SOMERSET PARTNERSHIP NHS FOUNDATION TRUST APPRENTICESHIPS IN SOMERSET PARTNERSHIP NHS FOUNDATION TRUST Report to the Trust Board 28 March 2017 Sponsoring Director: Author: Purpose of the report: Director of Workforce and Organisational Development. Director of Workforce and Organisational Development. To update Trust Board members on the: the existing position of the Trust in respect of the employment of apprentices; the changing context relating to apprentice employment driven by new legislation and the introduction of the apprenticeship levy, and in light of this to outline; a simple revised strategy for the implementation of apprenticeships to help tackle our future workforce challenges. Key Issues and Recommendations: A national employer levy (0.4% of annual paybill) will be introduced in April 2017 to support the Government s vision to deliver three million apprenticeships by 2020. In line with the Enterprise Act 2016 the public sector requirement is for new apprenticeships to equate to 2.3% of headcount (including bank staff). Based on current headcount the statutory requirement would necessitate a need to enroll a minimum of 101 apprentices per year. Our work with apprentices has been recognised by Health Education England and locally Bridgwater College have identified us as an apprentice employer of choice, indeed we recently won the award for Apprenticeship Employer of the Year 2016. This provides us with opportunities for attracting and recruiting high-quality apprentices in a post- Levy climate where industries will be competing for young talent. March 2017 Public Board - 1 -
The statutory obligation to enrol 100+ apprentices will present us with a number of challenges and these are outlined in the paper. The benefits of tackling these challenges, also outlined in the paper, are significant however and a proposal for the implementation of apprenticeships within the Trust is therefore proposed for consideration. Actions required by the Board: The Trust Board is asked to note the contents of the report and support the recommendations outlined in Section 7. March 2017 Public Board - 2 -
APPRENTICESHIPS IN SOMERSET PARTNERSHIP NHS FOUNDATION TRUST 1. BACKGROUND/NATIONAL STRATEGY 1.1 Workforce supply is a key challenge facing Somerset Partnership and the wider NHS. 1.2 A national employer levy (0.4% of annual paybill) will be introduced in April 2017 to support the Government s vision 1 to deliver three million apprenticeships by 2020. Based on a paybill of 125 million, the Trust s levy contribution will be in the region of 500k annually. This means that a sum equivalent to this will be withdrawn at source and held in a funding pool against which we can draw down resources. These are available to us for a maximum period of two years to support the establishment of apprentice posts within the Trust and also to provide education through an apprenticeship framework to our existing nonregistered colleagues. Any funds that we do not utilise in this manner will be lost to other organisations. 1.3 As part of the Enterprise Act 2016 2 the government established targets for public sector employers requiring them to have apprenticeships equating to 2.3% of headcount (including bank staff). Based on our current headcount we will need to enroll a minimum of 101 apprentices per year to meet the statutory requirement. 1.4 The levy covers the cost of education and does not fund the salary received by apprentices. The appointment of new apprentices would therefore result in a cost pressure to the Trust, unless apprentices are appointed into existing substantive roles in which case some financial savings would be generated. 1.5 Developing the support workforce and investing in long term workforce development are prioritised in two national strategic frameworks from Health Education England, Talent for Care 3 and Widening Participation 3. Both frameworks outline the strategic intention to develop progression pathways that support young people to enter the workforce in a support role and progress through to registered professions. March 2017 Public Board - 3 -
2. CURRENT PICTURE 2.1 NHS Employers Age in the NHS 4 infographic shows that there are fewer young people working in the NHS compared with the English workforce as a whole. At Trust level 59% of our workforce is aged over 45 compared to a national average of 46% whilst just 4% are under 25 compared to the national workforce average of 12%. Attracting young people with the right values and attitudes and adopting a grow your own model will therefore be vital if we are to future proof our registered workforce. 2.2 Currently, across the Trust, we have eight young apprentices who have been appointed into non-clinical roles and are following a level 2 apprenticeship programme in Business Administration and Accounting. The bulk of our apprenticeship activity is focused on developmental programmes at levels 2, 3 and 5 for our existing clinical support workforce to develop skills and enable progression. Indeed at present 80 colleagues in both clinical and non-clinical roles are currently undertaking apprenticeships across the Trust at levels 2, 3 and 5 (see Fig. 1). Fig. 1 March 2017 Public Board - 4 -
