North London Nurse Degree Apprenticeship Pilot Call for Employer Partners in Primary and Social Care The North London Nurse Degree apprenticeship pilot is supported by the Capital Nurse programme. We seek involvement from all health/care employers in north London 1, including NHS Trusts, General Practices and Nursing Homes. This document is intended to help employers to make an informed decision as to whether they want to join the pilot. We hope you will decide to support one or more staff to become a Registered Nurse and join the pilot. However, we want to hear from you whether or not you want to join the pilot. Please complete the short form in Annex 2 by 15 th June 2018 to let us know your view. What is it? The Nurse Degree apprenticeship is a different way of training a staff member to become a Registered Nurse. The degree they achieve is the same as the degree they can achieve through the traditional university/hei 2 route and the training is provided by the same universities/heis. It is approved by the Nurse and Midwifery Council (NMC) and once qualified the individual can gain their full Nurse registration with the NMC. What is the difference compared to a traditional degree? The Student Nurse apprentice is your paid employee. They do not pay tuition fees so don t need to take out a student loan. The majority of the funding for the Nurse degree training comes through Apprenticeship Funding, although some employers may need to pay a proportion of this (see section on costs below). Who can join the Nurse Degree Apprenticeship Programme? People joining the apprenticeship programme will be your staff either existing or newly recruited staff - usually working on a full-time basis. They will have experience as HCAs/care staff and will have a level 3 qualification preferably in health/social care. They will usually be existing, high calibre staff and demonstrate the right values and potential to take on a more responsible/complex role. They will have level 2 Maths and English (a GCSE Grade A-C/9-4 or equivalent) qualification 3. In addition, they will need to demonstrate the potential to cope with an intensive academic programme, eg the ability to write about complex issues in essays and assignments. Potential Student Nurse apprentices will also need to demonstrate a strong motivation to complete this intensive training programme which includes intensive learning in the classroom and the workplace, plus self-study and homework. Their 1 North London is defined as all the London boroughs north of the Thames, representing three STP areas: North East London, North Central London and North West London. 2 HEI = Higher Education Institution 3 There are training programmes available for individuals who don t hold Maths/English qualifications. Ask your local apprenticeship lead for details.
personal situation and lifestyle needs to allow them to fully focus on the programme. As we are using Apprenticeship funding to support the programme, staff also need to have lived in the UK/EU for the past 3 years, be eligible to work in the UK and not already have a qualification similar to the nurse degree. What does the training programme look like? The programme lasts between 3.5 and 4 years. The full-time staff member spends 34% of their time working for you, and 67% of their time at university or on student placement. This has been calculated based on the following: The NMC specifies the hours that must be allocated for theory and practice (placements) over the course of the nursing degree programme. For a 3.5-year long programme: Total hours on programme (assuming staff member is full time 4 ) = 6,825 (100%) Hours allocated to theory = 2,300 (34%) Hours allocated to Practice (Placement): = 2,300 (34%) where staff must be supernumerary Remaining working hours = 2,225 (33%) One of the placements they undertake will be at your organisation but they also need to do placements in a range of different settings. During placements the NMC stipulate that they should be supernumerary. This means that the employer is making a significant investment in the staff member by paying a full-time salary while they are in structured learning for 67% and working for 33% of the time 5. The content of the training is set by the Nursing and Midwifery Council (NMC) standards for the Nurse Degree 6 and the Apprenticeship Standard and Assessment documents 7. The structure of the programme will be set by the pilot partnership. We will work up the detail over the next 4 months and all participating employers will have the opportunity to influence this. What organisation will deliver the programme? The pilot will be delivered by one of the Higher Education Institutions (HEIs) that is already delivering the traditional Registered Nurse Degree programme and is approved by the NMC to deliver the Nurse Degree apprenticeship programme 8. We will be launching a procurement process shortly which will invite suitable HEIs to bid against our pilot specification. We will require the classrooms to be delivered in London, but we cannot specify the precise location at this stage. 4 Assuming full time staff member at 37.5hrs per week 5 Based on 3.5 year programme 6 See NMC standards for pre-registration nursing 7 See Nurse degree apprenticeship standards and assessment plan 8 Their nurse degree apprenticeship programme must already be validated by the NMC or they need to provide evidence that the validation will be achieved in good time before the programme starts. 2
