What providers need to know about health and care apprenticeships

Demand for health and care apprenticeships is set to soar, yet providers seem unprepared to grasp these business opportunities, says Sally Garbett

The 2013 Cavendish Review identified significant weaknesses in induction training for 1.3 million healthcare workers delivering the bulk of hands-on care. This led to the introduction of the Care Certificate, which now forms a crucial first stage of the trailblazer health apprenticeships.

Demand for these apprenticeships is set to increase significantly, given that 23 per cent of all new jobs (that’s almost 320,000) are expected to be in health or adult care by 2022 – according to the City and Guilds Great Expectations report. But are providers ready to meet this demand?

The new health standards have been available for implementation since February 2017 and although the funding allocations to colleges and providers were lower than expected, money started thumping into levy accounts in May. So why are several of the colleges I have spoken with lately not going to be ready to deliver these health apprenticeships until September?

We need providers who can deliver what we need in the way we need it

Is it possible that problems in provider understanding might be delaying implementation of these standards?

The health apprenticeship standards are central to the new Health Education England career pathway from health care assistant to registered nurse (see the HEE report ‘Raising the bar: Shape of Caring’) and will include new nursing associate and registered nurse apprenticeships by September 2017.

The healthcare apprenticeships at levels two, three and five are part of this career pathway and the future healthcare workforce depends in part on their availability.

The apprenticeship must be delivered in the way we need, not the way the college or provider prefers. This requires a partnership with us, with the employer delivering some of the teaching and assessment and being paid for that as a subcontractor.

But provider understanding is patchy: in recent weeks in my work across England I have spoken with a provider who told me that the level three senior healthcare support worker apprenticeship took 15 months – but the standard suggests 18 to 24. I met with a college that suggested part-time apprenticeships were not allowed; another who insisted the employer could not choose the qualification they wanted in the level two healthcare support worker standard, which they can, as none is specified. One provider made no mention of the Care Certificate, a key component of the health apprenticeships.

As the vocational programmes manager for St Christopher’s Hospice, a levy-paying employer-provider, apprenticeship delivery partnerships are of paramount importance.

The primary function of St Christopher’s Hospice is of course to provide skilled, compassionate end-of-life care but we, like many other hospices, also deliver education and as charitable organisations we have a heightened responsibility to use our levy wisely. To do so, we need providers that are able to work with us.

We need providers who can deliver what we need in the way we need it. We need providers who are flexible and able to work with us to develop meaningful delivery models that include off and near-the-job learning.

We need quality approaches that cover the entire apprenticeship standard, not just the qualification within it, so that those who achieve the apprenticeship can carry out the job role it was developed to support.

St Christopher’s has an established relationship with our local college; we co-deliver apprenticeships. Our clinical staff are dual professionals – healthcare professionals with teaching and assessment qualifications, so there is no problem with due diligence or contractual arrangements.

The partnership is not without challenge but we work together to resolve problems. If our college can do this, so can many more.

Let’s start a dialogue to open channels of communication and work better together. Our future nursing workforce may depend on it.

Sally welcomes your comments and can be reached here.


Sally Garbett is vocational programmes manager at St Christopher’s Hospice

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  1. This employer view should be put to Keith Smith of the EFSA who clearly said at the AELP conference that subcontracting to employers is a direct risk to providers contracts – is it employers ownership or government directed? clarity would be most welcome

  2. Chris

    Very good article and great to see the issues raised, and the partnership sounds very beneficial for both parties.

    I have to raise a couple of points in defence of FE Colleges, like mine, who are in a process of negotiation with our health partners due to new procurement procedures. Personally I don’t feel the procurement process agrees the best quality delivery, I have trusts who need to obtain 3 quotes for any training over 10k as an example! Equally the 20% off the job training is seen as a barrier to front line services, despite the fact that they urgently require good quality staff and training, and this can be delivered flexibly to meet the individual requirements of each organisation.

    Partnerships should be standard process, but health partners need to involve colleges more on their widening participation plans and stakeholder discussions to agree outcomes, especially against the 5 year forward view and local STP agendas. I have excellent relationships with local trusts which we have built together over time, but now the decision on delivery is out of the hands of staff and in the control of centralised teams, based on costs and tenders rather than existing relationships. Equally, we are ready to deliver standards but have been told to wait for September starts due to procurement process?!

