Maximising the mutually beneficial value of apprenticeships in acute care

East and North Hertfordshire Trust is putting new recruits, and many existing staff, through an apprenticeship scheme which is designed to boost their qualifications, improve career prospects and ultimately improve patient care.

Since August 2009, the trust has recruited 266 staff to its apprenticeship scheme. Initially, it worked with the Prince’s Trust to offer, first, work experience and then a one-year apprenticeship to young people who were not in work, education or training – the so-called NEETs. Ten young people recruited through this were a part of the first intake of apprentices.

But apprenticeship has spread to become the normal method of entry for band two clinical support workers. They are given a one-year fixed term apprenticeship with the prospect of a substantive post if they successfully complete this. Some staff in non-clinical departments are now being recruited on to apprenticeships as well.

Knowledge base

For many support workers it means they get a “transferable” qualification which would be recognised elsewhere and gives them a greater knowledge base than other programmes.

“It always concerned me that we were not giving these people a national qualification so if their family moved for whatever reason, they could go to a different hospital and say these are the skills that I have,” says Freda Kelly, deputy director of nurse training, education and research. “In the past we were not giving them the underpinning knowledge and theory that they needed.”

Apprentices are paid the standard Agenda for Change rate for their jobs – they are by no means cheap labour. The academic component of the qualification involves local college and training from an external company.

Initial recruits tended to be young people but as the recession hit there has been a shift towards more older people keen to start a career in the NHS.

So what are the benefits for the trust? By insisting that apprentices reach level one in maths and English, it is ensuring that they have skills which will help them take on more advanced tasks and are important for good patient care and record keeping. Unlike the old system of simply offering NVQs, the apprentices are getting greater technical knowledge as well as hands-on skills.

Offering them a clear career pathway is likely to encourage retention. Fall out from the scheme has been relatively low – of the first wave of 18 apprentices recruited in August 2009, 15 went onto take up a permanent post. A handful don’t complete for personal reasons and some find the academic side challenging.

Higher qualifications

But many have been keen to advance their qualifications further – three of the first batch of “graduates” from the scheme are now working towards higher qualifications at level three with the prospect of going on to a foundation degree.

And eventually they will play a part in delivering care differently. Equipped with their new skills and underpinning knowledge, they will deliver care which might in the past have been done by registered staff. In the future, this care may end up being provided in different settings where staff have to be skilled and confident enough to work independently.

Jacqui Attrill, the trust’s professional development and recruitment nurse, says: “We are providing a better service because we are training the staff appropriately to deliver the care.”

Jane Fox, who leads on apprenticeships for Skills for Health, says that apprentice schemes “are not a flash in the pan – they are here to stay.”

The Department for Business, Innovation and Skills recently published a specification of apprenticeship standards for England. This lays down standards which schemes must meet – including a “good standard” of literacy and numeracy and at least 280 hours of guided learning a year. It also stresses the role of higher level apprenticeship schemes, effectively creating a development route for people who enter lower level schemes with few qualifications.

Ms Fox says take-up of schemes in the NHS has been good. Of about 8,000 people employed on apprentice schemes half have been in clinical roles and half elsewhere in the organisation, and there has been a similar split between new employees and existing ones who have transferred on to an apprenticeship scheme. hey can help employers address hard-to-fill vacancies and support clinical governance.

“It is very much being seen as one of the key routes…apprenticeships are job focused, competency driven and support the acquisition of skills and knowledge, and they also offer an opportunity to progress,” she says.