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The purpose of this paper is to investigate apprenticeship developments in two National Health Service (NHS) organisations since the introduction of the apprenticeship levy in April 2017 and considers potential impact on social mobility. This is a pilot for a broader exploration of implementation of government apprenticeship policy in the NHS.

Following ethical approval, semi-structured interviews were conducted with two key informants with responsibility for education and training in their respective organisations. Interviews were recorded and transcribed verbatim. Thematic analysis was undertaken to identify major and sub-themes of the interviews.

Four major themes were identified – organisational readiness, the apprenticeship offer, opportunities for further development and potential problems with implementation. Both organisations were actively seeking opportunities to spend their levy and had developed local strategies to ensure this. The levy was being used to develop both new and existing staff, with leadership and management being particularly identified as an area of growth. Similarly, both organisations were using levy monies to develop the bands 1–4 roles, including the nursing associate. The affordability and bureaucracy of apprenticeships were seen as potential problems to the wider implementation of apprenticeships in the NHS.

Although the apprenticeship levy is being spent in the NHS, there are some challenges for employers in their delivery. The levy is offering new and existing staff the opportunity to undertake personal and professional development at a range of educational levels. This has the potential to increase and upskill the NHS workforce, improve social mobility and possibly lead to larger cultural and professional changes.

This paper offers an early insight into the implementation of apprenticeship policy in a large public sector employer such as the NHS.

This paper reflects on changes to end-point assessment (EPA) brought about as a result of the COVID-19 pandemic and considers how proposed future change will impact on training providers and employers of health apprentices.

The paper provides an analysis of apprenticeship policy, the role of EPA and consideration of assessment strategies used in higher education and health professions. Implications for policy, training providers and clinical practice are proposed.

These changes will bring the completion of EPA closer to education providers and allow them to take a more direct role within the process. Education providers will need to be issued with clear guidance to ensure regulatory compliance. The pedagogical value of EPA is questioned.

Training providers and policymakers will need to review their processes and guidance appropriately. This paper provides a summary of salient points needing consideration.

The purpose of this paper is to critically reflect on evidence relating to the development and delivery of apprenticeships and its potential implications for pre-registration healthcare education.

An iterative review of English language literature published after 1995 to date relating to apprentices and apprenticeships was undertaken. In total, 20 studies were identified for inclusion. Only three related to the most recent apprenticeship initiative in the UK, and the majority were UK based.

Three key themes were identified: entering an apprenticeship, the learning environment and perceptions of apprenticeships. Successful completion of an apprenticeship relies heavily on both understanding the role the apprentice is seeking to inhabit, as well as well-structured and comprehensive support whilst on the programme. These findings are then discussed with reference to professional body requirements and pre-registration education in healthcare.

Appropriate work experience and support for learning are critical to apprenticeship success and apprenticeships should be given equal status to traditional healthcare education routes.

The introduction of the Apprenticeship Levy in April 2017 (Finance Act, 2016), acknowledgement that all National Health Service Trusts will be levy payers and the introduction of targets relating to apprenticeships for public sector employers have all contributed to growing interest in the apprenticeship agenda in health and social care.

Many studies look at the effects of human resource (HR) initiatives. Yet very few consider why organisations adopt them in the first place. Health and wellbeing interventions offer a critical case because they offer apparent benefits for all. Assessing the process of engagement reveals variations in managerial commitment, which has implications for studies of “effects”. This paper seeks to address these issues.

The study offered a free health intervention to organisations; this was separate from the research study, which aimed to assess the effects. A total of 86 organisations were approached, of which 53 indicated some interest in involvement. After further withdrawals and selection against criteria of size and sector, nine remained. The paper assesses the degree of engagement with the study, looking in detail at three organisations. The methods utilised included structured telephone interviews, qualitative interviews and observation.

The organisations underwent a rigorous selection procedure to ensure their full commitment to the study. On this basis it is expected that the participating organisations would be highly engaged. However, it became clear that there were considerable variations in how they engaged. This reflected the favourability of the organisational context, but also the enthusiasm and commitment of key actors.

Engaged organisations were a highly self‐selected group. Studies of effects of interventions may thus be systematically biased. The interventions studies here were also shaped by how they were put into practice; they were not fixed things whose effects could be understood independently of their implementation. The study was also able to make predictions of the subsequent effects of the interventions based on the process of implementation. The results of a follow‐up study to test these predictions will be reported in a further paper.

The paper aims to examine how a professional development school-district (PDS-D) partnership, enacting an improvement science stance, collectively explored social-emotional learning (SEL) during collaboratively designed professional learning experiences.

This qualitative study, guided by an improvement science orientation, enacted an iterative research design. Data sources consisted of anecdotal field notes and artifacts from 12 professional learning sessions. Using a constant comparative method, the authors applied an inductive thematic analysis to identify salient themes across data related to teacher wonderings and identified goals.

