Can Sustainability and Transformation Plans deliver a better future for the NHS?

“In short, ‘No’, not unless they change direction”, say the authors of a new report, entitled ‘Sustainability and Transformation Plans: How serious are the proposals? A critical review’, published today (Wednesday 14 June 2017) by London South Bank University.

To deliver a better future for the NHS, the authors argue that the 44 existing Sustainability and Transformation Plans (STPs) for the NHS in England, initiated by NHS England in December 2015, would need to be given the legislative powers and support necessary to achieve effective collaboration, plus some much-needed clarification on their role.

The report also recommends that STP leaders need to plan ahead based on the reality of their current situation, identify changes that are evidence-based, develop workforce plans that match their ambitions, and focus on reducing demand before removing resources from the acute sector.  At present some elements of these recommendations are missing in all of the 44 published STPs.

Overall, this critical review reveals a distinct lack of comprehensive planning and evidence-based policy making, in all 44 STPs, of sufficient quality needed to deliver the level, pace and scale of change required for the future transformation of the NHS.

The report finds that none of the STPs are ready for implementation due to:

·        The funding shortfalls,

·        The lack of legislative framework to support collaboration across health and care,

·        The lack of clarity on the role of the STP and its leadership,

·        The challenge of collaborating across multiple organisations in financial challenge,

·        The speed of planning that was required,

·        The failure to ensure engagement with local government,

·        The lack of clarity about accountability to citizens,

·        The failure to produce adequate business plans,

·        The lack of workforce plans (two thirds without any detail),

·        The lack of focus on reducing demand before switching resources away from the acute sector.

The authors propose that a viable business case must first be established in order to take full account of the proposed changes to the health and care system and to ensure that sufficient staffing and adequate capital are made available to establish new services and prove their effectiveness, before existing services are reduced. The STPs need clarity on their accountability and authority, and legislative change to enable collaboration.

Co-author of the report, health economist, Seán Boyle said: “The health and care system needs time to develop partnerships, and a legislative and accountability framework that fosters collaboration.”

“That is why this report recommends a constructive overhaul of each of the 44 STPs, looking at the appropriate framework for that work in terms of geographic area and what parts of the health and care system should be involved including the stakeholders for that area of work, the partnership agreements required and the accountability to the population of the proposed changes.”

Professor Rebecca Malby at LSBU’s School of Health and Social Care, who commissioned the report said, “There is an acute need for the evidence base supporting the case for change in each of the 44 STPs within the NHS to be substantiated further before the Service commits to launching plans for widespread ‘transformation’.  STPs also need time to clarify and develop their leadership function – moving from a top down command and control approach to a planning and enabling approach.”

Professor Warren Turner, Dean of LSBU’s School of Health and Social Care said: “Faced with tightening financial pressures on the NHS and social care the weakness or absence of serious workforce plans means there is little reason to believe that these ambitious reductions in demand and pressure on acute services will be achieved in the timescale proposed.”

More information

Read a full copy of the report and commentary here, under ‘Research’.

The 44 sub-reports can be read here.

Read a blog by Professor Rebecca Malby about the findings and the potential here.


Northern Ireland start-up, Connected Care Solutions, founded by local entrepreneur Deepak Samson, is set to make a big impact on the ageing population with Ethel, the elderly care smart hub, which is now being used by the Shetland Islands Council, under the EU-funded RemoAge project.

Ethel is an innovative touchscreen tablet that allows families and carers to stay in touch with their elderly loved one, via use of an ‘always-on’, large touchscreen tablet.  The tablet has a simple to use interface, specifically designed for those unfamiliar with technology that allows an older person to contact a pre-set list of contacts like family members, a carer or doctor simply by tapping the screen.  Ethel also allows additional functionality such as medication reminders, when to do exercises, etc. and can also send instant SMS alerts to family or carers if a user fails to respond to medication prompts.

Speaking about the recent success of the business Chairman of Lisburn & Castlereagh City Council’s Development Committee, Councillor Uel Mackin, said:  “Deepak is an inspirational innovator and a fantastic example of how working with the Council can enrich your business. He is fully engaged with the Council and has participated in the Council’s Business Start-up and Graduate Programme, as well as taking part in the highly successful Lisburn Castlereagh at Westminster investment event. His vision for the business is commendable and we are delighted to continue to work with Deepak through ongoing mentoring support to help grow his export base.”

