Rising to the QIPP challenge

If so, surely they should play a crucial role in QIPP  - the government’s Quality, Innovation, Productivity and Prevention initiative.

QIPP aims to transform the NHS by simultaneously improving quality of care and making efficiency savings. NHS staff, clinicians and patients are expected to assume some level of responsibility for this task, alongside the government.

We believe apprenticeships can help deliver QIPP. Take medicines management - a crucial area where quality and productivity can improved within the NHS. Within medicines management, pharmacy is fundamental to quality and patient safety. Within pharmacy, training for support staff is vital.

Traditionally, apprenticeships have been used to help support staff gain the relevant experience and qualification. Figures in the 2012 National Audit Office report ‘Adult Apprenticeships’ suggests apprenticeships are a good return on investment, especially in healthcare.

And indeed, a nationally recognised apprenticeship has been introduced for pharmacy technicians and assistants. The Qualifications and Credit Framework Level 2 Apprenticeship aims to provide a structured, efficient scheme which can be evaluated. It aims to deliver:

• Achievement of a set target within a measurable timescale
• A robust quality assurance framework
• Attainment of specific key skills
• A theoretical underpinning
• Better monitoring and evaluation
• Assurance of a comparable skills level for employers.

Before this, trainee pharmacy assistants often missed out on theoretical training, were known to stay on the programme for extended periods, and were not required to have a specific level of literacy or numeracy.

The University of Leeds’ Pharmacy Development Unit co-ordinates the monitoring and evaluation of apprenticeships in Yorkshire and the Humber, and works with NHS Yorkshire and Humber, trusts and training providers to achieve expected outcomes. Currently there are 122 QCF Level 2 apprentices in the region. Of these, 107 began their apprenticeship with their current employers, and are thus entitled to additional capacity support funding.

Given the potential impact of apprenticeships on quality and efficiency, particularly in the healthcare sector, surprisingly little evaluation has been published on existing apprenticeships.

In Yorkshire and the Humber, apprenticeships are seen as a way to provide robust, timely and efficient training. Recent PDU research with trust managers and pharmacy staff suggested the apprenticeship model was highly regarded as a means of improving skills such as numeracy and literacy. Evidence from an options appraisal indicated that training pharmacy assistants and technicians through apprenticeships led to cost savings of almost £1,500,000 for NHS Yorkshire and Humber.

Regionally, stakeholders have collaborated to administer and evaluate the apprenticeships, which has led to more efficient workforce planning; for example, PDU worked with employers and training providers to identify their needs and objectives. Employers could choose to either to develop existing staff, or train new staff for new roles.

The pharmacy apprenticeship has also been a boost to quality. The region uses a preferred provider system and all registered assessors need to comply with relevant quality management systems. This has ensured supervision is appropriate and competent.

Some challenges have also emerged: a PDU evaluation initially encountered some issues around data management; working with so many stakeholders makes it tough to gather the data necessary for rigorous surveillance.

Finally, funding changes could stall progress. Over the past three years there has been a 25 per cent increase in uptake of apprenticeships among Yorkshire and the Humber trusts and regional stakeholders are keen to maintain the momentum. However, there are concerns that changes in funding may slow or even reverse this trend.

The NHS reforms mean organisations face a bigger challenge than ever to equip staff to perform at their best. The apprenticeship experience in Yorkshire and the Humber demonstrates that this route of learning can help address identified skills weaknesses in the healthcare workforce. More importantly, the collaborative approach in the region ensures a supportive framework for employers who use apprenticeships and helps to guarantee the quality of training. Taken together, these factors could make a big difference to QIPP.

Apprenticeships in action

In 2012, one of the Yorkshire and the Humber apprentices in pharmacy services received national recognition. Margaret Green has worked at the Calderdale and Huddersfield NHS Foundation Trust for 5 years as a pharmacy assistant. Despite a bad experience with education, she achieved a distinction for her apprenticeship and as a result has won several local and national awards including the Vocational Qualification Learner of the Year for the region.

Business secretary Vince Cable said: “Returning our economy to good health will depend on skilled workers, and vocational qualifications are key in helping millions of people every year to develop the skills employers are crying out for.”

Gill Risby, Yorkshire and the Humber Lead, pharmacy development unit, University of Leeds; Obi Peter Adigwe, senior project officer, pharmacy development unit, University of Leeds.