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Enhanced Clinical Practitioner Apprenticeship (ECP)
Apprenticeship Webinar
@NHS_HealthEdEng
Welcome and Introductions
• Hello and Welcome!
• This event is a Microsoft Teams Live Event, which means
that you won’t be able to be seen or speak, but there will
be a Q&A bar to send in questions for discussion
• This webinar will be recorded and will be shared
• Slides will also be shared after the webinar
Fay Lane
@NHS_HealthEdEng
Agenda
•Current workforce context
•Trailblazer Chairs
•Hear from other Employers
•Understanding apprenticeships
•Choosing an apprenticeship provider / procurement
• Implementing and next steps
•Q&A session
Fay Lane
@NHS_HealthEdEng
Webinar Team today • Jane Hadfield, National Senior Programme Manager – Apprenticeships, Health Education England
• Sue Haines – Assistant Director Nursing (Professional Development, Education and Workforce), Nottingham University Hospitals NHS Trust
• Sam Cook, Manager, Critical Care Skills Institute
• Fay Lane, Apprenticeship Relationship Manager, National and North East and Yorkshire, Health Education England
• Joey Giles, Corporate Lead for Advanced Practice, University Hospitals Plymouth
• Tony Spence, Deputy Head of YAS Academy, Yorkshire Ambulance Service NHS Trust
• Simon Dennis, Strategic Commercial Manager, Salisbury NHS Foundation Trust
Fay Lane
@NHS_HealthEdEng
Context and the Trailblazer
Fay Lane
Background to Enhanced Clinical Practitioner Apprenticeship
Sue Haines and Sam Cook
@NHS_HealthEdEng
Back in 2015/16
• Critical Care Nurse Education review Forum had the idea that Apprenticeship route could offer an alternative way to train nurses who are new to the clinical environment of critical care…..
• Began to investigate the possibility
• Initial discussions with Institute of Apprenticeships (IfA) were unfruitful
@NHS_HealthEdEng
2018 Proposal stage• Employers still wanting to take this idea forward
• CPD was not necessarily working well from the employers perspective….many specialisms did not have post reg courses
• East Midlands ‘Nurse Supply and Demand Board’ Chief Nurses/Employers exploring apprenticeship options for developing clearer clinical career pathways in specialties, to attract and retain nurses, approached HEE
• Other examples of health care Apprenticeships were being accepted
• Discussions about the possibility continued with IfA
• Difficulty expressing the job role, targeting the apprenticeship between registration qualification and advanced practice…..
@NHS_HealthEdEng
2019 Proposal• Other “Specialisms” attended a meeting of “Interested Employers”
and a group emerged with the proposal of “Specialist Practitioner Apprenticeship”
• This encompassed all manner of professions and possibilities…to have 1 Apprenticeship Standard which will be used as a “hub” for developments of Apprenticeships to address many specialists roles in the Health and Social setting
• Proposal accepted in December 2019 following some alterations
@NHS_HealthEdEng
2020 Trailblazer group – Specialist practitioner
• Group formed; representatives from 30 employers from all over the country and a wide range of health care professions, including dental services, healthcare scientists, ambulance service, primary care
• 1st meeting March 2020 – following this all meetings have been virtually
@NHS_HealthEdEng
2020 Trailblazer group – Specialist practitioner
• Decision made to not include mandatory academic qualification to the apprenticeship as agreement could not be reached on level of study
• Group challenged by the breadth/scope of the apprenticeship and language used
• Evidence review included ‘Enhanced Practice - A workforce modelling project for Health Education England (Professor A Leary, Sept 2019)
• Following initial consultation phase, agreed change of name for the apprenticeship to “Enhanced Clinical Practitioner” , reflecting same language and levels of practice as described in Professor Leary’s report
@NHS_HealthEdEng
2020 Trailblazer group – Enhanced Clinical Practitioner
• “Enhanced Clinical Practitioner” Apprenticeship launched/published in May 2021
• Discussion and development of group ECP Implementation Network
@NHS_HealthEdEng
HEE Context
Fay Lane
@NHS_HealthEdEng
Enhanced Practice – HEE and Alison Leary• In 2019 Alison Leary completed a piece of work with HEE seeking to define a
workforce model in which the Enhanced Level of Clinical Practice can sit
• The Trailblazer used this work to inform them in their emergent thinking
Jane Hadfield
@NHS_HealthEdEng
The Enhanced Clinical Practitioner Apprenticeship
• The Enhanced Clinical Practitioner Apprenticeship Standard is approved for delivery by the Institute for Apprenticeships and Technical Education.
