Degree-level nurse apprenticeships that were originally intended to start this month have been largely delayed until 2018 at the earliest, amid claims that employers are struggling to support new training routes designed to ease workforce shortages.
Nursing Times has learnt that just two universities in England have so far been approved by the Nursing and Midwifery Council to run the first ever registered nurse apprenticeship programmes, a flagship policy that the government hoped to see introduced from September 2017.
“We are concerned about potential delays to the roll-out of the scheme”
The two higher education providers, the Open University and Anglia Ruskin University, expect to see a maximum of 46 apprentice nurses begin training with local employers this month.
The Open University said it had agreed with an NHS trust in the North West of England to start training five or six people during September – but it expected up to 150 further apprentice nurses to begin in February 2018 with employers in 10 regions across the country.
Meanwhile, Anglia Ruskin said it was recruiting two groups of between 10 and 20 apprentice nurses from employers in Essex and Cambridgeshire to start this month, but did not expect to train more until September next year.
“It is impossible to predict how many nurses will come through the apprenticeship route in the future”
In addition, among four universities that were provided with cash last year by the Higher Education Funding Council for England (HEFCE) to develop nurse apprenticeships, three have confirmed they will not be offering programmes until 2018.
Greenwich University said it expected to begin apprenticeships in a years’ time, while it is understood that Sunderland University does not expect to start programmes until 2018 at the earliest.
Derby University, meanwhile, said it planned to offer apprenticeship training from March 2018. Gloucestershire University was unable to confirm its plans to Nursing Times.
A range of factors have been blamed for contributing to the setbacks. Confusion over how to use the new levy funding system for apprenticeships, too little time to recruit apprentices over the summer since the assessment guidance was finalised in May, and the added requirement to support training for other new roles, such as nursing associates, have all contributed, it has been claimed.
HEFCE’s senior policy advisor, Dr Brooke Storer-Church, also said the body was aware that “broader healthcare budget pressures and uncertainties around placement numbers are two of many tensions within this system that may be having an influence”.
“Ministers should be hanging their heads in shame”
The Royal College of Nursing accused the government of trying to introduce the apprenticeship initiative during a period of “crisis” for nursing and claimed it had in fact increased pressure on the workforce.
“Many NHS trusts are still trying to get to grips with the introduction of trainee nursing associates,” said Anne Corrin, RCN head of professional learning and development.
“This new apprenticeship initiative puts added pressure on the current workforce to understand and provide support for yet another entry route into nursing,” she told Nursing Times.
But, in the wake of the scrapping of bursaries for nursing degrees, another union warned that delays to apprenticeships would prove “devastating” to aspiring nurses who are unable to afford the fees for university courses.
- Nurse apprenticeships to begin in September 2017
- Ministers set target to increase NHS apprenticeships
- Government announces apprentice plan to boost nursing careers
“The government said nursing apprenticeships would be up and running by the autumn. But promises are very easily broken it seems,” said Unison national officer Helga Pile.
“Many aspiring nurses, priced out of the profession by the removal of the bursary and the introduction of fees, will be devastated at the delay,” she said.
“With uncertainty about when and even if apprenticeships will come on stream, and the extra traditional nursing places pledged also failing to materialise, ministers should be hanging their heads in shame,” she said. “Without new recruits, the NHS staffing crisis is set to get a whole lot worse.”
Concerns have also been raised about the cost to employers, who have to provide a salary for apprentices that spend part of their time working – usually as a healthcare assistant – and the rest in training, at university or on placements.
“We expect the scheme to grow in 2018 as employers familiarise themselves with the new system”
Department of Health
Ms Pile said: “The high cost is also likely to be putting many cash-strapped trusts off. Employers who would want to recruit and train their own staff are clearly worried that the apprenticeship levy doesn’t stretch to cover salaries, and so are hanging back.”
The NHS Employers organisation, which represents trusts, acknowledged that only a “limited” number of universities were able to support apprentice nurses at this stage.