Deepak explains: “I am the classic accidental entrepreneur. I only ever wanted to help people access their families or care providers where face-to-face interaction was impossible or impractical. I was a health service manager, had no formal background in development of technology, but it seemed obvious to me that there had to be an easier way to allow an ageing population to stay in touch in a simple way. The support I have received from the Council has been so valuable to me personally and to my business.  I would urge anyone with that Entrepreneurial spark to contact the Council to see how they can assist.”

The Mayor, Councillor Brian Bloomfield, MBE said:  “The news that Deepak is working with various NHS Trusts, Local Authorities, Hospices, Domiciliary Care agencies and Housing Associations in England, Scotland and Northern Ireland, is very exciting.  The product created by Deepak will clearly lead to significant efficiency savings for Trusts and provide a much better patient experience, so it is beneficial to many.   The demand for the product is growing and with requests from all around the world Connected Care Solutions is set to be one of Lisburn Castlereagh’s fastest growing tech businesses.”

Deepak is supported in his efforts to grow his suite of innovative products and enhance his export capability through the Lisburn & Castlereagh City Council’s Business Support and Investment Programmes and also through Invest NI.

To find out more about Ethel go to: or follow @ETHELsmarthub

End of life care planning: Why it should be everyone’s concern

To mark Dying Matters Awareness Week (May 8-14), Michelle Brown, Deputy Head of Department for Healthcare Practice, explains why everyone – young or old – should make sure they know what end of life care planning involves.

What is end of life care planning?

There is little doubt that end of life care is important to everyone. People generally recognise that both they themselves, and those around them, may have specific fears, wishes, or requests when it comes to the end of life care.

Starting any discussion surrounding end of life care can induce anxiety among health and social care professionals but also generate anxiety in those close to the person who is reaching the end of their life and to the individual facing that prognosis. Without those discussions however, there is a definite risk that the individual’s wishes may not be determined or, worse still, professionals and loved ones run out of time before they can put plans into place.

Everyone has a right to the highest quality care no matter what diagnosis, geographical area, age, socioeconomic status and, in addition, marginalised groups should have equal access e.g. travellers, prison population. Having those key, important discussions in a timely manner is vital in being able to determine a person’s wishes regarding the end of life.

When to initiate end of life care planning

A shared anxiety may be ensued concerning when to initiate palliative and end of life care. Tools have been initiated, for example, The Gold Standards Framework Prognostic Indicator Guidance, to aid professionals with the difficult decision about when the right time to discuss end of life planning is. Thinking about the surprise question asked in this guidance can be helpful in informing that decision surrounding end of life planning discussions. The surprise question is:

  • Would you be surprised if this person died within the next 6-12 months?

This should not be the only consideration. Experience surrounding discreet and obvious deterioration can all help to identify when a person is nearing the end of life. Ascertaining that they are nearing the end of life can help to ensure they receive the support, care and interventions which may aid a ‘good death’ rather than patients experiencing urgent care that has not been anticipated and the patient has had very little time to think about what they would want or worse still no time to discuss their wishes.

Communication and its importance in end of life care

The National Council for Palliative Care pledges to raise awareness surrounding death, dying and bereavement using, among numerous publications, the Dying Matters website. Their current work surrounds the question ‘what can you do?’ and its aim is to get more people active in planning for death and dying.

There are, however, numerous barriers to achieving high quality, end of life care in addition to lack of planning. These include lack of recognition that a person was approaching end of life, failure to communicate effectively to carers/ family, people kept in hospital unnecessarily, lack of education and knowledge and lack of understanding surrounding commissioning resources for end of life care. This means that there are significant challenges in delivering end of life care in a proactive, effective manner, in a patient’s place of choice.

Discussing end of life care requires constant reiteration; checking and information provision as people can change their mind particularly when they are faced with new fears, concerns and/or symptoms on a daily basis.

To ensure there is a mutual understanding and awareness regarding the current issues in the patient’s journey, the plan of care, any new symptoms or concerns that may present, and regular discussion utilising a holistic approach, is vital in ensuring a responsive approach to their care needs. Communication in palliative care sets the tone for all the care which may be required because without effective communication, patients and relatives may be left feeling isolated, unaware of the current situation presented and begin to lack trust in those providing care.

