The apprenticeship pathway to a more robust Psychological Wellbeing Practitioner workforce

Psychological Wellbeing Practitioners (PWPs) work in NHS Talking Therapies services, providing assessment and treatment to people with common mental health problems, typically anxiety and depression (NHS England, 2023). To become a PWP, someone must complete a British Psychological Society (BPS) accredited training programme (National Collaborating Centre for Mental Health, 2024). This training involves studying alongside working as a trainee PWP, allowing the person to learn theoretical knowledge as well as the core skills required as a PWP – how to engage and assess a patient with common mental health problems; how to effectively support a patient to manage and improve their symptoms using evidence-based CBT-based interventions; and how values, diversity and context applies to their work.

Historically, PWP training has been provided by Higher Education Institutions as a Graduate or Postgraduate Certificate. In March 2019 an apprenticeship standard for PWP training was approved for delivery, providing another route to train PWPs. The PWP apprenticeship is not reinventing the wheel of existing PWP training routes – the content and requirements are almost identical – but the training pathway is what is different.  

As Oxford Health NHS Foundation Trust already provided apprenticeships more widely, we decided to undertake the substantial task of adding a Psychological Wellbeing Practitioner Apprenticeship Programme to our portfolio. The aim was to support the maintenance and expansion of the workforce within the Trust – which has two Talking Therapies services. 

Why did we set up a PWP apprenticeship programme? 

There is a growing emphasis on using apprenticeships to train staff (see the NHS Long Term Plan) and using this supplementary funding route enables the NHS to have a range of pathways to train staff, including into the psychological professions. As a result, there has been substantial growth in apprenticeship standards available for psychological professionals, including PWPs. Adrian Whittington, psychologist and National Clinical Lead for the Psychological Professions at NHS England, has written about this. 

A key benefit of apprenticeships is the focus on the relationship between learners and employers. Given that our PWP programme teaching team is embedded within the Trust, this allows us increased awareness and understanding of the local context, as well as Trust policies and procedures. This means that where the curriculum and standards allow, content can be tailored to the needs of the local services – focusing on, and enhancing, the practical applicability of the programme content. It also allows us to work closely with services to structure the programme in a way that not only works for trainees, but services too. This in turn ensures that trainees experience a more collaborative approach to supporting their development journey between training provider and employer. 

By setting up the programme, we were also able to support the growth of the PWP workforce within the Trust. Growing the psychological workforce is a key aim of the NHS Long Term Plan, but to do this relies on the retention of staff (NHS England, 2019; Health Education England, 2021; National Collaborating Centre for Mental Health, 2024). 

Can an apprenticeship pathway support retention of PWPs? 

We know we need to retain staff to support the expansion of the psychological workforce, however, retention of PWPs has been an ongoing issue for many years (see the 2018 report by Liz Kell and Claire Baguley; and National Collaborating Centre for Mental Health, 2024). Turnover in PWPs is greater than in other psychological professions roles. This leads to a need to recruit and train additional PWPs and creates instability within services by losing the skills and experience of those leaving the role. Consequently, a key objective nationally is to focus on the retention of PWPs.

There are likely to be many factors associated with retention and turnover, including most notably career progression. One of the benefits of the apprenticeship route is that candidates do not need to hold an existing degree. We also anecdotally know that some turnover is linked to relocation after qualification, and so we also aim to recruit local people who wish to pursue a career as a PWP in the area. These aspects fit with the national objective to ensure that a significant number of staff recruited are looking to remain and develop in their role. 

Health Education England also argued that the apprenticeship pathway could attract those who wish to change career and move into the PWP role as a later career point. This should hopefully go some way towards creating a more diverse, representative and stable PWP workforce. 

How have we developed our apprenticeship programme? 

During late 2019 and early 2020, we set about ensuring the programme was ready for delivery. In May 2020 – near the start of the Covid-19 pandemic! – we welcomed our first cohort onto the programme. Since then, we have had another ten cohorts start to date. 

Over the five years we have continued to review, evaluate and develop the programme to ensure it meets the needs of learners and services, something which was recognised during our latest BPS accreditation visit, where the reviewers commented that 'the programme team's evident culture of ongoing reflection and self-review is commendable; the programme team take a proactive and flexible approach to continually reviewing, developing and enhancing the programme'. They also highlighted that 'the effective working relationship between the course team, the trust and the university enables the delivery of a cohesive, collaborative programme that meets the needs of stakeholders and supports the healthcare offering'. 

What impact has the programme had? 

Our own review and evaluation is ongoing, seeking to ensure learners receive a high-quality experience which prepares them for the job role. The accreditation noted that our 'enthusiasm and commitment to the ongoing development of the programme adds value and enriches the student learning experience'. 

Trainees are encouraged to regularly apply their learning to their role, to further enhance their development. Many of their assignments are linked to clinical practice and the final submission is a portfolio of evidence demonstrating that they have been able to successfully apply and use their knowledge and skills in practice. This portfolio is signed by their supervisor in service, further evidencing that trainees achieve the required competencies for their role in the workplace.

Trainees are assessed throughout the programme, culminating in their final end-point assessment (EPA) which is conducted by an independent assessor and organisation. The EPA assesses against all the knowledge, skills and behaviours as outlined in the apprenticeship standard. To date, 100% of learners undertaking EPA have passed, including 83% on first attempt, and 51% of learners achieved distinction. 

Of the 225 people who have so far completed the apprenticeship and gained qualified PWP status, 216 were employees of our Trust – 64% remain employed in the Trust, of which 83% remain working at step 2. Many of those who have qualified via our programme have gone on to develop their PWP career within their service, moving into senior and lead PWP roles – demonstrating that they have become equipped with the relevant knowledge and skills to progress in practice.

What does this mean for the future of PWP training? 

I feel there have been two keys to the success of the programme. The first lies in the collaborative and partnership working with all stakeholders – i.e. trainees, employing services, BPS, validating higher education institution, EPA organisation, etc. It is essential that everyone involved is clear on what is required to train as a PWP and the support that is involved – and that all parties have an insight into the roles of the other stakeholders. The second lies in the ability to be flexible and be ready for making changes. There have been a lot of developments to keep up with over the five years, including national curriculum updates, accreditation standards updates and revised apprenticeship standards.

Our experience indicates that the apprenticeship pathway can be a viable option to increase routes into PWP training and may contribute to supporting the development of a more robust PWP workforce. It is worth everyone involved in the PWP workforce continuing to consider ways to widen access to training, to diversify the workforce and take steps to retain PWPs. And why not consider additional promotion of the apprenticeship pathway, with an increased focus on attracting local people? They may be more likely to remain in the service they train in, and to represent the communities they support. 

• Emma Corless is Learning & Development Manager for Psychological Practitioner Training and PWP Programme Director at Oxford Health NHS Foundation Trust