The rise and rise of the nursing apprentices.

This blog comes from Alwin Puthenpurakal, an experienced senior lecturer and researcher working at The University of Greenwich. He led University apprenticeship programmes since its inception and highly values the impact it has on widening social mobility and addressing the national workforce challenges. With almost two decades worth of clinical experience, he is an experienced senior nurse with an intensive care background who has worked on workforce transformation projects and has implemented new models of care in various clinical settings across the country.

The nursing apprenticeship programme is a government-funded initiative that provides a pathway for people to train as a registered nurse, without having to go to a university as a full-time university student. Apprenticeship programmes are generally delivered in partnership with the ‘learner’s’ employer and the university. In the case of nursing apprentices, this will be their NHS trust or community NHS practices and their employer-partnered universities. Unlike traditional university courses, university apprenticeship programmes offer the dual benefit of on-the-job training with their employer and associated practices with university level academic study.

In the UK, the nursing apprenticeship programme was first introduced in 2017. This was put in place to both aid social participation for those who were unable to go to university and study full time degrees and, most importantly, to increase nursing workforce supply. Although it was recognised early on that nursing apprenticeship initiatives won’t be enough to resolve the national shortage of nurses [1]

Workforce shortages in the NHS remains a very long-standing problem, spanning more than a decade. In 2022, vacancies of FTE nursing staff remain well above pre-pandemic levels. Nursing, a safety critical profession, continues to remain a key area of shortfall in NHS trusts with nurse vacancies accounted for more than a third (approx. 43,600 FTE) of all vacancies in December 2022 [2].

Motivating and retaining staff, particularly nurses, remains a big issue in the NHS – the world’s 5th largest employer and the biggest employer in the UK. Year on year, staff leaver rate has increased from single figures and climbing north towards 15%. Although the NHS Long Term Plan and the NHS Long Term Workforce Plan recognise this and many other metrics, the ‘Train, Retain and Reform’ principles set out in the plan still yet to bear fruit to a growing crisis of more than a decade. In 2023, significant push has been planned through the NHS Long Term Workforce Plan with domestic education and training to expand between 50 – 65 % by 2031/32 and additional funding of over £2.4B to be invested in education and training until the end of this decade. The ‘need to train’ more nurses to meet the national workforce shortfall is also met in other healthcare professions such as medicine, podiatry etc. Particularly in medicine for 2024/25 NHS England has geared up for piloting degree apprenticeship medical training programme with the aim of supplementing traditional medical training routes.

The same mantra of offering up more training opportunities is echoed in the nursing profession with an expectation of surpassing the current national nursing workforce shortfall by 2031/32. Degree level apprenticeship nursing route will see a rise of 28% by the end of the decade and more precedence and training places given this time to specialities such as mental health nursing, learning disability nursing and health visitor training [3].

Pursuing an apprenticeship route of education has its own benefits. It is a more affordable way to train as a nurse, particularly when the UK inflation rate continues to remain higher than the long-term average of 2.80% and the prices of consumer goods and services remains at its peak since the inception of CPI National Statistic series in 1997 [4]. Apprentice learners do not pay tuition fees and they earn a salary while they study. Apprentice programmes offer more flexibility compared to traditional degrees and this offers many learners flexibility whilst managing other commitments. More importantly, unlike traditional degrees, apprenticeship programmes offer the opportunity to gain real-world experience in a variety of healthcare settings. This, consequently, can offer more competitive advantage and real world lived experience professionally compared to their traditional degree counterparts. On the other hand, it is equally important to appreciate some of the general drawbacks in pursing nursing apprenticeship routes. Programmes can be more demanding than their traditional degrees, where the learner is expected to balance expectations both at their workplace and from their university-level academic training. Although employers have partnership agreements with education providers, they can be limited to certain catchment areas, done to support growth in grassroot talent within a particular geography. On the other hand, applicants for traditional courses welcome the opportunity to relocate for their university experience and ongoing work experiences. Apprentice learners are contractual obliged to adhere to their employer-specific terms and conditions and this may seem inflexible to some applicants, for example, when planning for a period of leave due to wider commitments.

Despite these indications, the UK nurse apprenticeship university programmes offer an industry leading world class education regulated by OFSTED and the NMC and demands high quality education standards and learner-centric support, not only from the education provider and the employer but also from the wider participating members, such as the End-point assessment organisations who are part of the apprentice’s journey in securing a registered nurse or registered nursing associate job in the NHS.

In the UK, the apprenticeship sector is growing rapidly [5]. In 2023, the current Government has pledged more than ever in terms of opportunities to train and funding to increase national capacity to meet with the growing demand for skilled labour within the health sector. More specifically, in the nursing profession, the growth in national recognition of the sectoral challenges and consequent untoward investment, offers an invaluable way to learn and earn, especially when there is a national workforce shortage in nursing. For the next decade, the nursing apprenticeship university programme routes remains the most attractive and fruitful option to consider for anyone desiring to become a registered nurse in the UK.

  1. The Nurse Degree apprenticeship: in poor health? (2019) Eighth Special Report UK Parliament Publications. Available at: Nursing degree apprenticeships (parliament.uk) (Accessed: 27 August 2023).
  2. Retaining NHS nurses: What do trends in staff turnover tell us? (2022) The Health Foundation. Available at: Retaining NHS nurses: what do trends in staff turnover tell us? – The Health Foundation (Accessed: 26 August 2023).
  3. Breaking down the NHS Long Term Workforce Plan (2023) Bevan Brittan LLP. Available at: The NHS Long Term Workforce Plan – Key Points and Links to Further Reading | Bevan Brittan LLP (Accessed: 29 August 2023).
  4. Office of National Statistics (2023) Inflation and price indices. Available at: Inflation and price indices – Office for National Statistics (ons.gov.uk) (Accessed: 29 August 2023).
  5. Jack, P. (2023) Degree apprenticeships to get £40 million funding boost, Times Higher Education (THE). Available at: £40m funding for UK degree apprenticeships | Times Higher Education (THE) (Accessed: 25 August 2023).

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