Patient rights

Patients have the right to self-determination. In other words, their autonomy should be maximised. When approaching the end of life, a patient’s right to make decisions rather than decisions being made for them is even more crucial to facilitate a patient-centred experience. Care delivered which is in conflict with the patients’ wishes falls far short of what they deserve; therefore clear communication is paramount.

A compassionate and non-judgmental approach is crucial in allowing those who are nearing the end of their life to be open and honest. A poor or less than adequate assessment/ discussion may leave those being cared for feeling anxious, upset or frustrated, or that they are misunderstood or not listened to.

Making every moment count with an individual at the end of life is crucial as this may be the last contact a health or social care professional has with the dying person making it the last thing that anyone does for them. Ensuring care remains patient-centred and maximising any opportunity to hear the patient’s wishes and preferences is fundamental as a patient approaches the end of their life.

Home exercises ‘effective’ at reducing rheumatoid arthritis hand problems

HOME hand exercises provide huge benefits for people with rheumatoid arthritis, researchers from the University of Salford have found.

In the first ever review of its kind, researchers found that home exercise programmes improved patients’ grip strength and hand movement while reducing the amount of pain they experienced, but that high-intensity programmes were the most effective.

Rheumatoid arthritis often causes problems such as pain, stiffness and joint swelling in the hands as an early symptom of the disease, with women’s grip strength reduced on average to less than half within six months of diagnosis.

These problems sometimes mean people are unable to carry on working while 59 per cent of people develop hand deformities within a decade of developing the condition.

Although medication can improve symptoms, it does not stop the loss of muscle function and occupational therapists and physiotherapists often teach home hand exercise programmes as a way of managing the illness – although the type of exercise and number of sessions varies widely. Little work has been done to assess how effective they can be.

Professor Alison Hammond and Dr Yeliz Prior from the University’s School of Health Sciences looked at home hand exercise trials involving 665 patients with an average age of 59.

They had taken part in a range of exercise programmes included squeezing, pinching and rolling therapeutic putty, squeezing hand exercise balls and pulling against resistance bands.

Their report, published in the British Medical Bulletin, concludes that those who had done exercises using therapeutic putty giving medium – or stronger –  resistance at high intensity did best. 

People regularly doing such exercises reported improvements in grip strength, hand movement and their ability to carry out everyday tasks, as well as experiencing less hand pain. Longer-term, if they keep doing them, these benefits continue.

Alison Hammond, Professor in Rheumatology Rehabilitation at the University of Salford, said: “Rheumatoid arthritis effects nearly 700,000 people in the UK, with many suffering hand problems which can be both agonising and can reduce their ability to work and carry out everyday tasks. We have found that hand exercise programmes are an effective way of reducing these problems, but that high intensity resistive exercises are by far the best and most cost-effective method.

“We found that the most effective programmes were high intensity and supervised by therapists for four or more sessions at first, to make sure people with arthritis can do the exercises right, steadily build up resistance and get into the habit of doing them. These resulted in consistent improvements. In comparison, low-intensity, low-resistance programmes, taught in just one session – which is common practice in the NHS – don’t produce these results.

“Our findings showed that people should do between four and six resistive hand exercises performed at high intensity – such as 10 repetitions of each exercise performed daily, and then up to three times a day as their hands improve. Although this takes 20 minutes or so a day, they can be spread through the day and easily done when taking a break or watching TV.”


New resources are being made available to employers, training providers and employment professionals to help alleviate London’s social care skills shortages from today.

Through Ambition London, funded by JP Morgan Chase Foundation, two new toolkits are being made available to promote the rewards and tackle common misconceptions of careers in health and social care sector.

Both the health and Adult social care sectors faces an acute shortage of skilled workers with too few entrants, poor career progression and poor retention. As London’s population gets older, more has to be done to support employers built attractive career pathways in these vital sectors.

These toolkits, developed with experts from Skills for Care and the National Skills Academy for Health, clearly articulate the benefits of a rewarding career in both the social care and health sectors and provides training providers and employment professionals with better information to support people who are unemployed or in long-term low-paid work. In addition, the toolkits promote information on the careers and training routes for job roles within these professions and promote Advanced Learner Loans as a funding route for those individuals who wish to invest in their skills and progress their career.

