Resolution: Nursing apprenticeships

This resolution was passed by voting members at Congress 2024.

The NHS Long Term Plan (2023) states the ‘what’ and ‘why’ needed for all those in need of its services are able to have timely access and treatment from appropriately trained staff.

What it fails to explain is the how; no additional funding and no adjustment to the use of the apprenticeship levy support the plan. The levers it describes, ‘train, retain and reform’, are therefore unachievable. However, enabling the use of the levy to support staff backfill could be transformational.

The government apprenticeship levy is a tax paid by employers. The money collected is stored in a fund which can be accessed to pay for apprenticeship learning and assessment, but crucially not salaries or backfill while apprentices are away training. The NHS is the largest contributor to the apprenticeship fund, contributing approximately £200 million. Any employer with a wage bill of over £3 million pays in 0.5% of their pay costs. A Unison survey (2019) found that 79% of NHS apprenticeship levy funds remained unused.

There are many constraints on the levy, including that it must be spent within two years or the money will ‘expire’ and be reallocated to other apprenticeships. The Education Select Committee (2018) recommended using it to fund nursing degrees, however the Government rejected the recommendations, along with an increase in the timeframe to four years. 

The NHS long-term people plan (2020) and long-term workforce plan (2023), both make reference to apprenticeships, with the workforce plan stating an aim of, “significantly increasing education and training to record levels, as well as increasing apprenticeships and alternative routes into professional roles”. Its goals include increasing the number of nursing and midwifery training places to around 58,000 and providing 22% of all training for clinical staff through apprenticeship routes by 2031/32.
Instead, there has been a 26% decrease in applications to three-year nursing degree programmes over the last two years  and over 43,000 nursing vacancies remain in England, including 10,000 in London. As of March 2023, there were over 112,000 vacancies across NHS.

There is a chronic shortage of registered nurses. Despite the bursary/financial support in both Scotland and Wales, the numbers are not significant enough to fill the vacancies. Many support workers cannot afford to self-fund through university. The apprenticeship route could be more accessible if organisations were able to utilise levy funding more flexibly. To train a registered nurse via the apprenticeship route costs 3 years of a full salary, usually at Band 3. They are fully supernumerary for the 3 years meaning their salary becomes a cost pressure, while millions of pounds of levy funds remain untouched. There is also no obligation for the employee to stay on completion of the apprenticeship.

It is imperative that appropriate access to the levy funding is remedied if we are to begin reversing the staffing crisis in nursing.

The reading list for this debate is available here.

References

House of Commons Education Committee (2018) Nursing degree apprenticeships: in poor health?. Available at: https://publications.parliament.uk/pa/cm201719/cmselect/cmeduc/1017/1017.pdf 

NHS Digital (2024) NHS Vacancy Statistics England, April 2015 - December 2023, Experimental Statistics. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey 

NHS England (2020) NHS People Plan. Available at: https://www.england.nhs.uk/ournhspeople/

NHS England (2023) NHS Long Term Workforce Plan. Available at: https://www.england.nhs.uk/long-read/nhs-long-term-workforce-plan-2/ 

Rolewicz, L, Palmer, B, and Lobont, C (2024) The NHS workforce in numbers. Available at: https://www.nuffieldtrust.org.uk/resource/the-nhs-workforce-in-numbers

Royal College of Nursing (2024) ‘Emergency package of measures’ needed following collapse in nursing applicants, RCN tells government. Available at: https://www.rcn.org.uk/news-and-events/Press-Releases/emergency-package-of-measures-needed-following-collapse-in-nursing-applicants-rcn-tells-government

Unison (2019) It doesn’t add up: the apprenticeship levy and the NHS. Available at: https://www.unison.org.uk/content/uploads/2019/11/It-doesnt-add-up-report-1.pdf ‘Emergency package of measures’ needed following collapse in nursing applicants, RCN tells government