The Learn and Earn career pathway (LECP) was established in 2017 following a pilot by Islington, Haringey and Camden community education provider networks (CEPNs) and is managed via Community Matters. It attempted to address some of the perceived barriers to employers’ engagement with apprenticeships by means of administrative assistance, financial incentives and the development of a bespoke ‘apprenticeship-plus’ model where additional training, particularly clinical skills, are included within the offer. Specifically, it was set up to promote the career pathway towards nursing and to explore the viability of using apprenticeships as a sustained funding source for training required to progress along the pathway.  

The central ‘offer’ on the pathway was a Healthcare Assistant (HCA) programme, adapted to accommodate both newcomers to the HCA role (e.g. admin or reception staff) as well as experienced HCAs who want to gain the level 3 Diploma in Clinical Healthcare Support, and to develop additional clinical skills. The programme was based on a traditional apprenticeship model but with  additional clinical skills classrooms that reflect the tasks typically undertaken by HCAs in General Practice. 

Evaluation commissioned
In 2019 a research team from the Centre for Critical Research in Nursing and Midwifery Education in Middlesex University led by Mike O’Driscoll was commissioned to carry out an independent evaluation of the Learn and Earn project. The evaluation aims included understanding the take up of each course on the Learn and Earn pathway (numbers of employers/learners, profile, progress, outcomes, reasons for take up and barriers to take up);comparing progress against targets; understanding what worked well and what did not work well and evaluating the impact of project activities at individual/business and project level.

Evaluation methods
The mixed methods process evaluation which was completed in early 2020, involved an online survey, focus group and telephone  interviews with all stakeholders  (learners, training providers, employers, CEPNs and the project managers). It also included a ‘business case’ analysis of the project, providing  a tool to inform and support employer decision-making regarding placing learners on the LECP. The business case tool, developed by Dr Wendy Knibb, provides a structure around which employers can develop their consideration of key aspects of the decision-making process such as benefits and potential non-monetary benefits of training; costs and potential non-monetary costs to training; perceived risks/challenges of training and comparing the apprenticeship model to other training options.
The evaluation also provided an evaluation toolkit, to facilitate future evaluations.

Key evaluation findings included:
Learner’s main reasons for taking part in courses were  career development (86%), followed by wanting a role which involves more healthcare expertise (83%) and job satisfaction (72%). 62% said that they had taken part in course/s because they wanted to improve their employability and just over half (51%) chose ‘get a better salary or working arrangements’ and 38% did the course/s because they ‘want a role with more contact with public’.

Level 2 HCA Apprentices

Overall satisfaction with courses, which may have been negatively impacted by some initial teething problems, was moderate – however the vast majority of current learners  (84% ) reported feeling very or fairly confident about taking part in their current course and satisfaction with current course was high for peer interaction and support (79% very or fairly satisfied), employer support (74% very or fairly satisfied) and timing / pattern of course (68% very or fairly satisfied).

Many learners felt that their course would have a positive effect on their career and their current employing organisations (or had already done so) and that their course had had a positive effect on the level of service provided to patients (especially in increasing capacity and the range of services which are offered in a GP practice).

Employers were, on the whole positive about their experiences of Learn and Earn courses and recognised benefits such as the ability to ‘grow their own’ primary healthcare workforce, i.e. to increase skills and capacity in their existing staff and to gain specific skills which the employer needed and which could be tailored to the needs of the employing organisation and to provide a better service for patients.

If you would like to commission an evaluation please contact Mike O’ Driscoll (m.odriscoll@mdx.ac.uk)

For more details of the evaluation findings please contact Community Matters (training@communitymatters.co.uk)

Report title:
Learn and Earn Project – Evaluation Report
O’Driscoll, M., Traynor, M. and Knibb, W. (2020). Middlesex University, Centre for Critical Research in Nursing and Midwifery.



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