Stephen Evans, chief executive at Learning and Work Institute, which runs Ambition London, said:

“We are all going to have to rely on health and social care services in some way during our lives and all of us expect the highest quality services for our loved ones. Not only is this vital sector under enormous pressure financially, but shortages in skilled workers are set to get worse as we rely less on migrants post-Brexit unless urgent action is taken. That’s why we’re proud to be working with partners to promote the excellent career opportunities available in social care and help those who work with jobseekers to enter and progress in the profession.”

Ali Rusbridge from Skills for Care, said,

“We know that we’ll need around 275,000 more workers in adult social care by 2025 to meet the growing demand for services. In a sector where the average age of workers is 43 years old, we’re working with employers to inspire the next generation of care workers.  We have been delighted to be involved in Ambition London and to develop materials which help set individuals’ ambition for working in social care in East London.”

Candace Miller, Executive Director Learning Services and Consultancy, National Skills Academy for Health, said,

“The health sector is ever evolving and the need to provide a highly skilled workforce, who can apply those skills to a variety of settings and specialist roles, continues to be a challenge. Ensuring employers, learners and providers have the right information advice and guidance about programmes and the funding routes available is key to achieving this aim. Providing access to this information allows individuals to take ownership of their career and thrive in the workplace.”

 Hang Ho, Head of the JPMorgan Chase Foundation for Europe, the Middle East and Africa, said:

“Addressing skills shortages is key to ensuring the success of any economy particularly in growth sectors like health and social care. We are passionate about ensuring the maximum number of people are able to benefit from the jobs created in these important sectors and that existing employees are supported with progression and the chance to improve their skills. The new toolkits will help employers address difficulties in attracting and retaining new workers, which left unchecked, will not only have a negative impact on the UK economy, but long term, on the quality of life for those who depend on these services.”

 The toolkits are available for download at:

New working paper from Skills for Health shows high-quality development is key to workforce integration

Skills for Health has today published a working paper examining a crucial issue for the future of the healthcare sector: the successful integration of the health and social care workforces.

‘Integration and the Development of the Workforce’ will provide healthcare organisations with insight and guidance on how their workforce needs to adapt to support successful integration.

Developed in coordination with health and social care employers in the UK and internationally, the paper is the third in Skills for Health’s series of research papers on the health sector workforce, ‘Our Health Heroes in Focus’ .

By working more closely together, health and social care providers will be able to pool their skills, knowledge and resources to increase efficiency and quality of care. However, integration will require breaking down and redrawing traditional boundaries in the way care services are managed and delivered, meaning the two workforces will need to work in a completely different way.

Jon Parry, Principal Research Manager at Skills for Health, said, ‘Integrating the health and social sectors will require moving from a top-down, centrally-managed health system to one that delivers both health and social care seamlessly, shaped around the needs of the patient.

‘Successful integration will not be achieved through simply introducing new policies, but through the concerted effort of those working every day in health and social care.’

This paper explores the high-quality, persistent and effective workforce development that is essential to ensure their buy-in and support them to make this change.  Individuals will need to change mindsets, build relationships beyond traditional boundaries and develop their knowledge of other roles and organisations.

Jon Parry continued, ‘The integration agenda will be increasingly important for the foreseeable future, with the healthcare sector’s workforce being a vital component in ensuring its success. Such fundamental change will not happen overnight; organisations will need to consider the long-term support needed.

‘We hope this paper and the others in the series provide a useful contribution to the sector’s thinking about the development of its workforce in this crucial area.’

Download ‘Integration and the Development of the Workforce’ here.

For more information about Skills for Health visit

First UK Professor of Kidney Care appointed at London South Bank University

Professor Nicola Thomas at London South Bank University (LSBU) has just been appointed the first Professor of Kidney Care in the UK.

Throughout her career Nicola Thomas has worked within the renal speciality and has gained extensive clinical, teaching and research experience. Her clinical interest lies in the care and management of chronic kidney disease within primary care.

Professor Thomas also holds honorary nurse consultant post at Barts Health NHS Trust where she is involved in running the East London Community Kidney Service. Her specific expertise lies in patient and carer involvement in education and research.

Nicola Thomas said, “I am delighted that London South Bank University has recognised my work and it is an honour and a privilege to contribute to the improvement of care of people who have kidney disease through my teaching and research. This promotion is also very important for the development of renal nursing practice in the UK.”

Professor Warren Turner, Dean of LSBU’s School of Health and Social Care, said,

“This is fantastic news – not only for Nicola, who has worked so hard and well deserves this honour – but for LSBU’s School of Health and Social Care.

