With a career spent running training in the medical device industry, Steve Dickson, training academy manager at Avensys UK Training, believes apprenticeships should be made more accessible and widely used to help address healthcare recruitment issues and skills shortages.
The debate about whether we are producing too many graduates and not enough skilled staff for lower level specialist positions is gaining momentum. On paper, the UK has the most skilled workforce the country has ever had, yet is not as productive as many other developed countries, due, employers say, to a lack of technical skills in the workplace. Graduate labour market statistics show that almost one in three graduates are not doing graduate level jobs. A typical student on a three-year course outside of London might expect to leave university with up to £40,000 of student loans and then, if they are able to find a job at all, go into a profession for which they are overqualified. Even if they end up in a graduate level job, the ‘graduate premium’ - the extra amount a graduate can expect to earn - is narrowing.
However, there is an alternative, one that is currently the focus of the biggest shake up in skills-based learning for a generation apprenticeships. While traditional degrees undoubtedly have a value and play a vital part in the makeup of our educational and employment landscape, alternative paths that offer a more flexible, skills-based approach give a far broader cross section of people the chance to realise their potential and help drive the country forward.
At Avensys UK Training, we believe apprenticeships are ideally placed to fill the skills gap. When developed and delivered properly, they are an exciting and progressive way to produce the workforce we actually need, a partnership between employer, training provider and apprentice that works to the benefit of all and, of particular interest in my field, an ideal solution to the issues around training and recruiting the medical and clinical engineers the NHS desperately needs if it is to continue delivering the outstanding patient care we have come to rely upon
Why the NHS needs medical and clinical engineers
Engineers in the NHS work across many specialities, maintaining, repairing and servicing equipment to keep it working correctly. Properly functioning medical equipment is a critical tool for doctors, nurses and all healthcare professionals.
If something malfunctions during use, the quality of care can decrease and may even affect patient safety. Properly maintained equipment is also much less likely to need replacing, so in addition to being safer, helps the facility to be more cost efficient.
In 2013 alone, 13,642 incidents related to faulty medical equipment were reported to the Medicines and Healthcare Products Regulatory Agency (MHRA), leading to 309 deaths and 4955 people sustaining serious injury. The MHRA data incidents included a pacemaker that had faulty sensors, a blood glucose monitor that gave incorrect low results and a defibrillator that had inadequate electrical pulse.
As the technology used in hospitals becomes increasingly complex, the danger of improperly calibrated and validated equipment is also increasing. There are huge implications to the miscalibration of even basic equipment such as weighing scales - in 2008, a medical devices alert was issued warning of incorrectly calibrated weighing scales that had led to a number of patients being given the incorrect dosage of medication. Faulty equipment or the unavailability of the right equipment is also a major cause of cancelled operations.
To put it bluntly, the lack of NHS engineers puts lives at risk. From those entering with graduate degrees to those just starting on an apprenticeship scheme, their work impacts directly on patient treatment and wellbeing, playing a vital role in the chain of care from a patient entering the hospital to leaving it.
Boosting recruitment and addressing an ageing workforce
Increasing the number of engineers in the NHS would help to cut the amount of incidents caused by faulty medical equipment and assist in delivering safe and effective treatment. However, for some time the healthcare sector has been struggling to recruit high quality, well-educated engineers. Hospitals have resorted to recruiting engineers trained in other fields and converting knowledge, understanding and skills to the medical environment. The knockon effect of this recruitment strategy is an ageing workforce and there are significant concerns about the availability of engineers in 10 years’ time, when a large percentage of the workforce is due to retire. A way has to be found to recruit new blood into a profession that may not have the obvious appeal of some other engineering-based jobs.
Apprenticeships are an effective way to bring more people into the profession. While graduate level entry clearly has an important place in recruitment policy, an apprenticeship in clinical engineering allows someone to start at Level 2 and work their way right up to a Level 6 Degree Apprenticeship, leading to a BSc Honours degree and professional registration. An apprenticeship programme ensures knowledge and skills are embedded before progressing to a Level 6 Degree Apprenticeship, whereas graduates who have come up through the traditional route may have outstanding theoretical knowledge, but struggle to complete more practical assessments.
The new Apprenticeship
Levy Historically, industry’s commitment to running apprenticeship programmes has been voluntary, with the Government supporting them through commercial incentives and subsidising training and salaries. The support that was available was more commercially significant for 16 to 20 year olds than it was for 20 to 24 year olds, at which age it was dramatically reduced. However, that all changed last year when the Government launched an important new initiative, the Apprenticeship Levy, to stimulate the delivery and uptake of apprenticeships, thereby, as they put it, “boosting productivity by investing in human capital,” (Policy Paper: Apprenticeship Levy). It is hoped that new apprenticeship standards and increased funding from the levy will give employers more control over designing training to suit their requirements. The Department for Education estimates that the Apprenticeship Levy will help double the annual level of spending on apprenticeships to £2.5 billion by 2019 to 2020. This should encourage employers to invest in high quality apprenticeships, ensuring more people have a chance to reach their full potential.