Why should I support a staff member to become a Registered Nurse? Helping staff to reach their potential: The Nurse degree apprenticeship programme can support HCAs/care staff with experience and the right values to fulfil their potential and become a Nurse. Perhaps you have a staff member who has such potential? The apprenticeship route can support people who are unlikely to be able to follow a traditional degree programme with a Student loan, so this programme provides a viable alternative route to become a Registered Nurse. Helping to address the shortage of Nurses: We have a shortage of Nurses, particularly in London. Over the next 5 years the position will worsen as many Nurses will reach retirement age. Supporting a staff member to become a Nurse may assist with your succession planning and/or increase the number of Nurses within your workforce. Helping to build your profile as a good place to work: Employers providing a career progression route through HCAs/care worker to Registered Nurses will be more attractive to jobseekers and this will help you to attract high calibre applicants to your workforce. Progressing staff along a career pathway through entry leve roles towards Nursing will support staff retention. Supporting staff who are likely to stay: If we target existing experienced staff, it is likely that many of them will already be established in the area with stable housing and strong family/support networks. We believe that such individuals are less likely to leave the area once qualified. What s the timescale? The pilot is planned to start in November 2018. This is dependent on sufficient numbers of employer partners and a successful HEI procurement process. The precise length of the course will depend on the selected HEI (3.5 to 4 years). How do the Student placements work? In line with NMC requirements Student Nurse apprentices would need to undertake placements in a range of settings as well as your organisation. We are establishing a multi-setting pilot to support this process through a rotating placement arrangement between partners. This means that when your staff member is undertaking a placement elsewhere, the intention is that another Student Nurse apprentice will be undertaking a placement with you. Placement rotation to look something like this: Home Nursing (Community?GPs?) Health Visiting (Children & Newborn) Mental Health General / Specialist Medical Older Person (?Nursing Homes?) General/ Specialist Surgical 3
Remember, the NMC requires that placements are supernumerary. We will explore this in more detail as the pilot programme is developed. During placements, the Student Nurse apprentice will need to be supported in the same way as for the traditional university route with a Nurse mentor in your organisation, supported by the selected HEI. Further detail on how this works will be provided as the pilot develops. What is the cost to my organisation? There are 3 cost elements to this programme: Training Costs The training costs/ tuition fees will be covered by apprenticeship funding as follows: For Apprenticeship Levy payers this is 100% funded and drawn down via the digital levy payment system. For smaller organisations that are non-levy payers, 90% of the cost of training is provided via apprenticeship funding which is drawn down via the HEI. The employer is required to contribute the remaining 10%. In the case of this programme the total cost of Nurse degree apprenticeship training is 27,000, so the 10% is 2,700. We are exploring the possibility of utilising levy underspend to support non-levy paying employers that participate in the pilot so that 100% of the funding is accessed, although this is not guaranteed. The NCL CEPN Learn and Earn project is able to reimburse 5 employers for this 10% contribution 9. Salary Costs Although individual employers can decide on the salary for Apprentices, we want one consistent approach to salary for all Student Nurse Apprentices within the pilot. There is varying guidance regarding salary level for this apprenticeship and we have not yet finalised the salary for this particular pilot. Once agreed all partners within the pilot would need to agree to pay their Student Nurse Apprentice this salary. Employers will be making a significant investment in paying a full-time salary while the Student Nurse apprentice is working in their organisation for 33% of their time, in order to attend university and complete the required clinical placements for 67% of their time. Salary options range from a starting salary of 21,168 (with Inner London Weighting) to 7,125 (minimum apprenticeship salary for the first year, then rising to minimum wage). Recognising that the pilot requires a significant investment in salary for the employer and in order to keep things simple across different settings we are currently proposing a spot salary across the board of 15,900 with no increments over the 3.5-4 years but reflecting estimated national minimum wage increases over the life of the programme. This is an approach that a small number of NHS Trusts have adopted elsewhere for 9 Reimbursement is open to 5 employers which are either Care Homes based in any of the 5 boroughs and GPs in Camden, Enfield, Haringey or Enfield. 4