• The apprenticeship levy funding band of up to £7k.
• This is a post graduate, mutli-professional apprenticeship at Level 6 with an indicative programme length of 18 months.
• No mandated qualification other than the standard and EPA- open to employer requirement can be one level up or one down
• We now await the final stages of the process – defining employer intentions, strategic fit, HEIs preparing for delivery, and employer procurement.
• See the standard here https://www.instituteforapprenticeships.org/apprenticeship-standards/enhanced-clinical-practitioner-v1-0
Jane Hadfield
@NHS_HealthEdEng
What the employer scoping is telling us• Summer 2021 HEE, in conjunction with the trailblazer group, conducted an employer scoping
exercise.
Purpose -
• to better understand employer workforce demand for the apprenticeship - identifying areas of interest and employer intentions.
• to inform a national procurement process, to source both national and regional training providers
• Employer Scoping – runs until 30th October 2021. We are keen to see more feedback particularly from primary care colleagues / and Training Hubs https://healtheducationyh.onlinesurveys.ac.uk/enhanced-clinical-practitioner-apprenticeship-scoping
From this The TfC Apprenticeship Team will develop a procurement framework – this will enable education providers to apply to deliver against the framework
Jane Hadfield
@NHS_HealthEdEng Jane Hadfield
@NHS_HealthEdEng Jane Hadfield
@NHS_HealthEdEng
What are the typical job titles of your Enhanced Clinical Practitioners?
Specialist nurses in teams such as
bladder & bowels, pain management, respiratory, cardiac rehab, heart failure
Cancer Nurse Specialist
Specialist Oncology Dietician
Brachytherapy specialist
radiographer
Proton Principal Radiographer
Highly specialisedClinical Physiologists – Neurophysiology
Respiratory specialist practitioner
Clinical Specialist physiotherapist
Senior Occupational Therapist
Reporting radiographer
Critical Care Practitioners –Physiotherapy,
RNurse
Psychiatric liaison practitioner / nurse
Emergency Care Practitioner
Specialist ParamedicEmergency Nurse
Practitioners
Extended Scope Practitioner
(physio/dietician/ podiatrist)
Jane Hadfield
@NHS_HealthEdEng
The apprenticeship may or may not have qualifications or accredited modules as part of the programmes for example -
leadership PGDip
Physiology -Neurophysiology/Slee
p Physiology/Respirator
Level 7 NMP
Advanced Psycho Social Assessment
and formulation
CBT interventions for MH professionals
Asthma modulesNon-medical Prescribing
Graduate Diploma
Clinically focused 10 to 20 credit modules, such as leader, multi professional working,
practice teaching
advanced patient assessment,
pharmacology, critical care
caseload management,
Emergency Care Practitioner
Jane Hadfield
@NHS_HealthEdEng
Innovations in discussion• In addition to what is being drawn out of the scoping exercise to date, we have seen enquiries
about the use of the apprenticeship in many other areas - for example –
• Dental technical roles• Mid career General Practitioners with special interest• First Contact Practice • Healthcare science• GPN Specialist Practice
Areas to clarify –
• How ECP differs from ACP
• How does the ECP articulate in career trajectories
• Opportunities for Employer based delivery of this apprenticeship for some clinical areas e.g. Critical Care
Jane Hadfield
@NHS_HealthEdEng
Employers –sharing their
vision
Fay Lane
Enhanced Clinical Practitioners
The vision
Joey GilesCorporate Lead for Advanced Practice
University Hospitals Plymouth
Advanced Practice Spectrum at UHP
Enhanced Clinical Practitio
ner
Advanced Clinical Practitio
ner
Consultant
Practitioner
ACP
CPECP
Enhanced Clinical Practitio
ner
Advanced Clinical Practitio
ner
Consultant
Practitioner
- Evaluate existing roles
- Ascertain level of practice being demonstrated
- Establish service line requirement
- Plan the workforce accordingly
- Talent management
- Succession planning
Advanced Clinical
Practitioner
Enhanced Clinical
Practitioner
Consultant Practitioner
How will the apprenticeship help?
Advanced Clinical
Practitioner
Enhanced Clinical
Practitioner
Consultant Practitioner
How will the apprenticeship help?
