Different paths

September generally marks the beginning of the academic year. As a former physiotherapy lecturer I thoroughly enjoyed this time of new beginnings and looking forwards, as well as thinking back on the previous academic year.

Background to apprenticeships

Let’s start by looking back. Apprenticeships go back to the Middle Ages and are associated with the craft guilds. The current iteration was born from Modern Apprenticeship policy (1993-2004) and, after the 2010 election, progressed into Higher Apprenticeships (foundation degree and higher awards). The political rational was to develop skills, workforce and career pathways within distinct occupational roles, including through degree-level apprenticeships that provide entry routes into professions.

The CSP has been involved from the outset of the development of the physiotherapist degree apprenticeship, working to ensure the quality of the learning experience and outcomes was upheld. Indeed during the consultation stage there were mixed responses from CSP members with some being concerned that a two-tier system would be created. Let me assure you that, because these routes must be approved by HCPC and accredited by CSP (as lobbied for by the CSP), they therefore undergo the same quality assurance processes as non-apprenticeship routes.

The physiotherapist apprenticeship standard was approved for delivery by the Institute for Apprenticeships and Technical Education in December 2018, and the first programme started at Sheffield Hallam University in April 2019, followed by Coventry University in September 2019. You’ll be seeing more apprentices coming through this route from other parts of the country as two new routes have recently been approved.

Comparison with non-apprenticeship route

As previously mentioned, all physiotherapy programmes undergo rigorous quality assurance processes and graduates must meet the HCPC Standards of Proficiency along with undertaking the 1,000 hours of practice-based learning, covering the breadth and depth required for preparation for practice as a physiotherapist in the UK as required by CSP.

The main differences are that an apprentice is a paid employee and as well as learning ‘off the-job’ there is also ‘on the-job’ learning. Off-the-job training is defined as learning that is undertaken outside of the normal day-to-day working environment and leads towards the achievement of an apprenticeship. This can include training that is delivered at the apprentice’s normal place of work but must not be delivered as part of their normal working duties.

On-the-job training

This has proved to be more difficult to define. Fundamentally there must be demonstration of new knowledge and skills that are transferable to physiotherapy practice and that they become integrated within the apprentice’s job. Examples include reflection on practice, critical appraisal including self, the service or an intervention, enquiry based learning.

While all learners have practice educators, apprentices also have a work-based mentor who is responsible for supporting the apprentice throughout their training and ensuring that they get the appropriate development and training opportunities in the workplace. Unlike a practice educator the mentor supports an apprentice for the duration of their studies.

Structure

While maintaining the quality of their learners’ academic and clinical experiences, Coventry University and Sheffield Hallam University (SHU) have approached the way they design their programmes differently. SHU offers block release while Coventry has one day a week assigned to university-based learning.

As these new routes spring up, it is worth remembering that, just as there are several pathways leading to registration as a physiotherapist – full time, part time, BSc, Post Graduate Diploma, MSc, and in Scotland PhD - no one size fits every learner. And that’s the beauty of all the physiotherapy educational models.

Let’s hear from Jo Clark, a physiotherapy mentor at United Lincolnshire Hospitals NHS Trust:

‘Most of us have found ourselves in the role of clinical educator, but being a mentor on the physiotherapy apprenticeship degree course is something very different. The role of the clinical educator is an intense but short period of time, whereas the role of mentor involves an investment of almost two and a half years of professional life into the development of your apprentice.

The role of the mentor is an important one, providing support and guidance throughout your apprentices’ journeys. It is a misconception to believe that the role of mentor is essentially to provide further teaching when the apprentice is not on placement, as the role involves much more than that. As mentor you listen to your apprentice, question their ideas, encourage problem solving and guide them to develop their own ideas and talents.

However, the mentor is not expected to be the font of all knowledge, and is neither coach nor tutor, but is there to provide resources and advice should the apprentice need extra support.

The mentor role encompasses a range of skills, knowledge and behaviours. The mentor must be able to act as role model as well as provide insight into the culture and values of the organisation. The mentor is the corner stone, the fixed point of contact for the apprentice, the person with whom the apprentice shares not only their problems but also their successes and achievements.

Mentoring is led by the needs of the individual apprentice and so the mentor must be flexible and intuitive. The complexities of balancing mentoring and large caseload can be challenging but also highly rewarding.

As a mentor I have learned a lot about myself and have come to realise that mentoring is a two-way street, my apprentice has established skills and knowledge, and has contributed much to our team.

Crucial to the apprenticeship is the learner themselves

Chloe Brumpton is halfway through completing the two-and-a-half-year physiotherapist degree apprenticeship at Sheffield Hallam University and is supported by Nottinghamshire Healthcare NHS Foundation Trust. She started her career as a support worker, progressing through Band 2 to Band 4 before staring her degree apprenticeship.

Here is a little of her story:

‘After working as a support worker for 10 years, I knew I wanted to pursue my career as a qualified physiotherapist.

I was so excited when I heard about the physiotherapist apprenticeship programme and I tracked the progress on this course until it went live, and I was able to apply. I previously completed an NHS apprenticeship and enjoyed the hands-on learning approach. Earning whilst learning is an added bonus.

The course can be challenging at times, with just the same amount of workload and learning to be completed as a full time physio student, therefore as apprentices we must be disciplined to complete tasks, self-learning and development alongside exam preparation and assignments. This can sometimes be difficult and demanding however I am lucky to have support from the university, my NHS trust, work colleagues and fellow apprentices. The university has a lot of support services that are available to help me with revision, assignments and exam prep. These support services are so valuable when the workload can sometimes appear demanding.

My background knowledge from previous support worker roles has helped me on the course and on placements. The ability to work with and communicate with patients is a vital skill to physiotherapy to achieve patients’ goals.

My transferable skills have given me confidence and lecturers have commented in the past about how valuable our underpinning knowledge is. I think at times it is great to be able to use learnt skills however I have to remember to work within my scope of practice while working.

Key to the success of an apprentice’s learning is the partnership working between employer, the apprentice, and the university.

Cassie Hayes is a senior lecturer in physiotherapy and the course director for the integrated apprenticeship physiotherapy BSc course at Coventry University

She reinforces the importance of this tripartite relationship:

‘As we are all more than aware, communication is paramount to most aspects of physiotherapy practice. From early on in a student’s training and throughout their CPD, communication is emphasised as a skill which must be at the forefront of clinical practice.

Since the apprenticeship course at Coventry University began in 2019, communication between the university (personal tutor), workplace (workplace mentor) and apprentice has remained key. Although following an overall course plan, apprentices are not allowed to re-learn skills they already have. Therefore, the apprenticeship course must deliver an individual programme for each person. A skill scan establishes prior learning and highlights what the apprentice is able to competently do. This is considered by the apprentice, their workplace and the university –the tailor-made changes are made as required. This individual approach is completely reliant on the three-way discussions between all parties to ensure appropriate changes are made and quality of the apprentices’ learning remains high.

Physiotherapy apprentices have the challenge of participating in a new route of qualification but also have the challenge of doing so while juggling family and home life and a full time job. Personal situations are widely different and these have to be fully considered when supporting someone on our apprenticeship programme. The tri-partite relationship between mentor, apprentice and personal tutor is critical in supporting every apprentice on our course –discussion between them varies from individual study support to supporting the apprentices’ requirement for more flexible study time from work. Sound communication is vital to ensure these discussions take place.

We have learnt, and continue to learn, many things from the first run of this apprenticeship course –but communication between parties has been key to making this new qualification route work for all involved. The importance of communication continues to be profound to be able to develop a high quality course which equips the apprentices for the future and move our profession forward.