Staffing is the issue keeping NHS leaders awake at night – and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, will make sure you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence

The NHS long-term plan hailed apprenticeships as an important way to widen social participation in the workforce and as a career ladder for staff wanting to develop and progress. The scheme – introduced by George Osborne in 2017 – certainly had the potential to achieve this but in reality its progress has been slow, and as reported by HSJ, trusts have struggled to take full advantage of the funding.

The government launched the scheme with a target of hitting three million new apprenticeships by 2020, but in a select committee earlier this year education minister Damian Hinds admitted this wasn’t going to be reached. According to government figures, there were over 256,000 apprenticeship starters between August 2018 and February 2019, which is still down from before the levy was introduced and from May 2015 there have been around 1.7 million starts in total.

Employers with an annual pay bill of more than £3m are required to pay a levy of 0.5 per cent to the government and can withdraw this money, with a 10 per cent top up to spend on apprenticeship training.

The catch is, this fund must be spent within 24 months, so trusts are beginning to find the funds are starting to expire, month by month.

NHS Employers has argued for some time the way levy is used needs to be changed and the organisation has been critical about the lack of flexibility offered by the government, which often prevents NHS organisations in making full use of the £200m.

For example, at the moment apprenticeship funds cannot be used to pay for ‘backfill’, which refers to people employed by the trust to cover for the apprentices released to train. Trusts also cannot use the levy to pay for apprentices’ salaries and at present only 25 per cent of the value of the scheme can be shared with other local organisations.

The Commons education committee inquiry on nursing degree apprenticeships argued this route into the NHS would forever be a “mirage” unless barriers are “torn down” and criticised the “maze of bureaucracy” faced by the NHS and employers when trying to navigate the system. It also called on the government to double the amount of time employers have to spend on the levy and prioritise continuing professional development for nurses.

However, the money announced in the recent spending review to boost CPD funding and news of plans to launch a form of student nurse financial support could have a further impact on the popularity of the apprenticeship scheme.

Shocking wake up call

Research released this week by trade union Unison has revealed the full extent of this lack of flexibility. Freedom of information requests revealed almost 80 per cent of funds held by 131 trusts remained unused – this equates to only around £55m out of a possible £256m, which has been described by Unison’s head of health Sara Gorton as a “shocking wake up call”.

“Hundreds of millions of pounds are sitting idle at a time when budgets are stretched and there are 100,000 vacancies across the NHS,” Ms Gorton said.

She called on ministers to reform the apprenticeship system to ensure money allocated to the health service stays within it, rather than be diverted elsewhere if it isn’t spent within the time limit.

Unison also called for the government to allow employers in the same location to pool their levy funds to run joint schemes. This chimes well with the current emphasis on integration, could help to build and strengthen local relationships and also make the apprenticeship training scheme more efficient.

With around 100,000 vacancies across the English NHS the government should be looking to unlock the potential of the apprenticeship scheme and in order to do this, reform is essential.

If the government truly wants to fulfil the ambitions set out in the long-term plan, the Department of Education must adapt the scheme so it works for both for the NHS and for future healthcare workers who could benefit from it.