The paper illuminates teachers' voices while highlighting information gleaned from participant wonderings, their identified goals and how this information informed the iterative development of future professional learning experiences within a district-university partnership.

Due to the chosen research approaches and limited number of participants, the research results may lack generalizability.

This paper provides original insight into collaborative development of recursive professional learning experiences within partnership spaces.

Healthcare service quality in the USA has gained importance under value-based payment models. Providing feedback to front-line staff is a vital component of managing service performance, but complex organizational dynamics can prevent effective communication. This work explored the performance management of appointment desk staff at Mayo Clinic Arizona, identified barriers to effective management and sought to standardize the process for monitoring service performance.

Multiple data sources, including qualitative inquiry with 31 employees from the primary care and surgery departments, were used. The research was conducted in two phases – facilitated roundtable discussions with supervisors and semi-structured interviews with supervisors and staff six months after implementation of service standards. Participants were probed for attitudes about the service standards and supervisor feedback after implementation.

While all staff indicated a positive work environment, there was an unexpected and pervasive negative stigma surrounding individual feedback from one’s supervisor. Half the participants indicated there had been no individual feedback regarding the service standards from the supervisor. Presenting service standards in a simple, one-page format, signed by both supervisor and the patient service representative (PSR), was well received.

Combining rapid-cycle quality improvement methodology with qualitative inquiry allowed efficient development of role-specific service standards and quick evaluation of their implementation. This unique approach for improving healthcare service quality and identifying barriers to providing individual feedback may be useful to organizations navigating a more value- and consumer-driven healthcare market.

In this chapter, the authors contribute to the scholarly discourse on poverty, inequality, and economic mobility within low-income families who have children with disabilities. Few extant studies have addressed issues of socioeconomic mobility relative to families with children who have disabilities. Accordingly, we employed analyses of secondary longitudinal ethnographic data from the Three-City Study to explore socioeconomic mobility among 31 mothers of children with disabilities in Boston, Chicago, and San Antonio. The authors examined two central issues that emerged in our ethnographic data: (1) mothers’ aspirations regarding their socioeconomic mobility, and (2) the barriers which make it difficult for them to reach their mobility aspirations. The authors also considered the role of family comorbidity and cumulative disadvantage in this inquiry. Through our analyses of mothers’ talks regarding socioeconomic mobility, we identified three domains of their aspirations – work and career, education, and intergenerational. We also identified three “barrier bundles” – pragmatic needs, relationship and social liabilities, and socio-emotional concerns – which compromised mothers’ abilities to be upwardly mobile. In essence, we found that mothers’ aspirations were not aligned with the barriers that precluded them reaching their goals. The authors conclude with a discussion on the implications of this research for future studies.

Leadership development programs (LDPs) have emerged relatively recently in the healthcare context as a mechanism not only to develop capable and competent leaders but also to retain them. The purpose of this paper is to describe a perspective on practice by illustrating a case example that showcases a pilot LDP for newly promoted healthcare leaders. The details about how it was developed and implemented collaboratively by a healthcare consortium and higher education institution (HEI) to address shared healthcare leadership talent pipeline and retention challenges are provided.

This perspective on practice describes how a consortium of competitive healthcare organizations, a type of branded Inter-organizational Relationship referred to as “Coopetition,” contracted with a HEI to design, develop and launch a pilot LDP, referred to as the Academy for Healthcare Education and Development program, using the analyze, design, develop, implement and evaluate model.

The significance of this illustrative case example is discussed along with some initial lessons learned based upon this pilot LDP that 24 program participants completed. Implications for research, theory and practice are presented, followed by limitations and a conclusion.

Inter-organizational relationships, particularly coopetition, are relatively new in the healthcare sector, along with collaboration with HEIs to develop interventions to solve compelling industry problems. This illustrative case example offers insights that address scholars’ calls and practitioners’ needs to explicate different approaches for LDPs to build the healthcare leadership talent pipeline.

This chapter describes public agriculture services’ business goals, purpose, and strategy. It reinforces agriculture organizations’ fundamental bureaucratic administrative culture (Tier 1). The authors describe the influence that political appointees as leaders may play in shaping public sector cultures. The bureaucratic culture of agriculture is deconstructed, and each of the five layers is described in detail. Additionally, the authors explain why behavior is the dominant layer and the most critical starting point for understanding agriculture cultures. The public service culture (Tier 2) brings an essential element of leveling, access, and equity to the larger context. It brings the focus back to service to the people and community rather than performance. It also gives greater emphasis to the role of safety and well-being. The chapter lays out the landscape of external influencing cultures (Tier 3) in agriculture. Finally, the potential value and challenges of developing internal knowledge, learning, and collaboration (KLC) cultures (Tier 4) are explored.