The implementation of apprenticeship policy in the national health service in England: a grounded theory study

This thesis explores what happens when two great British institutions are drawn together – apprenticeships and the National Health Service (NHS). Both are firmly entrenched in the British psyche and are spoken about with passion by their supporters. But both are highly politicised, at the mercy of government funding decisions and, as this thesis will demonstrate, bring about a battle for governmental supremacy when the two worlds collide. The researcher was granted privileged access to key participants at the centre of the action, which has enabled the development of a new model of implementation using constructivist grounded theory methodology. Through interviews and documentary analysis, a unique narrative of policy implementation is constructed, revealing a convoluted and intricate journey from policy to reality and chronicling the latest chapter in Britain’s history of vocational education and training. Skills development, productivity and social mobility lie at the heart of current apprenticeship policy intent. This research demonstrates that the NHS views apprenticeships as an opportunity to meet rising workforce demands and secure funding to train and retain existing staff. Through interviews, representatives with responsibility for apprenticeships or health identified the value and significance of successful policy implementation but with strikingly different priorities. The research undertaken shows that successful implementation has required extensive debate and dialogue, new ways of working and mobilisation of new roles in both the NHS and the higher education sector to deliver significant numbers of apprenticeships. Funding is a strong motivator, and this thesis describes how both have evolved and adapted in order to thrive and optimise opportunities provided by the apprenticeship levy. The NHS has embraced apprenticeship policy, and actively sought to engage with developments, but not without emphasising its unique and special position in British society. In turn, this has required government policy to evolve and adapt to achieve successful implementation. Using grounded theory methodology, this surprisingly dynamic, conflicted and complicated process is uncovered, a new model of implementation is proposed and another instalment in apprenticeship history provided.