Nurse Degree apprenticeships 10. For a 3.5year programme this has been estimated as a total salary of 57,201 plus on costs of which the investment (for the 67% of time they are learning) would be 38,324 plus on costs. This has not yet been agreed and we will inform interested employers as soon as a decision has been made. We recognise that the spot salary of 15,900 will be a salary drop for many staff but this reflects the significant investment that the employer is making over a number of years, as well as the fact that the staff member is not required to pay tuition fees and/or take a student loan. Some staff will be interested in this opportunity and others will not. Annex 1 gives different salary scenarios and the assumptions made in current calculations if more information is required. Staff resource and time As with the traditional degree programme, Student Nurse Degree apprentices would need to be supported in their placements by Nurse mentors who, with support from the HEI, will be responsible for supervision, observation and sign off of agreed placement activities. This will be both for your staff member and for other Student Nurse apprentices undertaking placements in your organisation. We are exploring the issue of placement support and what we can ask of the HEI as well as the feasibility of building Nurse Mentor training into the programme for those employers who wish to participate but who require their current Nurse become a mentor. In addition, as with all long-term training programmes, there will be some involvement from management in terms of management of the staff member and liaison with the HEI to ensure the programme is running as intended. This will include arrangements for rotating placements within your organisation and agreed communication with other employers. We will also need all participating employers to contribute to the evaluation process. Additional support provided by the NCL CEPN Learn and Earn project This is one of the steps in a clinical career pathway within primary care, which the Learn and Earn project is promoting. Any staff who are seriously considering taking up this Trainee Nursing Associate programme or the Nurse Degree Apprenticeship programme are strongly advised to consider joining the fully funded study skills programme that will help to prepare them for the intensive academic study required. If they book a place now the course will be completed before either programme starts. For more information see the flyer. For more information about the pathway in general, email: jo.barter@communitymatters.co.uk. Study skills flyer.pdf 10 Trusts that have adopted the spot salary approach have secured union agreement on the basis that the spot salary reflects the old student secondment arrangement. For example CNWL NHS Trust and West London Mental Health Trust have collectively started 28 nurse degree apprentices in April 2018. 5
Can I require the staff member to remain in my employment after they become a Nurse? Not really. While it is possible to build clauses into a contract, we have been advised that it is very difficult and potentially costly to enforce this. We recognise that there is a risk that the individual may leave your organisation once qualified. Organisations already running Nurse degree apprenticeships and similar are working to provide a highly supporting and positive environment during the programme, so that the employee values the employer and enjoys working there. These personalised work relationships are influential in people s decisions to remain with a particular employer. They are also starting discussions on what happens once Registered and future career prospects well before the end of the programme. Steps to recruiting the right staff member for the Nurse Degree Apprenticeship The decision to support a staff member on the programme sits with the employer. However, we need to ensure that they are have the potential to be a high calibre Nurse once Registered and suitable for the programme in the sense that they stand the best chance of succeeding. So, we also need to take account of the HEI entry requirements for the programme. These will be further defined once we have selected the HEI. We will expect them to be involved in the process which we will streamline as much as possible. The process will include the following key steps: The employer identifies a potential Student Nurse apprentice. We expect that usually this will be an existing valued staff member but it may be that the employer decides to recruit to the role. The employer will want to ensure that the individual has the right values, track record and experience to be suitable not just for the programme but suitable for their workplace and the potential nurse role once qualified. They will also need to be highly motivated and be able to undertake the intense academic learning required, including having time for completion of homework and assignments. The individual makes an informed decision as to whether they want to take up the programme. The staff member needs to understand the level of effort they will need to put into study and work placement. This is an intensive programme and a move from vocational training to academic study which is hard for many individuals. They need to really think about what is involved and what is expected of them and have thought through whether they feel this is a realistic option for them. The HEI checks suitability for the Nurse degree programme. We expect the HEI to require them to have health/care experience and a level 3 qualification, preferably in health or social care. They will also need to have good English and Maths skills and potential study skills. Regarding the English and Maths, the preference will be that they already have a GCSE (A-C) or equivalent qualification. All individuals will be assessed by the HEI 6