“There are a number of medical doctors in the UK with the title of Professor, but Nicola is the first nurse to be awarded a Professorship specifically for kidney care. Nicola’s new role will help to put the spotlight on renal research carried out at LSBU.”

Nicola also holds the position of Deputy Vice President (Education) of the British Renal Society and is the Editor of the Journal of Renal Care. She has previously been President of the European Dialysis and Transplant Nurses Association/European Renal Care Association.

Unmanageable GP workloads at ‘critical point’, new report warns

GP Pressures

GP Pressures

“My job makes me feel utterly, totally stressed, depressed and suicidal. I realise I have to change something soon to save my sanity.”

“Not being able to deliver safe or quality care is both demotivating and frightening – how long before I make a major mistake, because I am just too drained and shattered to pick up on an important cue?”
“I am shocked to see how many GPs in early or mid-career are solving this problem on an individual basis by cutting down their sessions or moving out of general practice altogether.”
These are just some of the quotes from over 1000 GPs from across the UK who have been surveyed for the new report, ‘Diagnosing the GP crisis: voices from the front line of primary care’, released on Tuesday 14 March.
The report reveals the unprecedented effect of unmanageable workloads on GPs – on their own wellbeing, on their ability to perform their duties safely, and on the future retention and recruitment of doctors into general practice.
Key findings include:
  • Unmanageable workloads are compromising the quality and consistency of the care that GPs are able to provide: 85% say that the volume of their workload prevents them from doing their job well.
  • Unmanageable workloads are forcing GPs out of the profession and contributing to a recruitment crisis: more than 90% have either left or considered leaving due to increasing workloads, or have reduced their hours in order to cope.
  • Less than a third (30%) would choose to train as a GP if they were given the option now.
The findings suggest that the effects of unmanageable workloads may prevent the NHS from meeting its target to recruit and train 5000 new doctors into general practice over the next five years.
The report is part of a wider campaign by GP education provider Red Whale that aims to counter negative perceptions of GPs, highlight the issues they face, and provide them with professional support.
“We know that GPs want to provide high-quality, consistent care to their patients, but in many cases the vast and unmanageable workloads that they face prevent them from being able to do so,” says Caroline Greene, GP and Business Development Director at Red Whale.
“This report shows that the impact of those workloads has reached a critical point, leaving many GPs feeling unable to safely and effectively do their jobs, and forcing others out of general practice altogether.
“We are listening to what GPs are saying, and we want those in charge of making decisions to listen too, before it’s too late.”

The Diseases Around us are Still Evolving – Are we?

Bird Flu

Bird Flu

It seems like every few years, a new disease comes along and spreads like wildfire, leaving a trail of death and devastation in its wake. Are we getting worse at fighting off infections, or are they getting better at invading our bodies?

A lot of the diseases that humans tend to catch regularly, like the common cold or flu, have actually evolved with us over millions of years. This is called co-evolution. Just as we evolve to battle them a little better, they evolve to attack in a slightly different way that bypasses our new defence – it’s an ongoing arms race.

Lots of bacteria and viruses have developed very clever ways of avoiding our immune systems so they can survive in our bodies. Some are able to go into hiding, like the herpes virus (spread by physical contact) which causes cold sores. This hides in the large junctions between nerve cells (called ganglia) in the head and spine, waiting for you to get ill or stressed. It then travels back towards your face and causes those unmistakable blisters.

Others are attacked and taken up by white blood cells because of the immune response, but are able to escape. Instead of being destroyed by the white blood cell like normal, they go on to cause further illness. This strategy is used by a particularly nasty bacterium called Shigella dysenteriae (spread by contaminated water and poor hand washing practices) – this infects the large intestine and causes severe bloody diarrhoea.

Different animals have different types of cell surface signatures that microbes either can or can’t interact with. If it can, then the germ can attach to or get inside of the cell and cause illness – like having the right key to unlock a door. Bird cells only have a single type of signature, but pig cells have their own different type of signature as well as the same sort of signature as birds.

This means pigs can be infected by both pig and bird diseases, and these diseases can then interact with each other. Additionally, the signature found only on pig cells is actually compatible with humans. So pigs can act as mixing bowls of bird (avian) and pig (swine) illnesses, creating new diseases and then passing them on to humans. This is actually one way that new kinds of flu are ‘made’ or evolve. When these new strains crop up, our immune systems don’t quite know how to deal with them at first, and depending on how unpleasant the virus is, they may even cause death.

