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The government’s tin ear on nurse apprenticeship funding puts a golden recruitment opportunity at risk

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Gain the knowledge and skills you need to become a registered nurse while earning a salary and getting practical experience at the same time – what more could you ask for?

Formerly the territory of manual labour professions, the government introduced a nurse degree apprenticeship in 2017, which conveniently coincided with the scrapping of the bursary.

It’s been a hot topic this week, not least because it’s National Apprenticeship Week.

But also because the government issued a statement on nurse degree apprenticeships that has riled a few people. No prizes for guessing what it was about. Yup, money.

“Recent debate has focused around the burden on employers”

There’s no doubt that apprenticeships provide an enticing offer for aspiring nurses, but recent debate has focused around the burden on employers.

You may have heard the term “apprenticeship levy” blurted out in rage or muttered in a sigh of frustration – but what is it?

On the surface it’s a great idea. The government collects tax from employers meeting certain criteria and this goes into a big pot of cash, which is then redistributed to those who want to train apprentices.

As the largest employer in England, the NHS makes a significant contribution to the levy – some £200m a year.

To use the entirety of this, it would have to employ 27,500 apprentices annually, but it currently only recruits around 20,000. The degree nurse apprenticeship was introduced as part of ambitions to increase this.

However, in November last year, a group of cross-party MPs in the Education Committee highlighted that take-up of nurse apprenticeships was falling way behind target.

They warned that inflexibility around the use of the levy – which can only be used to fund the training and assessment of apprentices and not associated costs – was a major barrier to success.

They proposed to the government that nurse apprenticeships should be made a “special case”, given the “uniqueness” of the programme.

For example, nurse apprentices are required by the Nursing and Midwifery Council to spend 50% of their contracted hours in off-the-job training – way higher than the 20% minimum for other apprentices.

And because they are granted supernumerary status, even when nurse apprentices are in clinical practice employers must spend money on backfilling them with another worker because they cannot be counted in safe staffing numbers.

When salary, mentoring and supervision are factored in, the cost of training a registered nurse through a four-year apprenticeship tallies up to £137,392 – and only £27,000 of that is covered by the levy.

Given that NHS providers were £900m in the red last year, this an investment that cannot be taken lightly.

No wonder the MPs argued that employers had “little incentive” to develop nurse apprentices under the current system.

This was backed up by NHS England when it stated in its long-term plan in January that “the terms of the levy may need to change if the NHS is to provide opportunities to more clinical staff in future”.

Despite the compelling evidence for change, the government this week refused to budge on the levy policy, claiming that to do so would “quickly make the programme unaffordable”.

Unsurprisingly, this didn’t go down well in some circles.

Danny Mortimer, chief executive of NHS Employers, branded the response “hugely disappointing” and contended that trusts were being “priced out” of using nurse apprenticeships.

“The apprenticeship has the potential to widen participation in nursing and win back those who have been put off joining the profession”

While Labour’s shadow apprenticeships minster Gordon Marsden told a group of nursing associates at the University of East London this week that policy in this area should not be rolled out like products from Willy Wonka and the Chocolate Factory but rather should be fit for purpose for each sector.

The loss of the bursary led to applications for nursing degrees plummeting by a third and means nurse education now comes with a hefty price tag that some people just can’t afford.

The apprenticeship has the potential to widen participation in nursing and win back those who have been put off joining the profession by the prospect of taking on a loan.

But I fear that by refusing to listen to the concerns of those on the ground delivering them, the government will miss a golden opportunity to repair some of the damage done by the funding reforms and secure apprenticeships as a viable and prosperous pathway into nursing.

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