In addition, it also confirmed that discussions on how much apprentice nurses should be paid by the NHS were unlikely to come to an end before programmes started this month.
As an interim measure, NHS organisations are being advised to pay apprentices band 3 wages – £16,968 – unless staff are already working within the organisation and, therefore, their salary should be kept the same, up to the top of band 4.
“Subsequent years would be subject to the conclusion of discussions around pay for the nurse apprenticeship,” said NHS Employers.
The organisation also warned of future delays to a national roll-out of the initiative due to universities potentially waiting for new pre-registration education standards to be finalised by the NMC. But it highlighted that, despite these factors, more apprenticeships were expected in spring 2018.
“We recognise that only a limited number of universities are so far able to offer nurse apprentice places, and we are concerned about potential delays to the roll-out of the scheme,” said Danny Mortimer, chief executive of NHS Employers.
“However, it is important to note that we believe we will see a major increase in the number of nursing apprenticeships being offered from March next year,” he told Nursing Times.
“Employers have told us there is a real desire to offer these apprenticeships as a way to strengthen the nursing workforce, forming part of their workforce plans for next year,” he said. “But as with any new development, there will be some challenges along the way.”
Mr Mortimer added that it was important to ensure employers could support apprentice nurses and that universities taking part in the initiative “must become more widespread”.
The Council of Deans of Health, which represents UK university nursing departments, said it was not possible to know how many nurses would be trained through apprenticeships, but stressed that at least 12 further universities planned to offer the programmes.
Council of Deans executive director Dr Katerina Kolyva said: “It is impossible to predict how many nurses will come through the apprenticeship route in the future.
“Employers will choose how to spend their apprenticeship levy, individuals will have to decide which route best suits their needs and universities will come to their own conclusions about their participation in apprenticeship delivery,” she said.
“We do know that at least a dozen universities are seeking NMC approval for apprenticeship delivery in early 2018,” she added.
The universities that Nursing Times spoke with said they expected more apprentices would be recruited in 2018 but, despite this, some noted the training route was unlikely to significantly reduce the workforce shortage.
Julie Messenger, head of nursing at the Open University, acknowledged the expected intake of 150 apprentice nurses in February – in the mental health and adult fields of nursing – would effectively replace those that would usually be recruited in the autumn.
Nursing and Midwifery Council
“It is probably more likely that apprenticeships will increase the variety of routes rather than the number of nurses,” said Ms Messenger.
“I hope that the numbers though apprenticeships across England do grow significantly and increase capacity but I see it as an alternative route,” she added.
She noted that her university had been running work-based nursing degree programmes – that were effectively apprenticeships – for around 15 years, with an important benefit being that employers found the training format helped retain staff.
At Anglia Ruskin University, which plans to support up to 40 apprentices in adult, children’s and mental health nursing this September, course leaders said they expected to train more in the future.
“We are working closely with all our employer partners but some are further along than others for this September,” said Professor Ruth Taylor, dean of the faculty of health, social care and education at Anglia Ruskin. “We are anticipating the number of people that will come forward will increase – and I expect that will be the same across England.”
But while older staff – who may have been put off by traditional degrees due to the removal of bursaries – were showing a lot of interest in apprenticeships, Professor Taylor agreed it was unlikely enough apprentices could be trained to plug gaps in the nurse workforce.
“We see this as a complementary approach, building some numbers,” she said. “For me, there is no getting away from the fact that a three-year undergraduate programme is going to be the route that brings in the most number of registrants at the end of the day.”
She added: “We are concerned at the downturn in the number of applications to our nursing courses, particularly mature students.”
A Department of Health spokeswoman said: “Our new nursing apprenticeship scheme opens opportunities for people from all backgrounds with the right skills and values to become a nurse in our world-leading NHS.
“The first apprentices will begin their studies in September, and we expect the scheme to grow in 2018 as employers familiarise themselves with the new system and begin to work more closely with Universities,” she said.