irrespective of whether they hold English and Maths qualifications in order to ensure that they can apply these skills to the context of academic study (eg writing essays). They will also be interviewed. Once the university confirms suitability, the employer makes the offer. We expect that this will be in the form of a specific contract of employment as a Student Nurse Apprenticeship on the agreed salary over the period of the programme. Different employers will have different approaches regarding the offer, for example some will specify that there will be progression to a Nurse role with a new contract of employment subject to achievement of the qualification and Registration. We will provide sample contract templates. Decision on suitability of individual sits with the employer, HEI and individual themselves. Decision to support and employ the individual as a Student Nurse apprentice sits with the employer. Decision to accept an individual onto the programme sits with the HEI. Are there other ways of growing staff towards nursing? Yes. It is possible to take smaller steps as shown in the chart overleaf: Nurse Degree Assistant Practitioner Nursing Associate Top up to Nurse Degree This means you could: 1. Support a staff member to become a Nursing Associate. This is a 2-year Trainee Nursing Associate (TNA) apprenticeship and there are programmes starting in Autumn 2018 in each STP area. 11. Once qualified, if you wish you can support them to complete the full Registered Nurse degree through option 2 below. 2. Support an existing staff member who already holds the Assistant Practitioner (or equivalent qualification) to move onto a shortened Registered Nurse degree which takes account of their existing skills/qualifications. Some Universities plan to run top up programmes starting this autumn. What next? 11 For more information on the Trainee Nursing Associate programmes, contact: Debbie Jurasz for TNA programme in North East London: debbie.jurasz@bartshealth.nhs.uk Jo Barter for TNA programme in North Central London: jo.barter@communitymatters.co.uk Diane Morgan for TNA programme in North West London: diane.morgan@hee.nhs,uk 7
If you are not interested/able to join the pilot, please still provide the information requested in the form in Annex 2. Reasons why you have decided not to join the pilot are really important to know and will help to inform strategic discussion. If you are interested in joining the programme. Please complete the relevant parts of the form in Annex 2 and send to us as soon as possible and by the deadline specified at the latest. If you need more information, please email the contact given in Annex 2. We will update all who respond regarding the decision on salary. Those who wish to participate will be invited to join a delivery group which will give the opportunity to influence the design of the programme. 8
ANNEX 1: Salary Options Different Salary Scenario 1 Salary Guidance NHS Employer guidelines for nurse degree apprenticeship - Point 6 of Agenda for Change Band 3 INNER LONDON Inner Year London rates year 1 21,168.00 Year 2 21,724.00 Year 3 22,357.00 Year 4 (6mths) 11,266.50 TOTAL 76,515.50 SALARY COSTS (100%) hourly rate Salary including on costs 10.86 26,671.68 14,182.56 11.14 27,372.24 14,555.08 11.47 28,169.82 14,979.19 11.56 14,195.79 7,548.56 96,409.53 51,265.39 Salary Investment: This is when staff is being paid but undertaking SALARY INVESTMENT (67%) learning or placement Salary Salary including on Comments costs 17,870.03 Assume salary rises by a Band point 18,339.40 each year (NHS Employer guidelines 18,873.78 do not specify at this stage) 9,511.18 64,594.39 2 Agenda for change year 1: 60% 21,447.60 11.00 27,023.98 14,369.89 18,106.06 guidelines for long term Year 2: 65% 22,884.90 11.74 28,834.97 15,332.88 19,319.43 trainee. - specified % of Year 3: 70% 24,322.20 12.47 30,645.97 16,295.87 20,532.80 band 5 maximum ( 34,495 inner London) Year 4 (6mths): 75% 12,935.70 13.27 16,298.98 8,666.92 10,920.32 TOTAL 81,590.40 102,803.90 54,665.57 68,878.62 No cost of living increases included 3 Apprenticeship minimum wage guidelines - apprenticeship min wage for year 1 then national min wage for 25yrs+ year 1 ( 3.70) 7,215.00 3.70 9,090.90 4,834.05 6,090.90 Year 2 ( 8.18) 15,951.00 8.18 20,098.26 10,687.17 13,465.83 Year 3 ( 8.54) 16,653.00 8.54 20,982.78 11,157.51 14,058.46 Year 4 (6mths) ( 8.92) 8,697.00 8.92 10,958.22 5,826.99 7,342.01 TOTAL 48,516.00 61,130.16 32,505.72 40,957.21 Assumed 25yrs min wage and increased by 4.5% each year - expect first year to be unacceptable 4 National Minimum wage (25yrs +) year 1 ( 7.83) 15,268.50 7.83 19,238.31 10,229.90 12,889.67 Year 2 ( 8.18) 15,951.00 8.18 20,098.26 10,687.17 13,465.83 Year 3 ( 8.54) 16,653.00 8.54 20,982.78 11,157.51 14,058.46 Year 4 (6mths) ( 8.92) 8,697.00 8.92 10,958.22 5,826.99 7,342.01 TOTAL 56,569.50 71,277.57 37,901.57 47,755.97 Assumed 