2.3 Implementation of the Level 5 Apprenticeship in Health (Assistant Practitioner) has opened a progression pathway to pre-registration programmes for aspirational clinical support staff. This new role enables the Trust to offer the workforce stepped career progression using apprenticeship frameworks from entry level to registered professional supporting the pipeline of nurse and AHP development. It will enable our support staff to progress to registration, following educational pathways. Indeed one of our recently qualified Assistant Practitioners has secured a place at UWE on the nursing degree, joining in the second year of the programme. The Nursing Associate programme will commence in April 2017 and will be funded through the Apprenticeship levy from 2018 onwards. 2.4 We are currently working with partners in Health and Social Care (Yeovil District Hospital NHS Foundation Trust, Taunton & Somerset NHS Foundation Trust and Somerset County Council) to develop a scheme for rotational apprenticeship posts for new appointments in 2017/8. This will enable new apprentices in healthcare to gain a wider understanding of the patient journey and wider health and social care systems in Somerset. 2.5 Both of the partner Trusts referred to above employ more apprentices than we do (based on 2016/17 figures). However, we have established an excellent learning / supporting environment for our apprentices which has been recognised by local education providers and Health Education England (HEE). HEE has recently commissioned the National Skills Academy for Health to develop a set of metrics to assess the level of employer engagement in all aspects required to implement apprenticeship programmes within an organisation. We have been rated excellent against each of these metrics securing an overall rating of Gold/Excellent, the only NHS organisation in Somerset to achieve this rating. 2.6 We have also been recognised as an Apprenticeship employer of choice through Bridgwater College and we recently won the award for Apprenticeship Employer of the Year 2016. 2.7 This recognition is a reflection of the work we have done to date but will also enhance our attempts at attracting and recruiting high quality apprentices in a post-levy climate where industries will be competing for talent. 2.8 The funding for education generated by the levy will support a number of management and leadership programmes at levels 4 and 5 to enable emerging and existing leaders to develop their leadership skills through a Chartered Management Institute (CMI) - accredited qualification. March 2017 Public Board - 5 -
3. CHALLENGES 3.1 Aside from the statutory obligation to enroll 100+ apprentices in line with the Enterprise Act 2016 new apprenticeship standards dictate that 20% of apprentice time is protected for study, this includes existing staff who are following an apprenticeship framework who are not paid an apprentice salary. The impact of this will be pressure in operational teams to release team members for study as well as delivery of education within workplaces by the education provider. However, this has been recognised nationally and programme providers are being encouraged to offer considerable flexibility in respect of the delivery of learning thus minimising the impact on service delivery. 3.2 A key challenge will be workforce supply in light of the demand created by the availability of new apprenticeship programmes across all industries. There is likely to be a shortage of suitable candidates following the introduction of the Levy and increased opportunities for apprenticeships in the region. As indicated we believe that we are well placed to meet this challenge but by way of enhancing our reputation as an employer of choice for apprentices we may also wish to consider releasing clinical staff to support the development of a network of ambassadors within the organisation who will promote apprenticeship pathways within their professions. 3.3 Another challenge relates to the ongoing commitment to provide learning environments that meet quality standards outlined by the newly formed statutory body the Institute for Apprenticeships. The assessment of quality standards will be undertaken through a National Education and Training survey which is part of the new HEE Quality Strategy. This will provide assurance in respect of the quality of education delivery and placement provision and will be key measure of the continued suitability of organisations to support apprenticeship posts. 3.4 Again current evidence suggests that we will be able to satisfy regulators in respect of the quality of our learning environment but we will need to invest in additional resources to ensure that we can replicate existing practice on a larger scale. 3.5 As a consequence of 3.3, we will be required to permit regular education provider access to workplaces, although this is not expected to have a significant impact on operational delivery. 4. BENEFITS 4.1 Developing an approach to maximise apprenticeships within the Trust will enable us to: March 2017 Public Board - 6 -
comply with the requirements of the Enterprise Act 2016 and ensure that we maximise our use of the levy; derive substantial savings in employing apprenticeships compared to entry level Band 2 salary. The difference in salaries would amount to a saving of between 5k and 9k, depending on role and age of apprentice; provide a new entry level offer to attract school leavers into career pathways in health; benefit from new approaches to process and technology associated with the fresh perspective of those engaged in learning and the study of best practice; change the age profile of the organisation, reducing risks associated with an aging workforce; promote the development and progression of existing workforce, grow your own registered workforce Improved recruitment and retention associated with investing in workforce development; benefit from opportunities to use funding raised through the levy to provide substantial management and leadership development opportunities at levels 4 and 5 to new and existing managers; improve community engagement via schools and colleges. 