This article continues my ongoing series exploring the evolving landscape of degree apprenticeships. In this next piece, the focus turns to quality, not only as a regulatory construct, but as a lived experience shaped by people, culture, data and the realities of the health and physiotherapy workforce. Apprenticeships have become one of the most dynamic shifts in higher education in recent years. For many of us working in physiotherapy education and across the allied health professions, they’re no longer an “alternative route”, they’re part of the mainstream and as the national apprenticeship landscape continues to grow, the question becomes not simply “Does it work?” but “How do we know it’s working well?”  

   

The National Picture Reminds us Why Quality Matters  

Apprenticeships continue to expand. In 2023/24, there were over 339,000 apprenticeship starts in England, with nearly 50,000 at Levels 6 and 7, a huge shift from only a decade ago (DfE, 2024). Higher-level apprenticeships are no longer an exception; they’re part of a broader rebalancing of work-integrated learning.  

However, when we reflect, we can see that the national quality picture is mixed. Achievement rates currently sit at 54.6%, meaning almost half of learners don’t complete on time (House of Commons Library, 2024). Yet for those who do reach end-point assessment, outcomes are strong at 89% pass EPA on their first attempt (ESFA, 2024).  

These figures reflect both the opportunity and the challenge. Quality isn’t just about high-level success; it’s about the structures and support that help apprentices get there.  

From Pedagogy to Proof  

In traditional HE settings, quality sits within module evaluations, assessments and academic regulation. Apprenticeships ask something more complex through evidence of learning across two ecosystems, the university and the workplace.  

Every part of the learner journey generates a piece of this evidence:   

Initial assessment → the starting point  

On-programme monitoring → attendance, off-the-job learning, progress reviews  

Gateway → readiness for assessment  

EPA performance → validation of competence  

Destination outcomes → the workforce impact  

Recent figures show 94% of apprentices move into sustained employment or further study (DfE, 2023). When compared to the 87% employment rate among working-age graduates (ONS, 2024), apprenticeships are proving their value as professional pipelines. For physiotherapy, this is especially relevant because the demand for registered practitioners, advanced practice roles, and community rehabilitation capacity continues to rise.  

The Physiotherapy Apprenticeship Lens  

The Physiotherapist Degree Apprenticeship is still relatively young, but it is already reshaping the workforce landscape.  

CSP workforce modelling highlights several important trends:   

Physiotherapy university applications have risen by 48% since 2019  

Attrition on physiotherapy programmes remains low (around 2.6%)  

The workforce needs to grow by 7% annually to meet projected NHS demand  

Apprenticeships are widening access, particularly for support workers already embedded in NHS and community teams  

These insights align with recent evidence published by the Chartered Society of Physiotherapy, whose workforce modelling and apprenticeship briefings continue to shape national understanding of physiotherapy education and future workforce demand (CSP 2024b). These are signals that physiotherapy apprenticeships are not an optional extra, they’re a response to a workforce gap, a service demand challenge, and a need for flexible, inclusive entry routes.  

Culture, Belonging and the Unseen Side of Quality  

Quality is often framed as a technical construct of data, metrics and compliance, audit, however, in apprenticeships, quality is also deeply relational. Physiotherapy apprentices come from diverse cultural, professional and educational backgrounds. They bring different communication styles, expectations of feedback, and prior experiences of learning. The NHS and wider health sector are equally diverse, shaped by multicultural teams, shifting hierarchies and a range of workplace cultures.This means apprenticeships are not just learning pathways, they are cultural meeting places.  

Quality, then, must include questions such as:   

Do apprentices feel safe to ask questions?  

Do mentors understand the learner’s background and learning style?  

Are progress reviews spaces of challenge and psychological safety?  

Do university and workplace cultures align in their expectations?  

Finance, Governance and the Ecosystem Around Learning  

The Apprenticeship Levy has reshaped employer engagement since 2017. Starts fell initially, but higher-level routes have grown significantly, a trend especially visible in health and science.  

For physiotherapy, the financial and operational landscape matters:   

Apprenticeships sit within the Health, Public Services & Care subject area, which makes up 27% of all apprenticeship starts  

The NHS Long Term Workforce Plan expects 22% of clinical training to be apprenticeship-based by 2031/32  

Breaks in learning, temporary withdrawals and changes in circumstances carry direct funding and quality implications  

This means financial quality, ILR accuracy, review timeliness and mentor capacity directly affects learner continuity, subsequently affecting workforce continuity.  

The Workforce Delivering Apprenticeships Also Needs Support  

A point often overlooked in apprenticeship conversations is the academic workforce itself. Many educators and clinical colleagues entered HE through traditional routes, whilst apprenticeships require a different kind of literacy, that blends pedagogy, regulatory awareness, employer engagement and relational skill. If we expect apprentices to adapt, reflect and grow, then we must offer the same to staff. Quality is as much about capability-building as it is about compliance.  

Looking Forward  

Apprenticeships remain one of the most exciting, challenging and human forms of education we have. They are complex because people are complex and they demand collaboration because learning happens across boundaries, and they matter deeply because they shape the future workforce our health system relies upon. As physiotherapy continues to evolve, so too must the way we understand and measure quality. True quality extends far beyond compliance or EPA results; it is lived through the confidence apprentices carry into practice, the contribution they make to their teams, and the sense of being genuinely seen and supported throughout their journey.  

Thank you for reading, and I look forward to sharing the next piece in this series soon.  

   

Steve  

Assistant Professor at Coventry University  

Consultant Physiotherapist in Primary Care  

Course Director BSc Physiotherapy Apprenticeships  

Course Director MSK FCP