Apprenticeships are gradually becoming available to all members of the dental team; Michael Wheeler explains what, why and how to access.

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Apprenticeships date back to medieval times; trace back through the history1 of dentistry and you will find examples of apprenticeships existing in the era before formal qualifications. As dentistry developed, apprenticeships died out. Between the 1930s and 1970s, the only apprentices were dental technicians, while in the 1990s a few dental nurse apprenticeships came into existence.

In 2012 the Richard Report2 was published and set a new agenda. The report outlined the need for greater employer engagement with apprenticeship developments as well as clear and trusted qualifications, with more robust quality assurance. The concept of an end point assessment (EPA) along with a more formal approach to assessment was introduced.

'The final test and validation must be holistic, in that it seeks to test the full breadth of the relevant competencies not merely the incremental progression of the apprentice. That may take the form of a project or an assessment in front of an examiner. It should be performance and real world based, rather than just theoretical. It should be primarily at the end of an apprenticeship, not measuring progress during it' (Richard report 2012).2

Apprenticeships must fit into the following educational levels as set out by the Governments of England, Wales and Northern Ireland (See Table 1).3

Table 1 Apprenticeships and equivalent educational standards
Full size table

Employers were asked to take forward apprenticeships and form 'trailblazer groups.' Genix Healthcare rose to this challenge and set up the dental trailblazer group in 2014 leading to the development of dental nurse, dental technician and dental practice manager apprenticeships.4 These are in operation today, although in the process of further development. The dental nurse and dental technician apprenticeships are being reformatted into what are known as 'integrated awards'. This means that the EPA becomes the final stage of the apprenticeship and is the last assessment before applying for GDC registration.

The apprenticeship training course is funded through the apprenticeships levy. The income for this comes from all UK large employers with a pay bill of more than £3m.

To be an apprentice you should meet the following criteria:6

  • Be employed for a minimum of 30 hours per week

  • Work alongside experienced staff

  • Gain job-specific skills

  • Have a contract of employment, earn a wage and get holiday pay

  • Be given study time related to the role (the equivalent of one day a week)

  • Be aged over 16 (there is no longer an upper age limit).

The apprenticeship training course is funded through the apprenticeships levy. The income for this government-controlled levy comes from all UK large employers with a pay bill of more than £3m. Introduced in 2017,5 large employers contribute 0.5% of their wages bill into the apprenticeship levy funds. In dentistry, most NHS trusts and the large dental corporates are classed as levy paying organisations. They pay no training fees for employees classed as an apprentice. Small employers such as dental practices or laboratories can still take advantage of the apprenticeship levy. They contribute 10% of the total apprenticeship training costs and the government pays the remaining 90%. However, the employer contribution will reduce to 5% at some point in 2019.6 For dental nurses, the training provider may draw down up to £6,000, this is the funding per dental nurse made available via the Education and Skills Funding Agency for delivering and ensuring the necessary assessment is carried out as part of the training programme.

If an NHS trust or very large dental corporate body is paying into the levy, they will pay no training fees for their dental nurses.

If the dental nurse is employed by a non-levy paying dental practice, (the majority of traditional dental practices), the training cost to the practice is currently 10% of the funding band. Therefore, the cost to the employer is only £600.00, reducing to 5% (£300) in 20197 (See Table 2 and Table 3).

Table 2 Dental apprenticeships recognised by the Institute for Apprenticeships and Technical Education
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Table 3 Dental apprenticeships in development and recognised by the Institute for Apprenticeships and Technical Education
Full size table

As the following apprenticeships lead to GDC registration, the current modes of training, entry criteria and curriculum based on Preparing for Practice8 do not change:

  • Dental nurse

  • Orthodontic therapist

  • Dental technician

  • Clincal dental technician.

The General Dental Council regulates and inspects training providers and awarding bodies to the current standards. The laboratory technician level 3 award is being reviewed by the dental trailblazer group to provide an initial award for dental technicians, which may be undertaken before progressing to the level 5 GDC registerable award.

The Institute of Apprenticeships and Technical Education sets out that apprentices are playing an increasingly important role in british industry, and it is important that the right structures are in place

The oral health practitioner apprenticeship has been developed for dental nurses wishing to enhance their skills and gain a formal qualification in oral health education and promotion. It is designed to support dental practices in delivering enhanced oral health promotion in the community they serve eg to early years groups, ante-natal groups, care home staff or targeted OHI at individual patients within the dental practice. This apprenticeship will provide an opportunity for skills in systemic health screening as well as the topical application of fluoride to be acquired.

In addition to the dental specific apprenticeships there are others that support the development of the dental team. Management and leadership skills are key; apprenticeships in this area are already agreed and being delivered by several universities, these include:

  • Level 6, Chartered manager

  • Level 7 Master's degrees in leadership and management and MBAs.

Teaching and mentoring qualifications from level 3 to 6 are in development; already agreed and in delivery is a level 7 (MSc) for an academic professional engaged in teaching and /or research. Also, recently agreed is a level 7 (MSc) in Advanced Clincal Practice which provides for universities to deliver programmes in subject-specific areas, such as periodontology, endodontics and oral surgery, and for students on these programmes to receive funding of up to £12,000 to complete the award.

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In order to deliver an apprenticeship in any subject, the training provider must be on the Register of Apprenticeship Training Providers (RoATP).9 They must ensure that it's possible for apprentices without a qualification in Maths and English at level 2 to reach this level. Additional funding is available to support these apprentices as it is a requirement that level 2 English and Maths is completed prior to taking the EPA. For those with an Education Health and Care (EHC) plan or a Personal Legacy Statement, the minimum requirement in Maths and English is entry level 3.10 Those who have British Sign Language (BSL) as their primary language can substitute the BSL qualification for English.11

The Institute for Apprenticeships and Technical Education recognises that apprentices are playing an increasingly important role in British industry. It's important that the right structures are in place to equip people with the right skills; for the dental team this equally applies and allows for much greater support for training and skills escalation than has been possible in the past.

The oral health practitioner apprenticeship has been developed for dental nurses wishing to enhance their skills and gain a formal qualification in oral health education and promotion.

Apprenticeships are available to suit the training needs of all members of the dental team. Details may be obtained by visiting the Institute of Apprenticeships and Technical Education: http://www.instituteforapprenticeships.org/.

Michael Wheeler is an RAF trained dental hygienist, an honorary senior lecturer at the University of Kent and an HEE programme manager.