Leveraging the power of apprenticeships in Northumbria Healthcare NHS Foundation Trust
As the largest employer in the country, the NHS has a vital role to play tackling the root causes of inequality by helping more people - particularly those furthest from the labour market - to access good, secure work. Apprenticeships are a key mechanism for achieving this, offering valuable routes into NHS careers and supporting people to develop and progress within the health and care system.
However, if apprenticeships are not designed and delivered inclusively, they can unintentionally create additional barriers and deepen existing inequalities. This case study explores how the Northumbria Healthcare NHS Foundation Trust has worked to ensure its apprenticeship programmes reach - and are accessible to - a wider range of people, ensuring that more individuals can benefit from the opportunities an NHS career provides.
Introduction
Northumbria Healthcare NHS Foundation Trust (NHCFT) serves a large, geographically diverse area, including rural coastal communities that often experience lower educational attainment and poorer health outcomes. Recognising the profound link between good employment, economic stability, and long-term health, the Trust has positioned its workforce and education initiatives as a core part of its public health agenda.
Through its Our Community Promise framework - centred on five key pillars, including Employment and Education - apprenticeship pathways are seen not just as a recruitment tool, but as a critical mechanism to raise aspirations, create career stability for local people, and address health inequalities at their root.
Background to the work
When the Trust first became an employer provider of apprenticeships it offered only a small number of programmes. However uptake was limited and the model wasn’t successful in reaching a diverse range of candidates. One of the key barriers identified was a financial one. With the national minimum apprentice salary not paying a living wage, many potential candidates - especially those from lower socio-economic backgrounds - were put off applying.
With this insight, the Trust identified a clear strategic opportunity: by investing in a more inclusive, targeted apprenticeship model, they could simultaneously meet their future recruitment needs as well as providing opportunities to the areas of greatest deprivation and lowest school attainment.
To capitalise on this, the Trust built a business case to pay apprentices a real wage and to conduct targeted, proactive recruitment in areas where lower levels of educational attainment or other factors might be acting as barriers to entry. This shift transformed apprenticeships within the Trust from a small-scale internal training offer into a key route for inclusive recruitment, enabling more people from local communities to access good work and long-term careers within the organisation.
Who was involved? What were the key enablers?
In order to develop a more inclusive and effective apprenticeship offer, there were a number of key enablers that needed to be in place.
Firstly, executive team buy-in was crucial, ensuring the apprenticeship programme and strategy moved beyond being a solely HR function to becoming an integral part of both the workforce development and population health strategy for the Trust at large. This in turn enabled the Workforce team to get approval of a business case to increase the number of apprentices and to offer a salary.
Secondly, NHCFT created strategic links with local schools, colleges, and local authorities to ensure a coordinated approach to connecting potential applicants from a wide range of backgrounds with potential apprenticeship opportunities.
For example:
The Trust developed Apprentice Career Ambassadors, presenting at school assemblies and events to show young people that "if you can see it, you can be it."
Additional recruitment pathways for adults were created, for example by linking with Veterans and Armed Forces organisations.
The Trust committed to guaranteeing interviews for Care Experienced People up to the age of 25, as part of its Universal Family Project, in addition to providing dedicated pastoral support for vulnerable groups at each stage of the apprenticeships programme.
Developing the Model
The central intervention was to move away from the minimum wage. For their direct entry apprentices on level 2 apprenticeships the Trust pays the national living wage and for level 3 apprenticeships they pay Agenda for Change band 2. This "real wage" addresses the financial barrier that often prevents people who are further from the labour market from applying.
Furthermore, the Trust:
Lowered entry criteria: Accepted a lower entry criteria for Level 2 apprenticeships to provide a stepping stone for those with low school attainment.
Broadened scope: Adopted 66 different apprenticeship standards across clinical, non-clinical, engineering, and digital services, demonstrating the breadth of careers in healthcare beyond the traditional doctor and nurse roles.
Design routes with clear progression: Developed clear career pathways, such as level 2 to 3 healthcare support worker apprenticeship, to then progress on the Student Nurse Associate training, ensuring recruits see a meaningful future with the organisation.
Organised a Northumbria Apprenticeship Open evening attended by 124 people.
Early Impact and Future Ambitions
The investment in the real-wage model has demonstrably supported the Trust’s recruitment trajectory. Between 2022 and 2024, Northumbria Healthcare recruited 497 direct-entry apprentices, with an impressive 93% of them continuing to work for the Trust after their apprenticeship ended. In addition, in 2023, 25% of the Trust’s apprentices came from deprived communities, up from 20% in 2021. 5.5% have a disability, compared to an NHS average of 3%.
The model is now fully embedded in workforce planning and development. The success stories, such as individuals progressing from Level 2 customer service to Level 3 business admin Data Specialist and ultimately pursuing a Student Nursing Associate apprenticeship, underscore the programme’s effectiveness in unlocking long-term career potential within the region.
One sign of the success of the revamped Apprenticeship program is that the Trust is now fully utilising its Apprenticeship Levy, making the most of the opportunity of available funding and preventing significant funds from being returned to HMRC. The programme has also gone on to win a number of awards.
Looking ahead, NHCFT is focused on:
Retention: Achieving a psychologically safe environment to ensure people from vulnerable groups, like those with care experience, have stable and meaningful careers.
Strategic partnerships: Building on their partnership with Education Partnership North East, which will see a new School of Health open in Ashington in 2026, creating further accessible routes into the NHS.
Wider public health gains: Continuously using good employment as a lever for better health outcomes for local people, supporting the overarching public health agenda.
Key Learnings for Others
Paying a salary equivalent to a Band 2 role for Level 2 and 3 apprentices is paramount to creating accessible and inclusive pathways, especially for hard-to-reach groups.
Securing executive team buy-in that views widening access to employment as worthwhile investment - both for the Trust and the wider community.
Role models who share the lived experience of key recruitment groups (such as veterans or apprentice ambassadors) are more effective than traditional careers guidance, as they can make opportunities feel tangible and relatable, whilst also addressing some of the barriers people face.
There is greater power and reach for this type of work when collaborating closely with local partners, including councils and schools, to work on the same agenda.
Final reflections
By expanding its apprenticeship programme and embedding it into workforce planning, the Trust has turned apprenticeships into a powerful tool for both workforce development and inclusion. Offering 66 standards across clinical and non-clinical roles, and paying a real living wage, the Trust has created opportunities for people from diverse and disadvantaged backgrounds to access meaningful work and build careers, while also supporting the organisation’s wider workforce needs. This approach demonstrates how strategic use of apprenticeships can deliver both social impact and organisational benefit.