Anything that tests a disease’s ability to survive in your body can provoke evolutionary changes. This is how antibiotic resistance starts. Inappropriate use of antibiotics – that is doctors having prescribed them when they aren’t needed, and/or patients not taking them properly – can expose germs to amounts of antibiotic that aren’t strong enough to kill them.

As the saying goes, what doesn’t kill you makes you stronger! The bacteria are able to get used to the antibiotic and develop immunity or resistance. This is how ‘superbugs’ like MRSA (often found in hospitals) and multidrug-resistant tuberculosis (MDR-TB) come about. MDR-TB is a particular problem because tuberculosis is usually treated with combinations of very strong antibiotics over a long period of time, these drugs are kept in reserve – used only for this especially difficult-to-treat disease. That means it’s quite scary that TB is evolving resistance, this is why drug companies are searching for new and improved antibiotics.

Although we humans may think of ourselves as being very advanced, our species went through a ‘population bottleneck’ tens of thousands of years ago. This means a significant proportion of the human population at the time was wiped out, and their genes were lost. The resulting loss of genetic diversity means that modern day humans are incredibly similar in terms of their genes, and we have to wait for random mutations to occur in order for evolution to take place. So our ability to evolve to prevent or better combat infectious disease, is much slower when compared to the speed bacteria, viruses and infectious fungi can evolve at.

One notable human mutation in this context is sickle cell disease. Although the disease itself (which is genetic, not infectious) has lots of unfortunate symptoms, in some cases it does in fact give protection from malaria. This is because the parasite which causes malaria makes sickled cells collapse after infection.

As progressive as our technologies and innovation may be, there could soon come a time when we run out of antibiotics, or we cannot adapt fast enough to fight these newly emerging diseases. Could it be possible that we might lose this arms race?

Article by Catherine Butterfield of University Birmingham for Blog About Healthcare


Three new apprenticeship standards for support workers in healthcare in England are now ready for use.

A steering group of healthcare employers, chaired by Kay Fawcett, OBE and Jane Hadfield, North Bristol Trust have developed these standards with employers, as part of the governments Trailblazer Apprenticeship activity.  These new standards are being developed by all sectors in England in response to the 2012 Richard Review of Apprenticeships.  The review puts employers in the driving seat to ensure that apprentices develop the right skills, knowledge, value and behaviours that are required for them to be effective in the workplace.

Each Standard is a short document giving an overview of what the apprentice should know and be competent to do on completion of their apprenticeship.

On-programme learning helps apprentices develop their skills and knowledge over a period of time.  The standard is not prescriptive in how this should be delivered and may or may not require the apprentice to complete an accredited qualification.  The standard outlines how long the apprenticeship should take and, if not already achieved, the apprentice will have to take English and Maths.

When the employer, supported by the on-programme training provider, feels that the apprentice is ready it’s time for End Point Assessment. End Point Assessment organisations are registered with the Skills Funding Agency and employers need to select one of these recognised bodies to carry out the process.  Criteria of what should be assessed in the End Point Assessment is defined in the assessment plans that accompanies each of the standards.  Once the End Point Assessor is satisfied that the apprentice meets the assessment criteria they will give the apprentice a grade (pass, merit, distinction) and the apprentice will be awarded their certificate.

The apprentice is now job-ready and can apply for a post.

Healthcare Support Worker

A generically written standard that can be applied to train apprentices for a range of different roles.  Role specific learning is evidence within the assessment process which observes the learner during their normal course of work.


12-18 months

Employers can choose whether to use an accredited occupational competence qualification e.g. clinical healthcare support at level 2 or to develop their own in-house training

Senior Healthcare Support Worker

This standard has a range of options specific to certain support roles:

  • Adult nursing support
  • Maternity support
  • Theatre support
  • Mental health support

In development:

  • Children and young person support
  • Allied health profession support


18-24 months

A range of accredited occupational competence qualifications at level 3 as described within the individual option

Assistant Practitioner

A generically written standard that can be applied to train apprentices for a range of different roles.  Role-specific learning is evidenced within the on-programme qualification and during the end point assessment process.


18-24 months

A range of accredited occupational competence qualifications such as  foundation degrees or level 5 diplomas