5. RESOURCE IMPLICATIONS 5.1 Current skills and experience within the Learning and Development team exist to support development of pathways and planning implementation including the new Nursing Associate pathways. We already have 1.5 WTE Band 6 Development Facilitators who are planning the implementation and will be working alongside colleagues across the wider Somerset health community to promote and enable progression into registered professions for the existing workforce as well as engaging young people into careers in health 5.2 In addition, our Workforce Analyst will work with the finance and recruitment functions to develop robust data processes to track activity and finances and monitor performance against targets as required by the Digital Apprenticeship Service and Institute of Apprenticeships as well as internal reporting. 5.3 However, roll-out across the organisation and promotion of the programme across the county will require additional resource to ensure successful outcomes. In order to support operational colleagues, March 2017 Public Board - 7 -
mentors, managers and apprentices, a new full time role is proposed to work within the Practice Placement team (Band 4 Apprenticeship Officer). This role will support all Apprenticeship activity including Assistant Practitioners and Nursing Associates. It is anticipated that this post will be funded from elements of the savings it is expected will be generated by the restructure exercise associated with the creation of the integrated HR team with Taunton & Somerset NHS Foundation Trust. 5.4 An implementation group will be convened by the Practice Placement team comprising representatives from Finance, Recruitment, Operations and the wider Learning and Development team to plan implementation and to link with stakeholders, including education providers and colleagues from partner Trusts. This Group will work with Divisional managers to identify where apprenticeships can be utilised within the skill-mix, promoting new progression pathways and preparing teams to develop capacity and capability to support learners. This will strengthen our commitment to our existing workforce to develop skills in readiness for new ways of working in line with the STP and prepare our workforce to progress to degree apprenticeships when they are introduced in September 2017. 6. CONCLUSION 6.1 We are seeking commitment from the Board to utilise apprenticeships fully to meet the health needs of our communities and the learning needs of our support workforce. 6.2 The introduction of the Levy provides an opportunity for growing our own registered workforce, an option that was previously cost-prohibitive for ambitious support staff. It will help us to develop and promote pathways that enable colleagues to work in new ways with new skills across the healthcare system in line with the ambitions of STP. It will also create an opportunity to attract younger colleagues with the right values and attitudes to help address the gaps in our age profile. 7. RECOMMENDATIONS 7.1 Trust Board members are asked to: support the ongoing work with the wider Somerset health community to appoint a small handful of education providers that can recruit and deliver across the county; support negotiations with these providers to fund/deliver operational support, pastoral care and careers advice for March 2017 Public Board - 8 -
apprentices in order to minimise the impact of supporting apprentices in our workplaces; note the work undertaken to support the organisation for delivery of apprenticeship standards; agree that from May 2017 all entry level posts in clinical and nonclinical roles should be advertised as a level 2 apprentice unless there are compelling reasons, supported at director level, to suggest that this would be inappropriate. References 1. https://www.gov.uk/government/publications/apprenticeships-in-englandvision-for-2020 2. http://www.sompar.nhs.uk/media/3211/annual-report-accounts-2015-2016.pdf 3. http://services.parliament.uk/bills/2015-16/enterprise.html 4. http://www.nhsemployers.org/case-studies-and-resources/2015/05/age-inthe-nhs-infographic March 2017 Public Board - 9 -
Links to Strategic Themes: Identify to which of the Somerset Partnership NHS Foundation Trust strategic themes this report relates by including a cross behind the relevant theme(s) Quality and Safety Viability and Growth Service Delivery Innovation Integration Culture and People X Links to the Assurance Framework: Links to the NHS Constitution and Trust Values: Links to CQC Domains: Identify to which risks of the Assurance Framework this report relates not related to a specific risk. Identify the Values to which the issues raised in this report relate by including a cross behind the relevant value(s Working together for patients Respect and dignity Commitment to quality of care Compassion Improving lives Everyone counts Identify which of the CQC domains are covered by this report by including a cross behind the relevant domain(s) X Is it safe? Is it caring? Is it well-led? X Is it effective? Is it responsive to people s needs? Equality: Identify whether the report has an impact on the protected characteristics set out below, including risks, and if so, say how these risks are to be managed. Only tick the relevant box for which there is an impact. ZAge Disability Gender re-assignment Pregnancy and maternity Religion or Belief Sexual Orientation Marriage and Civil Partnership Race Sex Learning March 2017 Public Board - 10 -
Legal or statutory implications/ requirements: Public/Staff Involvement History: Previous Consideration: No risks have been identified. Enterprise Act 2016 2 none none Disabilities March 2017 Public Board - 11 -