The Apprenticeship Levy affects employers in all sectors, requiring those with annual paybills in excess of £3 million to put aside 0.5% of their paybill to fund new apprenticeships. In England, control of apprenticeship funding will be put in the hands of employers through the Digital Apprenticeship Service (DAS), an employerfacing service that will allow employers to estimate apprenticeship funding, find apprenticeship training, recruit an apprentice, manage funding and add an apprenticeship. This flexibility makes the whole process very dynamic and responsive - the time from initial application to being on a course can be as little as six weeks. Any money not used by the contributing company within 12 months will go into a central fund to be used to finance apprenticeships for companies that do not reach the £3 m paybill criteria, and therefore it is crucial that organisations capitalise on their levy funds.
Under the new apprenticeship programme, which covers a range of levels from a semi-skilled operator (Level 2) through to a postgraduate engineer (Level 7), there are no age restrictions and apprenticeships are available for existing employees too. This means that in addition to attracting a wider selection of new people to the profession and thus encouraging diversity and social mobility, it allows companies to make the most of the potential contained within their existing workforce by using the levy to facilitate a form of funded training and development programme. The levy represents a bold move away from the traditional image of apprenticeships as being solely for school leavers. This makes it particularly relevant and beneficial to the NHS, which employs staff from a wide demographic. Also, for any company like the NHS that has large staffing needs, it is important that the field of applicants is as extensive and open as possible.
Companies will benefit from having a pipeline of qualified and experienced staff who are already emotionally invested in the business, having completed their training there. In addition, giving existing staff the chance to develop their careers while remaining with their employer improves staff retention and satisfaction. Even in the short term, this will make companies providing apprenticeship opportunities more resilient to the fluctuations of the skills market. Apprentices in turn have the opportunity to ‘earn while they learn’, gaining a first rate internationally recognised qualification with the security of having a job waiting for them upon completion of their course, possibly within a company they have already been working at and loyal to for many years.
The Transition from Apprenticeship Frameworks to Apprenticeship Standards
One of the main objectives of the Government’s reforms of apprenticeships is to switch delivery from the current Apprenticeship Frameworks to the new Apprenticeship Standards. The Institute for Apprenticeships, a public body sponsored by the Department for Education, is working with employers to create and develop new apprenticeship standards, in line with the introduction of the Apprenticeship Levy.
Apprenticeships were traditionally assessed by frameworks developed by sector bodies, which are primarily qualificationfocused. It is possible for an apprentice to achieve all qualifications in the framework but not actually have the right skills to carry out their job, meaning they may need further training from their employer. Apprentices are assessed throughout their apprenticeship with no overall end assessment, and once they’ve completed a unit, it is ticked off and they won’t necessarily need to demonstrate the skill again.
However, the Apprenticeship Levy has initiated a move away from Frameworks in favour of the more modern option, Standards. Standards are designed to meet the needs of employers, as a standard contains a list of the skills, knowledge and behaviours an apprentice will need to have learned by the end of their apprenticeship. Standards are occupation-focused rather than qualificationled. The learning happens throughout the apprenticeship and the apprentice is assessed at the end, having to prove that they can carry out all aspects of their job.
Clearly, a key element in the success of the new apprenticeships is how they are delivered. Employer-led delivery is one option, but even the largest companies lack the necessary resources - qualified personnel with assessor qualifications, policies and procedures etc. It is much more effective to work with an established partner, experienced in delivering training to the healthcare sector.
With the first anniversary of the Apprenticeship Levy fast approaching, now is the time for NHS trusts and hospitals to make the most of the money that has been put aside and seize the opportunity to get more people onto the new apprenticeships. In as little as 12 months, an apprentice can have completed their programme, gaining qualifications to help further their career progression and benefit the NHS and its patients.
The NHS – a key employer in the modern marketplace
The NHS employs around 1.2 m people - a staggering number of people working in a huge variety of roles. Within that complex framework, we must not undervalue or downplay the importance of medical and clinical engineers working at a lower level, or the pathways that bring them to that career. In the modern marketplace, a degree does not guarantee you a job, as it once did, and with so many graduates currently leaving university and not being able to find employment in the industry or at the level they were anticipating, we are in danger of becoming ‘top heavy’ and neglecting the professions that are vital to the way the country functions.
Accessing the Apprenticeship Levy empowers hospitals and Trusts, giving them a vehicle through which to train clinical engineers ready go straight into valuable and rewarding careers with one of our most important and respected institutions, the NHS. It also enables existing staff to develop their knowledge, skills and career, benefitting both themselves and their employer. The Apprenticeship Levy, when delivered in partnership with a trusted training provider, is poised to stimulate the job market and create a truly modern workforce, fit for purpose and ready to provide the skills the country, and the healthcare service, needs to move forward