships.
Instead, she said apprenticeships should play only a “limited” role in nurse training and that university-based education needed to remain the main route to becoming a registered nurse.
“When the formal workforce plan comes this summer, we expect to see a funded expansion of nursing’s place in university,” said Professor Ranger.
“Anything else will risk jeopardising the position of registered nursing as a graduate profession,” she warned.
“All the research shows that patient outcomes greatly improve when in the care of the right number of degree-educated nurses.
“The apprenticeship route must be limited and not come at the expense of university-based nursing graduates,” she said.
Since 2013, nursing in the UK has been a graduate-entry only profession, meaning a degree must be completed to become a registered nurse – a move that recognises the advancing role and status of nurses.
The degree-level nurse apprenticeship was launched in England in 2017, which allows nurses to work and earn while they train.
Nurse apprentices must meet the same requirements as other student nurses by completing 2,300 hours of off-the-job theory learning and 2,300 hours of practice learning in order to register, as per Nursing and Midwifery Council rules.
As of May 2022, around 6,000 nurses had either trained or begun training via the apprenticeship route in England.
Meanwhile, in September this year, the NHS will launch a new doctor apprenticeship scheme.
The newly agreed NHS pay deal in England is set to bring in greater pay protections for existing health service staff who choose to take on an apprenticeship.
The deal includes a commitment for “amendments to terms and conditions to ensure that existing NHS staff will not suffer a detriment to their basic pay when they undertake apprenticeships”.
Commenting on Ms Pritchard’s new plans, Unison health of health Ms Gorton said: “Apprenticeships are a valuable way to grow the workforce, allowing more health workers to study for nursing degrees alongside their work.
“But it is crucial staff are properly paid and supported during their studies and on the wards, otherwise many could leave before they graduate.
“The newly agreed NHS pay deal should make it easier for existing staff like healthcare assistants to access apprenticeships, build on their skills and train to become nurses.
“But for this to become a reality, the workforce plan must be published and properly funded,” she noted.
Vanessa Wilson, chief executive of University Alliance, which represents some universities that train nurses, backed degree-level apprenticeships.
She said: “Degree apprenticeships are delivered by universities in partnership with the NHS, and they are a high-quality option for training highly-skilled medical professionals.
“But for this to become a reality, the workforce plan must be published and properly funded”
“This is not an ‘either-or’ situation where students will have to choose between developing high-level skills at university or studying an apprenticeship: degree apprenticeships do both.”
However, she said there were “challenges” to expanding NHS apprenticeships, including “excessive bureaucracy” and “complex regulation”.
“Government and NHS England will have to work very closely with universities to address these issues if degree apprenticeships are going to be the solution to the NHS workforce crisis,” said Ms Wilson.
Similar concerns over costs and rules being a barrier to nurse apprenticeships have been raised by others in the past, as previously reported by Nursing Times.