Hiring apprentices in practices to boost digital services – and access new funding

GP practices have found the pace of change of digital transformation agenda and the Five Year Forward View plan to be extremely ambitious and challenging.

Practices in the London Borough of Bexley began to realise that a lack of digital skills among both clinical and non-clinical staff (clerical, administrative and reception staff) was hindering their ability to embrace change and keep pace with new developments.

GP staff and patients weren’t taking advantage of the full functionality of existing GP digital platforms, so not feeling its full benefits for patients or the practice. For example, reception staff were contacting patients by phone rather than using bulk text messaging, leading to a potential loss of income for practices. There was also limited use of digital access and services by patients, potentially affecting provision of care.

The Bexley Training Hub, which is funded by HEE, recognised this gap in digital skills. It came up with an innovative solution – the introduction of a Digital Support Technician (DST) apprenticeship scheme that would bring DSTs on site to support and train staff and patients on ever changing technology, while also providing a new route for learning and training in primary care. This was the first DST apprenticeship scheme in primary care to be run in the UK.

Who was involved?

This pilot scheme brought four organisations working together. These were: South East London CCG’s IT department, GP Federation Bexley Health Neighbourhood Care (BHNC), which acted as the employer, an apprenticeship training provider, Ginger Nut Training, and Bexley Training Hub.

How did the scheme work?

Apprenticeships are a mechanism by which staff can access fully funded training while gaining a nationally accredited qualification. The aim of the scheme was to increase access to and use of digital technologies commonly available to both practices and patients.

Bexley has 21 practices across four PCNs and it was agreed that one apprentice would be recruited for each PCN.

The scheme started in August 2021 despite the pandemic. The programme was structured into four placements with different GP practices. In the first placement (lasting five to six months), the apprentices gained experience of a primary care setting, and its key systems, software infrastructure as well as data protection regulations. In the second placement, the apprentices’ learning was consolidated. During the second and third placements, they started to find a better understanding of their role and how it differed from IT support, while also developing soft skills working with colleagues, service users (where applicable) and software partners to solve problems. In the final placement, the apprentices were based at a single GP practice but worked across their designated PCNs. 

The apprentices’ standard week comprised three days within a GP practice; one day working alongside the CCG IT department or the local GP federation, BHNC; and one day set aside for learning, training and reflection with the training provider. This structure supported the work-based learning approach that is integral to the apprenticeship model.

Each GP practice had a named mentor for the apprentice as a point of contact. Usually, this was a practice manager or senior administrator under the supervision of a GP.

The DST apprenticeship scheme ran for 15 months, with an assessment taking place at the end so the candidates could qualify as digital support technicians.

What were the benefits?

The apprentices covered a wide range of activities and developed expert knowledge in a number of systems such as EMIS, as well as multiple software packages such as Accurx.  They were instrumental in upskilling and supporting staff in streamlining work processes. For instance, they helped practices and patients to access services using apps, which in turn helped improve patient access to medication during lockdown.

Crucially, by supporting GP practices in their reporting processes, the new hires helped PCNs access new funding streams. For example, in order to pull down monies from the Impact and Investment Fund (IIF), PCNs need to be able to first generate key data for IIF reporting. The DSTs created the searches in order to evidence the data, helping the PCNs access the funds.

The Bexley GP surgeries recognised the value of having a DST. Following the programme, all four apprentices were offered full- time permanent employment as qualified digital support technicians, working across each PCN. They are financed by the PCNs but employed by BHNC.

How were the apprentices recruited?

Bexley Training Hub advertised via the job site Indeed rather than NHS jobs to widen the net and reach out to those not actively looking to work within the health service.

We described the job as being a level 3 digital support apprenticeship and created a job description and person specification. No experience was required but an interest in helping people and IT was essential. Those that achieve a level 3 apprenticeship, also known as an advanced apprenticeship, become qualified to the equivalent of two A-Level passes.

The full-time posts paid national minimum wage but as all four hires were over 20 years-old they were all paid at the higher level. The apprentices were recruiting from the local community and had previously been unemployed.

How were the roles financed?

The scheme was initially funded using some non-clinical training underspend at Bexley Training Hub as well as Five Year Forward View funding.  The hires were paid minimum wage for the first six months of the apprenticeship. At six months, their pay rose to Band 3, since this was the point at which they started working in practices and were contributing to supporting practice income.

On graduation, the DSTs were employed at Band 5 level. This reflected the potential increase in income generated via the IIF. Therefore, it’s suggested that once qualified, the digital support technician role should pay for itself via funding from the IIF.

The apprenticeship training element was covered by the Government via the Apprenticeship Levy.

What were the key factors for success?  

The University of Greenwich’s Centre for Workforce Development evaluated the pilot scheme and was able to report a very positive experience by the apprentices and practice staff.  It concluded that the programme has contributed significantly to the delivery of primary care in Bexley.

Despite the challenges of setting up the programme during Covid, communication between the apprentices and organisations involved was rated as being excellent. This was key to the project’s success.

This scheme has supported practices and staff in using software applications and digital options, which in turn has helped to build a forward-looking culture at practice level that recognises that digital transformation is essential if general practice is to be sustainable. Comments from practice managers were particularly positive.

The apprentices themselves reported having a great learning experience and appreciated the protected learning and management time they were given, as well as the support provided by the external trainer. This focus on learning and the split in their time across the different settings was also vital to the programme’s success.  

On a point of lessons learned, the evaluation noted that if planning another similar DST scheme, it would benefit from apprentices being given an induction that covers a fuller explanation about primary care settings, for example, the set-up of GP practices and how they fit in with other NHS organisations, and NHS terminology and acronyms, as well as briefings for mentors.

In conclusion, the Digital Support Technician Apprenticeship scheme appears to be very well-suited for GP practices. The apprenticeship approach offers local work for local people, and meets the needs of practices in delivering new digital options for patients and primary care organisations but who lack the required skills. Bexley Training hub is committed to providing support to other areas who may wish to introduce this exciting and innovative role to their workforce.

Liz Nicholls is Primary Care Tutor at the Bexley Training Hub, and Dr Marianne Markowski and Dr John Foster are both at the Centre for Professional Workforce Development, University of Greenwich,

If you need support or have any queries you can email Liz Nicholls on [email protected]