    It is becoming more and more difficult to get decisions made and agree future working partnerships but all this said, I’m not disagreeing with their process. This is the new world of levy delivery and we expected this to happen. Lets just hope other health care institutions welcome partnership working similar to this article in future, perhaps after procurement contracts have been agreed?

  3. Private training providers have been the main engine house for health and care apprenticeships. Most of these apprenticeships have been for 19+ adults. An apparent lack of preparedness can be linked to the significant challenges that have been thrown at providers and colleges in dealing with “system short-comings and naivety/incompetence” of government/departments associated with the implementation of the new apprentice agenda. These cannot be over stated and have made strategic planning almost impossible.

    Whilst we will hopefully see some progress now being made, the fact remains that many training providers supporting adult care still have significant concerns regarding the viability of supporting the new Apprenticeship standards. There are several reasons for this view:

    • The £3000 Funding bands approved represent a significant reduction in funding available for the new adult apprenticeships. In addition, most programme funding previously supported a 12-month programme. This reduced level of funding is now expected to support a 16 -24-month programme effectively diluting the funding by up to a further 50%.

    • The end-point assessment (EPA) costs are still emerging but early indications are that when combined with the awarding body fees, these could take up to a third of the available government funding away from providers.

    • The training provider will also have to undertake a significant amount of extra EPA work previously not required. This will include supporting and monitoring the learners with EPA project work, coaching and supporting preparation for online EPA tests/resits and invigilation of these, supporting preparation for professional discussions. No doubt over time providers will respond positively and develop flexible and effective methods to reduce the impact of these cost issues. But do they have the time!

    • The 20% paid time off to undertake an apprenticeship over a period of up to 24 months is unlikely to be attractive to employers being asked to release their adult employees who are already being paid the full going rate for the job they undertake. Indeed, where they are released from normal work duties to undertake the programme, employers have a double whammy of also having to pay for the staff cover. Adult care apprenticeships are rarely undertaken with day release to attend studies, but even if they were, the full day release offered by colleges would only account for some 30 days leaving a further up to 64 days to be paid and accounted for. If the apprentice requires to undertake functional skills then the time off to undertake these is additional to the above days. Can anybody justify the need for this in relation to an adult already employed in the job?

    • Employer cash fee contribution requirements rightly or wrongly does drive behaviour in this sector. Care providers are suffering government funding restrictions which are so challenging that the mere mention of them can lose a Prime Minster their job! This will add to the uncertainty for training providers in planning future volumes etc.

    This is a good article Sally from a Levy paying employer perspective. Further I do see the new Standards as a real opportunity to embrace 16-18-year olds into the adult care sector. But there are real issues for the majority of the sector employers who are SME sized and not Levy payers, and are facing enormous budget and organisational pressures.

    Given the above, it is inevitable that at best there is a tardy start to the new brave world of Apprenticeships. More dramatically it is possible that a significant drop in the number of adult care Apprenticeships is experienced. Many employers may now be exploring how they can support their staff in different ways. Some may explore how they can assist their staff doing Level 3+ qualifications utilising Advance Learner Loans rather than Apprenticeships. This gives both the learner and the employer what they want in a much short time than a new Apprenticeship Standard containing that qualification.

  4. I think she doesn’t really know what she is talking about. The Apprenticeship reforms are going to kill demand in the Care sector stone dead, particularly in the SME area and at lower level of Apprenticeships. Under current Care sector funding restraints, employers cannot afford to a) pay a mandatory contribution and then b) effectively lose the Apprentice from front line Care delivery for one day a week for up to 18 months in order to meet the 20% rule. Most Levy employers are using their pot to upskill at L5 and above, starts at L2 and L3 will fall off a cliff, if they haven’t already in the last 2 months.

    • Blue Boy

      I feel like Edward Everett Phil. He delivered a two-hour speech at the Gettysburg National Cemetery — but most people only remember the two-minute speech given by President Abraham Lincoln afterwards!