There are current discussions ongoing about the possibility of apprenticeships linked with orthodontic therapy training. To clarify some misconceptions about this, this short article by Michael Wheeler (Health Education England Programme Manager for Dental Apprenticeships) explains how apprenticeships are being introduced in all areas of work, including healthcare.

In 2012 the Richards Report was published.  This outlined the need for greater employer engagement with apprenticeship developments.  It defined the need for clear and trusted qualifications with more robust quality assurance and the need for a more formal approach to assessment at the end of the apprentice training which introduced the concept of an end point assessment (EPA).

The Richard Report highlighted that apprenticeships should just not be just considered for areas such as hairdressing, painter and decorator, motor mechanic or bricklayers but the range of apprenticeships needed to be expanded to encompass a much wider range of skills sets, at all educational levels. Today there are over 300 apprenticeships regulated by the Institute of Apprenticeships (who are accountable to the Department of Education in England) being delivered or in development in a very wide range of disciplines.

One of the misconceptions about apprenticeships is that they may lead to a reduction in standards in training. This is not the case. An apprenticeship is a method of training that has been used in many fields, including healthcare. It is important to recognise that the term apprenticeship does not relate to the level of qualification. I will explain this further.

In health care apprenticeships are being delivered by colleges and universities in conjunction with healthcare providers (especially NHS trusts) are degree level registered general nurse, the new foundation degree in general nursing (associate nurse), paramedics, occupational therapists, wide range of laboratory science, healthcare science technicians and physiotherapists. Recently agreed is an advanced clincal practitioner apprenticeship which is an MSc programme for a wide range of healthcare professionals to develop advanced skills in differing areas of healthcare. In development are apprenticeships for art therapists, psychologists, environmental health practitioners and pharmacists.

Before 2015 the only dental skill sets associated with the “government funded training schemes” outside of those supported by Health Education England and its predecessors has been dental nursing, which in most cases was aimed at young people under the age 24.  Today an apprentice can be of any age.

Dental team apprenticeships currently being delivered are:

  • Dental Nurses
  • Dental Technicians
  • Dental Practice Mangers

In development are apprenticeships in

  • Orthodontic therapy
  • Clincal dental technician
  • Laboratory technician (a dental laboratory assistant)
  • Oral health practitioner

The oral health practitioner role is a non-registerable GDC qualification which is designed for dental nurses wishing to gain a formal qualification in oral health education and promotion through a funded training route.

The advantage of an apprenticeships is that the actual course of training is largely funded by the government, but it does vary between employers.

The training course that an apprentice follows 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 3 million pounds.  Introduced in 2017 large employers contribute 0.5% of their pay bill into the apprenticeship levy funds.  In dentistry most, NHS trusts and the large dental body corporates are classed as levy paying organisations.  They pay no training fees for their employees if undertaking an apprenticeship. 

Small employers such as an orthodontic practice can still take advantage of the apprenticeship levy, but they contribute 10% of the total apprenticeship training costs and the government pays the remaining 90%.  However, at a point of time to be agreed in 2019, the amount the employer will contribute will reduce to only 5%.

For example, a dental nurse undertaking training as an orthodontic therapist through a training provider registered with the Institute of Apprenticeships who is employed by an NHS trust or a very large dental corporate; no training fess would be required to be paid.  As their employer is paying in to the apprenticeship levy.

If the dental nurse is employed by a non-levy paying orthodontic practice (which is most traditional orthodontic practices) the cost of training to the practice is currently 10% of the funding band.  This has yet to be set for orthodontic therapy training; however, for example if the funding made available by the Institute of Apprenticeships was £14,000, the orthodontic practice would only be required to contribute 10% of that fee e.g., £1,400.  Although this will reduce to 5% (£700) at a point of time to be agreed in 2019, as part of greater investment in training made by this government in the latest budget.

Moving to an apprenticeship model does not change the current training methodology, the entry criteria remains the same and the curriculum is still set and monitored by the General Dental Council who will continue to regulate and inspect training providers . These are common misunderstandings about apprenticeships, and as a result the standards of current training will not be compromised in any way.

Training will continue to be delivered by

  • didactic teaching in study blocks
  • development of clincal skills in the teaching environment
  • supported by close supervision in the practice of hospital department in which the apprentice orthodontic therapist is employed

The Institute of Apprenticeships sets out that apprentices are playing an increasingly important role in British industry, and it is important that the right structures are in place to ensure they 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.

For full details of apprenticeships visit the Institute of Apprenticeships website