Apprenticeship and progression in the healthcare sector: can labour market theory illuminate barriers and opportunities in contrasting occupations?

Abstract

There is growing research and policy interest in the extent to which government supported Apprenticeship in England provides a platform for educational and career progression in different occupational sectors. This paper makes a contribution to this debate by presenting research on the healthcare sector undertaken in a regional health authority in England, and by suggesting that ideas associated with labour market theory can shed light on some of the key differences in Apprenticeship frameworks and the progression opportunities available in different kinds of healthcare occupations. The research included policy and documentary review as well as qualitative interviews with employers in NHS Trusts. More specifically, our analysis applies key characteristics of occupational and internal labour markets to show how Apprenticeship frameworks fit and reinforce variations in employment, training and career opportunities in two contrasting Advanced Apprenticeship frameworks; Clinical Healthcare Support and Pharmacy Services. We conclude that the labour market lens is useful in focusing attention on the structures and key stakeholder relationships which determine the development of vocational training and the barriers or opportunities for educational or career progression in diverse sectoral contexts and occupations across the economy.

Keywords:

• Apprenticeships
• progression
• healthcare sector
• labour market theory
• occupation
• career

Acknowledgements

This work was supported by the Hampshire and Isle of Wight Lifelong Learning Network. We would like to acknowledge the support and cooperation of South Central NHS Strategic Health Authority and the NHS Trusts in the region who participated in the research. We would like to thank the two anonymous reviewers for their helpful comments.

Notes

1. The area of study for this research was within the NHS for England (Department of Health) jurisdiction. In addition, the Apprenticeship frameworks considered as part of this research were those for England.

2. The NHS Career Framework uses the concept of ‘Levels’ which do not always accord with the same AfC Banding. However, for simplicity this paper uses the terminology of AfC – i.e. Bands, rather than Levels unless directly referring to the NHS Career Framework. This is because it reflects actual practice within the Trusts who continue to use Bands to describe their workforce rather than Levels.

3. No attempt is made here to describe the development of dual labour market theory to segmentation theory, nor does it seek to identify the key factors that led to the development of this theory, such as the need to move away from human capital theory in the explanations of marginalisation and discrimination in the labour market. For example, the use of Dual Labour Market Theory to explain discrimination in terms of the primary and secondary labour market see Rubery (1978) and Ginzberg (1979).