- Defined starting point
- Drivers & blocks
- Opportunities
- Support & Governance
- Recruitment
ECP Recruitment- ‘Dead man’s shoes’
- Requires significant vision
- Apprenticeship announcement
- Workforce reviews
- Challenge assumptions - Medical recruitment v AP/ECP plans
- Rolling training plans
- Succession planning
Advanced Clinical
Practitioner
Enhanced Clinical
Practitioner
Consultant Practitioner
- CPD
- Quality Assurance
- Progression if appropriate
- Standardise workforce strategy
- Expand the ECP workforce
- Meet service demands
- Defined starting point
- Drivers & blocks
- Opportunities
- Support & Governance
- Recruitment
How will the apprenticeship help?
UHP Examples
Cardiology
- Develop front door service in ED & AMU
- Rapid access chest pain
- Triage STEMI alerts
- ?More
Cardiology
- Whole patient episodes and breath
of presentations
- Generalismexpertise within a
specialty
- Service level or strategic
perspective
- Discrete aspect of care in a specific context
- Specialism expertise within specific service
- Singular patient/group perspective
- ECP apprenticeship
- New EPs
- Upskill existing junior ENPs
- Standardisation at level
- Quality Assurance
- Training trajectory
- Banding
ENPs / Emergency Practitioners
Devon-wide Urgent Care Work Group
- Intention to reduce ED attendances by 15%
- Gap analysis into existing workforce
- Expand workforce – ECPs central- Hybrid workforce
- Support role development
- Unify Devon-wide competencies- Governance
Challenges
- Define the difference between ECP and ACP?
- Perceptions of level of practice and service line requirements
- Pay
Opportunities: Governance
- KSBs informing governance - Enhanced, Advanced & Consultant Practice
Framework
- Quality assurance
- Inform appraisals
- Role modelling regional hospitals
Opportunities: Academia and CPD
- Standard of Level 7
- With exceptions
- Academic support/bridging assignments
- Drive the CPD of the workforce
- Enable opportunities
Opportunities:
- Affirm the importance of the ECP role - Not just transitional post
- Allow progression – autonomy, pay, responsibility, career plans
- Safeguards of apprenticeships
- Allows service to develop - (Cardiology – ECP, then develop ACP roles too…)
- Inspires Opportunities
A YAS Perspective of ECP
Apprenticeships
Chris Harvey
& Tony Spence
Our Clinical Strategy
• Person centred, evidenced based care.
• Clinicians at the heart.
• Integrated urgent and emergency care provider.
• Improve patient outcomes.
• Improve patient safety.
• Clinical quality.
CoP Career Framework 2018
Advanced Practice
• 2 Consultant Paramedics
• 9 Advanced Paramedics Urgent Care (APUC)
• 140 Specialist Paramedics Urgent Care
• 4 Advanced Paramedics Critical Care (APCC)
• 44 Specialist Paramedics Critical Care
Urgent Care
• Rotational Models – supporting Primary Care Networks.
• Placements in Minor Injury Units.
• Clinicians working within call centres (EOC & IUC).
• Predominately targeted to CAT 3/4 incidents.
Critical Care
Critical care cell within the EOC - RRV
• Providing specialist remote advice to support crews
• Oversight of dispatch of critical care resources
• Senior clinical advice to EOC tactical commanders
• Targeted response to high acuity patients (Medical &
Trauma)
• Clinical mentorship & clinical support for ambulance crews
Aligning HART, HEMS & RRV based critical care resources to
provide a consistent delivery of critical care
Level 7 Education
• One university per ICS.
• PgDip 120 credits.
• Able to register with Centre for Advancing Practice.
• Advanced Patient Assessment.
• Pharmacology/ Independent Prescribing
• Minor Injury/Illness
• Contemporary issues in Advanced Practice
Enhanced Clinical Practitioner
Apprenticeship
• YAS Academy have developed the career development pathway and are supporting service
lines with education and apprenticeships.
• Currently have interest from 2 Universities to develop the ECP apprenticeship. Both are on
Salisbury procurement framework.
• It is likely to cover year 1 of the specialist paramedic education pathway.
• There is likely to be a level 7 qualification within the level 6 apprenticeship standard.
• YAS levy is £0 so we will be seeking further levy transfer with assistance from HEE.
