Apprenticeship levy: more flexibility is needed

Source: NHE May/June 18

Danny Mortimer, chief executive of NHS Employers, asks for three key changes that will significantly help the health service deliver the government’s apprenticeship vision as well as the upcoming NHS workforce strategy.

Employers in the NHS would agree that apprenticeships are good for the health service and the long-term care of our patients. They have the potential to address supply challenges at all levels of the workforce – providing the right national support is in place to do so.

Apprenticeship schemes offer new opportunities for organisations to diversify their workforce as well as their available routes into registered professions such as nursing.

They also provide alternative training options for people leaving school, looking for a career change, or those who want to get on the ladder of a steady career with room to grow.

It’s now been a year since the apprenticeship levy – a key step forward for the government on apprenticeships – was introduced.

In the last 12 months, we have seen a marked increase in the range of apprenticeship standards available for healthcare-specific courses, including in higher- and degree-level apprenticeships.

While employers across the NHS are expanding their apprenticeship programmes, they are facing some specific and significant challenges unique to the health sector. Unfortunately, these challenges are preventing the most effective use of the levy and hampering the ability of employers to scale up their apprenticeship offers as rapidly as they’d like.

To help ease the impact of these challenges, and to make best use of the £200m contribution the NHS makes to the levy, we at NHS Employers have three asks on behalf of our members, which we have also set out in our response to the draft workforce strategy from Health Education England.

An extended timeframe

The first suggestion is for the government to extend the timeframe for accessing levy funds.

Of the 1.2 million staff employed in the NHS, almost half a million are in roles that did not have a relevant apprenticeship standard available when the levy was introduced in April 2017.

And there are now 19 health and science in- dustry-specific apprenticeships available and 29 more in development, which is more than double what it was when the levy was first introduced. This represents a sizeable opportunity for employers.

But a considerable amount of time has lapsed since the introduction of the levy, during which employers’ ability to invest in the workforce for the future and broaden the range of apprenticeships offered has been limited.

Allowing an interim extension of 12 months to the time that levy funds are available in digital accounts, in addition to the existing 24 months, will have a significant positive impact on the NHS’s ability to increase its apprenticeship offer.

A question of access

The second flexibility would be if levy funds were allowed to be used for infrastructure development to support the growth of apprenticeship delivery.

In scaling up apprenticeships, employers in the NHS are required to provide increasing numbers of placements and learning support in the workplace.

This is further increased by government policy to expand the number of training places available for nurses and the introduction of the nursing associate training programme, for which extensive practice supervision and assessment is required. These are typically provided by registered healthcare profes- sionals working alongside the apprentice learner.

Better value could therefore be achieved from the levy if employers in the NHS were able to use a specific proportion of the money to train those who supervise, assess and mentor apprentices.

Allowing the levy to fund backfill for protected time for those undertaking supervision and assessment of apprentices will provide a long-term return on this investment. This will enable broader use of the apprenticeship training model in the future.


The third flexibility would be if the levy could be used to support the backfill of apprenticeships with supernumerary training time. Employers in the NHS recognise the value of and support the 20% ‘off-the-job’ training that forms a key component of an apprenticeship.

However, for healthcare-specific standards such as the Nursing Degree Apprenticeship, there is a much larger ‘off-the-job’ require- ment which is considered supernumerary. The Nursing and Midwifery Council defines this as: “Supernumerary means that stu- dents will not, as part of their programme preparation, be contracted by any person or anybody to provide nursing care.”

This means that, although the apprentice will be in the workplace undertaking tasks within their competency and scope of practice, they are not able to be considered a part of the workforce that is contributing to patient care. In order to support this level of ‘off-the-job’ training, employers will need to provide backfill for these individuals.

That’s why we recommend that, for apprenticeships where there is a supernumerary or ‘off-the-job’ requirement of over 20%, NHS organisations are able to access their apprenticeship levy funds to contribute towards this additional, unexpected cost of providing backfill.

Essential flexibilities

We’ve asked for these flexibilities because employers in the NHS need some further support to deliver the ambitions of both government policy in general and the NHS workforce strategy more specifically.

We want to ensure that we are utilising apprenticeships to invest in our workforce now and for the future, and these suggested changes to policy are a key way of supporting the service and its workforce to do this.


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