NHS workforce shortages: Could online apprenticeships help revolutionise the future workforce?

'The workforce challenges in the NHS in England now present a greater threat to health services than the funding challenges.' (Kings Fund, 2018)

When I read a statement like this, it gives me a bit of a sick feeling in my stomach. We are very used to reading about funding problems in the NHS, but this often focuses on the pressures posed by increasing numbers of patients or inappropriate use of services. However, it won't matter how much money we put into machinery, beds or treatments if we don't have the staff to care for the patients.

This isn't a new issue. We have known for a while that we are facing a problem with an ageing workforce who will retire over the next 5-10 years. These are the baby boomers or generation X who entered their professions and have remained in them for the majority of their working lives. We also know that keeping staff working in the NHS is a problem - the pay and conditions of service (including dealing with the increased demands for services) means that staff leave well before retirement age. This challenge have been discussed before, but the new King's Fund report (as well as other reports) really bring home the issue of making sure we have enough people in the workforce in the future.

What role does education play?

We have seen several changes to education in healthcare recently. Unions and students have been vocal about the removal of the bursary, which means health students now need to take out a student loan in order to train. However, there are other forces at play. We are in a demographic dip; with a smaller number of 18-year-olds in the population it reduces the number available to enter training. There is a lack of knowledge about the wide range of professions which make up the NHS workforce and the current publicity surrounding the working conditions in the NHS. It takes a special type of person to become a healthcare professional, and thank goodness that there are still people who have a 'calling' to enter the NHS workforce - we would be in an even worse situation if we didn't.

Unless we do something different, we are walking towards a cliff edge. Health Education England (HEE) recently published a report about the collective responsibility of all stakeholders to encourage students into professions, keep them in training and then support them in their early careers. HEE has also highlighted the number of potential vacancies in the workforce and some smaller professions which face particular challenges. We have begun to see a more concerted effort by a number of stakeholders to raise the profile of the NHS and encourage people to enter a career in care, but is it enough?

Diversifying routes into health careers

One of the actions identified by the King's Fund report suggests the diversification of routes into health careers, including apprenticeships. Recent information from the Society of Radiographers identified that all available placement areas were being utilised, yet we need to train more in order to diagnose and treat cancer more efficiently. Similar problems exist in other professions - we can train more students in the classroom, but one of the most important elements of entering a profession is placement experience. Unless we can think of new ways to help students gain the practical experience they need, we won't be able to significantly impact on the predicted workforce shortages.

How universities can help plug the gap

Universities are working hard to help employers meet their workforce needs, but it is a challenging time for them too. Apprenticeships present many opportunities for both employers and education providers, but it is new territory we are all navigating. At the University of Derby, we have recently taken a bold step to help employers do something a little differently and address the shortage of Operating Department Practitioners (ODPs). ODPs work in operating theatres helping with anaesthetics and operations and form an important part of the interprofessional team, but they too are in short supply. There are a select number of universities running training programmes, but these rely on students living close enough to attend teaching sessions and undertake practical training in nearby hospitals. Like other professions, numbers entering training are shrinking, and some parts of the UK do not have a local training provider at all.

Doing something different to address this requires vision and lots of support from employers. Fortunately, we have been lucky enough to bring the right people together to develop an apprenticeship which is delivered online with a summer school. This is not a new educational model, but for ODP, it represents a break from tradition and may help to revolutionise how the NHS workforce could be developed in the future. It won't replace more traditional or familiar methods, but it provides a real alternative for staff working in operating theatres who want to do more training. For staff that have been working in operating theatres for a while, but who cannot afford to leave work to undertake university training, it is a real opportunity to become a registered ODP.

The King's Fund report makes uncomfortable reading. Universities, employers, politicians, the NHS and anyone with an interest in health are all too aware of the pressures on the system, but thinking differently requires a whole cultural shift. Current student training does not look significantly different to my own training over 30 years ago, but the NHS and the workload does. If we are to prepare for the future, we need to act differently now.