@NHS_HealthEdEng
Understanding Apprenticeships
Fay Lane
@NHS_HealthEdEng
Apprenticeships in NHS ContextWorkforce Challenges
• Increased demand on services
• Aging population
• Demand for more innovation in service delivery and skills
• Maturing workforce presenting short/medium/long term skill shortages
• Reducing funding for education and training for new and existing staff
The Opportunity
• Opportunity with apprenticeships to upskill and develop staff :
• Staff equipped with the right skills
• Staff have the knowledge and skills to deliver new services
• Create transformational change – new models of care
• Enhance patient experience - Patients experience high quality care from skilled staff
Benefits of ApprenticeshipsApprenticeships bring a number of tangible benefits to NHS and other organisations they can create
skilled, motivated and qualified employees and, if used properly, can help to address skills shortages
across the workforce.
Increased flexibility of the workforce
Develop your existing workforce
Apprenticeships have lower attrition
rates
Attract and recruit from a wider pool of people in your local
community
Recruit a more diverse and local
workforceImprove retention
Reduce training and recruitment costs
Create a flexible training route
Recruiting a more local workforce to
improve staff retention
Fay Lane
Apprenticeship FundingThere are three ways to access funding to pay for apprenticeship training, this funding
does not cover salary costs you will have to fund the apprentice’s salary.
1.Apprenticeship Levy. Employers with a pay bill over £3 million each year, pay
the apprenticeship levy. Levy paying employers can spend their apprenticeship levy
funding on apprenticeship training.
2.Reserve government co-investment. If you don’t pay the apprenticeship
levy you can reserve funding, where the government pays 95% of the training costs
and the employer pays the remaining 5%.
3.Levy Transfers. Levy paying employers can transfer some of their annual levy to
other employers. These transfers cover 100% of the training costs of the
apprenticeship (you still need to cover salary).
Fay Lane
@NHS_HealthEdEng
Equivalency and Entry Requirements• Enhanced Clinical Practitioners must be registered with either one of the statutory healthcare regulators,
Social Work England or with one of the following accredited voluntary registers: The Academy for Healthcare
Science, Register of Clinical Technologists or Registration Council for Clinical Physiologists. They must undertake
revalidation processes or audit of their continuing professional development where these apply.
• Apprentices must achieve level 2 English and Maths (GCSE grade C/4) as part of their apprenticeship where they
haven’t already achieved this – some training providers will require evidence of English and Maths prior to starting
the apprenticeship Please speak to your provider about their specific English and Maths requirements
• If learners can’t find their certificates, they can request new ones from the awarding body
• If they aren't able to request new certificates, they will have to undertake FS level 2 prior to commencing the
apprenticeship
• All NHS organisations can access BKSB to support FS learning -
https://haso.skillsforhealth.org.uk/news/functional-skills-learning-access-funded-by-hee/
• Some funded exam provision – OpenAwards
Fay Lane
@NHS_HealthEdEng
Equivalency and Entry Requirements
Overseas qualifications and ENIC
ENIC (formally NARIC) is the designated national agency for the recognition and comparison of international qualifications and skills.
You can check your learners' oversea qualifications by contacting: [email protected]
What to do if your learner doesn’t meet the entry criteria?
• Don’t be put off
• Work with your learner and training provider to clarify what they need to access
• Access free functional skills learning and support
• They may need to join a later cohort
Fay Lane
@NHS_HealthEdEng
HEE is here to support you on your apprenticeship journey.
Your regional apprenticeship relationship manager can help you
with everything from understanding apprenticeships; procuring
provision; accessing levy funding; establishing apprenticeships in
your organisation as part of your long term workforce strategy.
https://haso.skillsforhealth.org.uk/news/health-education-england-
relationship-managers-meet-the-team/
HEE Employer Support
Fay Lane
@NHS_HealthEdEng
Choosing an apprenticeship
provider / procurement
Fay Lane
Apprenticeships & Education Procurements
Supporting Employers, Providers and Learners nationally
Why Salisbury?
• Leading provider of specialist education, apprenticeships, and professional development procurements to NHS and wider systems
• Strategic Partner to Health Education England and other key organisations
• In depth specialist knowledge of the sector
• Work across employers, professional bodies, providers and trailblazers to co-develop innovative courses and programmes with a true employer led focus
• Supporting employers at every level to deliver their educational requirements
• Over £600m apprenticeship spend managed and contracted, across NHS, local authority, central government and third sector employers
• Full support for employers
HEE National Procurements
• Salisbury, with HEE are leading on national procurements for NHS (and other) employers, in support of the development of Apprenticeship and other routes into study, across all sector of apprenticeships and professional development education
• The principle objectives are to streamline provider selection for employers, to ensure consistent quality across courses, and to assist education providers in understanding, and planning for, the size of the marketplace. We also aim to increase innovation in support of the new learning methods discussed in the NHS Long Term Plan.