25yrs min wage and increased by 4.5% each year 5 Spot Salary (no increments but reflects estimated nat. min. wage for 25+ from year 2) year 1 15,900.00 8.15 20,034.00 10,653.00 13,422.78 Year 2 15,951.00 8.18 20,098.26 10,687.17 13,465.83 Year 3 16,653.00 8.54 20,982.78 11,157.51 14,058.46 Year 4 (6mths) 8,697.00 8.92 10,958.22 5,826.99 7,342.01 TOTAL 57,201.00 72,073.26 38,324.67 48,289.08 2 NHS Trusts adopted this so far (in London). Unions going with this because it matches the nursing secondment salaries that they pay and one Trust has already included this scenario in the apprenticeship policy which was cleared by the Unions. London Living Wage year 1 19,890.00 10.20 25,061.40 13,326.30 16,791.14 Increased by 4.6% (each year) Year 2 20,804.94 10.67 26,214.22 13,939.31 17,563.53 reflecting most recent annual 6 Year 3 21,761.97 11.16 27,420.08 14,580.52 18,371.45 increase Year 4 (6mths) 11,381.51 11.67 14,340.70 7,625.61 9,608.27 TOTAL 73,838.42 93,036.40 49,471.74 62,334.39 NOTES a) Calculations based on ft=37.5 hours per week and course running for 3.5 years b) need to do calculations for outer London and Fringe c) calculations based on 3.5 year programme. Some HEIs are planning 4 year programme (we can ask for 3.5 via tender process) d) Salary + on costs assume: 126% This will vary by setting (NHS, Primary and Social Care) e) minimimum wage increases are estimated and based on individual aged 25yrs plus 9
Annex 2: Your response to the invitation to join the North London Nurse Degree Apprenticeship Pilot Please complete this form and send to jo.barter@communitymatters.co.uk by 15 th June 2018 Organisation Name Contact Name Organisation Address including postcode CONTACT DETAILS FOR EVERYONE TO COMPLETE PLEASE Borough your organisation is based in Phone (direct line) Email If you have decided NOT TO JOIN THE PILOT please complete the yellow section of this form only. If you have decided TO JOIN THE PILOT, please ignore the yellow section and complete the white form below. FOR THOSE WHO HAVE DECIDED NOT TO JOIN THE PILOT Please tell us why you have chosen not to join the Nurse degree apprenticeship pilot by choosing any of the reasons below (as many as you like). Reason 1. My organisation does not have the scope to create a Nurse job role once the individual has qualified. 2. We do not have the capacity to invest in the cost of a Nurse degree apprentice at this point in time. 3. We do not have anyone in the staff team who is suitable for this role currently and we don t want to recruit externally. 4. The Nurse based within our organisation does not have the capacity to support a Nurse degree apprentice. 5. We do not have a Nurse on site to support the Nurse degree apprentice. Other reasons please use this space if you wish: Put an X in any boxes that apply Now please email this document to jo.barter@communitymatters.co.uk Thanks for your response FOR THOSE WHO WANT TO JOIN THE PILOT (This is just an indication of interest at this stage) 1. How many Nurse Degree Apprentices would you like to employ? 2. Are they existing staff? 10
3. Do you have a Nurse (or Nurses) identified who would support the Placements? Please give details of your plan. 4. Does this Nurse (do these Nurses) have Nurse mentor training? 5. If we can build mentor training into the programme (at no cost to you) would you allow your Nurse(s) to attend if needed? 6. Are you prepared to allow your Nurse(s) sufficient time to fulfil the mentor function during Placements? You are aware that we are proposing a Spot salary of 15,900 (although this is not yet finalised) (see page 4). 7. Is your application conditional on the spot salary being agreed 8. Will you consider involvement if a higher salary option is agreed? 9. Please select which of the following statements reflects your position by deleting the incorrect statements: I am a non-levy payer and would be prepared to pay the 10% contribution towards training costs of 2,700 I am a non-levy payer and would not be prepared to participate unless the 10% contribution requirement was removed by transfer of use of levy underspend I am a levy payer. Please answer the following questions to confirm commitment and understanding of the pilot. I understand: 10. That the Student Nurse apprentice will be my employee and I will be responsible for their salary, terms and conditions and all aspects of their employment for the whole length of the programme (3.5-4 years) including when they are on placement with other organisations 11. That I will pay a full-time salary for the Student Nurse apprentice (salary to be defined by the pilot) 12. That 67% of the Student Nurse apprentice s time will be spent in learning or placements and the placements are supernumerary. Delete as appropriate 11
13. That my organisation will provide placements for other Student Nurse apprentices on the pilot while my employee is away from my organisation on other placements 14. That I will be required to provide data to support programme monitoring and also participate in the evaluation. 15. That I can confirm my involvement (or otherwise) once I am informed regarding the salary for the Student Nurse apprentice, and once more detail on the programme is available. I will be formally required to sign up to the pilot at a later stage. Please complete this form and send to jo.barter@communitymatters.co.uk by 15 th June 2018 12