Well, it finally happened. Level 7 apprenticeship funding will disappear for all but a very limited number of younger people from January 2026.
The shift in focus from level 7 to funding more training for those aged 21 and under seems laudable – and of course we all want opportunities for young people – but will it solve or create more problems for the health and social care workforce?
The introduction of foundation apprenticeships, aimed at bringing 16- to 21-year-olds into the workforce, includes health and social care. Offering employer incentives should be a good thing, right?
Care is not merely a job
Of course we need to widen opportunities for careers in health and social care, one of the guaranteed growth industries for the foreseeable future regardless of the current funding challenges. But the association of foundation apprenticeships with those not in education, employment or training (NEETs) gives the wrong impression of the importance of high-quality care for the most vulnerable sectors of our society.
Delivering personal care, being an effective advocate, or dealing with challenging behaviours in high pressured environments requires a level of skill, professionalism and confidence that should not be incentivised as simply a route out of unemployment.
Employers and education providers invest significant time and energy in crafting a workforce that can deliver values-based care, regardless of the care setting. Care is not merely a job: it’s a vocation that needs to be held in high esteem, otherwise we risk demeaning those that need our care and protection.
There are already a successful suite of apprenticeships leading to careers in health and social care, which the NHS in particular makes good use of. Social care providers (generally smaller employers) report challenges in funding or managing apprenticeships, but there are excellent examples of where this is working well.
So, do we need something at foundation level? How does that align with T level or level 2 apprenticeship experiences? If these pathways already exist and numbers are disappointing, why bring another product onto the market? And are we sending the correct message to the wider public about the value of careers in health and social care?
Career moves
The removal of funding for level 7 apprenticeships serves as a threat to the existing career development framework – and it may yet backfire on foundation or level 2 apprenticeships. The opportunity to develop practitioners into enhanced or advanced roles in the NHS is not only critical to the delivery of health services in the future, but it also offers a career development and skills escalator mechanism.
By removing this natural progression, the NHS will see role stagnation – which threatens workforce retention. We know that the opportunity to develop new skills or move into advanced roles is a significant motivator for employees.
If senior practitioners are not able to move up, out or across into new roles, how will those entering at lower levels advance? Where are the career prospects that the NHS has spent years developing and honing? Although we are still awaiting the outcome of the consultation around the 10-year plan – due for publication this week with revisions to the long-term workforce plan to follow – I feel confident in predicting that we will need new roles or skill sets to successfully deliver care.
So, if no development is happening through level 7 apprenticeships, where is the money going to come from? The NHS has been suggesting that there will be alternative funding streams for some level 7 qualifications, but this is unlikely to offer employers the flexibility or choice they had through the levy.
Could level 6 be next?
Degree apprenticeships at level 6 have also come in for some criticism about the demographics of those securing apprenticeship opportunities and how this has impacted opportunities for younger learners – an extrapolation of the arguments that were made against level 7 courses.
Recent changes to the apprenticeship funding rules, requirements of off the job training and the anticipated changes to end-point assessment could lead to pre-registration apprenticeships in nursing and allied health being deemed no longer in line with the policy intent because of the regulatory requirements associated with them.
The workforce plan of 2023 outlined the need for significant growth of the health and social care workforce, an ambition that probably is still true although how and when this will happen may change. Research conducted by the University of Derby and University Alliance demonstrated some of the significant successes associated with apprenticeship schemes in the NHS, but also highlighted some of the challenges. Even with changes to apprenticeship policy, these challenges will not disappear.
Our research also highlighted challenges associated with the bureaucracy of apprenticeships, the need for stronger relationships between employers and providers, flexibility in how the levy is used to build capacity and how awareness of the apprenticeship “brand” needs to be promoted.
A core feature of workforce development
The security of our future health and social care workforce lies in careers being built from the ground up, regardless of whether career development is funded by individuals themselves or via apprenticeships. However, the transformative nature of apprenticeships, the associated social mobility, the organisational benefits and the drive to deliver high quality care in multiple settings means that we should not be quick to walk further away from the apprenticeship model.
Offering apprenticeships at higher (and all) academic levels is critical to delivering high quality care and encouraging people to remain engaged in the sector.
So, as Skills England start to roll out change, it is crucial that both the NHS and higher education remain close to policymakers, supporting and challenging decisions being made. While there are challenges, these can be overcome or worked through. The solutions arrived at may not always be easy, but they have to be evidence-based and fully focused on the need to deliver a health and social care workforce of which the UK can be proud.