• This is not HEE selecting the provider – this will provide a menu of providers to enable employer choice all of whom have met certain criteria to ensure employers of a quality programme
Local Authority, NHS and Third Sector working together
• Collaborations across sectors require a different approach to provider selection
• Apprenticeships put employers in the driving seat to co-design, and co-deliver if wished (and legally able), the training for their future workforce
• National approaches to smaller learner number professions help drive innovation and ensure employer needs are at the forefront
• Employer involvement from the start is key to a successful programme
Why is Procurement required
• Apprenticeship levy funding is counted as public money and therefore demonstration of best value is required
• Education sits within Public Contract Regulations – a “light touch” regime is in place but this does not mean “no touch”
• Procurement enables employers to be protected by the correct NHS / employer contract, (DHSC requirement)
• Salisbury contracts protect employers from detrimental clauses – e.g. early leaver charges, additional costs,
• Providers are contractually obliged to deliver all the commitments they made under national frameworks, etc
• A much shortened order / contract process for the employer
Who can use the service
• Salisbury’s procurements are established at the outset for all public and third sector organisations, including health, local authorities, and education institutions. Additionally, any charity receiving public funds for their activities is eligible, along with smaller organisations such as GP practices, hospices and larger government departments and arm’s length bodies. Other private sector organisations who wish to use the procurements to work in partnership with other organisations can join; they just don’t need to meet the public contract regulations part of the contract, but they can certainly call-off providers through Salisbury so they get the same supplier commitments
Information for potential Providers
• Interested providers will need a supplier account on Salisbury’s Bravo portal -https://nhs.bravosolution.co.uk/nhs_collaborative/web/login.html
• The opportunity when live will be published as a Contract Notice on https://www.find-tender.service.gov.uk/Search
• Existing Framework providers will receive an invitation via Bravo
Enhanced Clinical Practitioner Procurement
• Minimum entry criteria will apply :
• Providers must hold a valid UKPRN and be registered on the Register of Approved Training Providers managed by the ESFA (and RoEPEO where offering End Point Assessment)
• Where a provider has an Ofsted rating, this must be Grade 1 or Grade 2, which must relate to apprenticeship delivery
• Where a provider has an Ofsted monitoring visit report, this must be Significant Progress or Reasonable progress, which must relate to apprenticeship delivery
• Suppliers with no Ofsted rating/visit must be able to demonstrate success rates above the national average for apprenticeships
• Suppliers must agree to the published NHS Terms without amendment
• All sections of the bid documentation published must be completed as per instructions – we will reject incomplete or incorrect bids.
• Bidders must include 1 resit per module, and 1 resit at EPA, without additional charge to employers
Next steps for Employers
• Please feed back to through HEE any criteria you would wish to see included in the Requirements for providers, especially delivery models, locations, and additional requirements (e.g.support for the apprentices’ mentor, frequency of teaching, day or block study, etc)
• Consider specialist delivery areas / learner skills / patient pathways you wish to see reflected in the apprenticeship programme
• Planning potential learner numbers is really useful to enable a sustainable provider market,
• Front-load any functional skills need with potential learners before enrolment dates where possible,
• Following the national procurement, provider delivery models will be available from Salisbury
@NHS_HealthEdEng
Implementing and next steps
Jane Hadfield
@NHS_HealthEdEng
• Guidance Material - we have developed our first ECP apprenticeship resource – FAQs https://haso.skillsforhealth.org.uk/wp-content/uploads/2021/08/Enhanced-Clinical-Practitioner-Apprenticeship-FAQs-v1-Aug-21-.pdf
• National Webinar – Today!
• National ECP apprenticeship procurement being developed
• Regional Engagement to support procurement and starts
• Regional Apprenticeships Relationship Managers – to engage with organisation and system wide meetings about workforce plans and how we can help embed the apprenticeship standard https://haso.skillsforhealth.org.uk/news/health-education-england-relationship-managers-meet-the-team/
Next steps
Enquiries/keep in touch via
Talent for Care
Jane Hadfield
Q&A session
Gemma Hall
@NHS_HealthEdEng
Close and Final Comments
Thank You!
Fay Lane
