As reported by the National Health executive, research published by the Institute for Fiscal Studies has found wide variation in access to career progression opportunities across the NHS, raising questions about how evenly training routes are being offered between trusts
The analysis, produced as part of the NIHR Policy Research Unit in Health and Social Care Workforce, suggests that differences in local recruitment pressures play a significant role. Trusts facing the greatest staffing challenges are more likely to invest in developing their existing workforce through apprenticeships and in house training.
The study identifies several key trends in workforce progression:
In 2024, more than 1,000 NHS staff began a nursing degree apprenticeship, up from just over 300 in 2019, indicating rapid growth in this route.
Since 2010, the proportion of clinical support staff moving into registered roles has doubled, with the sharpest growth seen in transitions into nursing.
Early cohorts of support staff who trained as nurses show higher retention rates than nurses recruited through traditional routes, suggesting stronger long term attachment to the NHS.
However, early evidence suggests this retention benefit may reduce as training pathways expand at pace and are delivered at larger scale.
The IFS warns that if apprenticeships are intended to support workforce development and social mobility, access must be more consistent. It argues that all NHS trusts need the capacity and incentives to offer progression opportunities, rather than these being concentrated in higher wage regions or areas under the greatest recruitment pressure.
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