The NHS is struggling to free up hospital beds, which is a key factor in reducing waiting lists. The answer may lie in homegrown social workers, who are being trained through apprenticeships. This approach has gained traction in England, with the number of enrolled apprentices nearly doubling from 660 in 2019-20 to 1,290 in 2024-25. Social Work England has approved 44 undergraduate and 11 postgraduate apprenticeship courses in the past year, reflecting a growing recognition of the value of this training route.
One such apprentice is Claire Colvill, who is in the final year of a social work degree apprenticeship with Hertfordshire County Council. She previously worked for the council in a related role, allowing her to progress without leaving. Before that, she worked in beauty and moved into home care because she wanted "something more rewarding". She had not previously considered social work as a career and believes its reputation is part of the challenge. "When you walk away, hopefully somebody's life is a little bit better than when you walked into it," she says.
Colvill's work involves helping people fulfil their wishes around where and how they want to live. She has had people who may have been considering care homes but didn't particularly want that, so to be able to find avenues where they can remain at home is rewarding. The team she works in dealt with an 8% rise in referrals between 2024-25 and 2025-26, with numbers increasing from 2,895 to 3,148.
Social workers helped arrange practical support to rebuild confidence at home, including a caddy clipped onto her walking frame and a height-adjustable chair in the kitchen. Her husband, Bill, was also helped to remain at home before he died in January. "As long as he was looked after, which he was, I was happy," she says.
In Hertfordshire, the authorities deal with about 30 complex discharges from Lister Hospital in Stevenage daily. The county council has 27 social work degree apprentices working in adult social care, all of whom were existing employees. Heidi Hall, head of its transfer of care team, says recruiting internally has clear benefits. "They understand what the work is and what they're coming into. They understand what's available in Hertfordshire and they've got that resilience," she says.
Hospital social workers in the integrated discharge/transfer of care teams can expect to earn between £42,327 and £45,176 a year. Hall believes more people will take this route, although Skills for Care believes there are limits to how many staff want to upskill. Hall says her team aims to get people out of hospital within 24 hours of being medically fit and has helped to speed up discharges at Lister Hospital in recent years. Numbers rose from 6,429 in 2022-23 to a peak of 7,020 in 2024-25. But she says it is becoming more difficult.
"The main thing has been the complexity of the need and balancing the number of people coming into the hospitals that we need to discharge," she says. "There used to be time when people stayed in hospital for longer. Now a lot of that care is completed in the community." She says pressures on beds mean people are discharged sooner, often with higher ongoing needs.
However, Nikki Jefferson, a senior lecturer at the University of Hertfordshire, says policy and funding often focus too narrowly on discharge. "It often misses the wider reasons behind why there's people in hospital," she says. "Can they be enabled and kept at home without the need for that very significant amount of medical support? So I think it's really important that when you're looking at how do you make things better, that you consider every aspect of the pathway."
Colvill agrees that prevention matters. "A lot seemed to change over Covid; things came and went," she says, adding that better community support can help people who are isolated avoid crisis in the first place. Andrew Reece, of the British Association of Social Work, says the profession is facing a big retention problem, with areas such as hospital discharge and older people's care "acutely affected" by "ever-increasing caseloads".
He says apprenticeships are valuable, but not enough on their own, and is calling for more funding for student bursaries for traditional degrees. The government offers grants of up to £5,000 to a limited number of students on traditional degrees. It says applications – particularly from postgraduates – have fallen, prompting a public consultation on changes to the scheme, which closed on 7 April. Results are now being analysed.
A Department of Health and Social Care spokesperson said: "Social care apprenticeships are an important route, offering individuals the opportunity to earn a salary, avoid tuition fees and get hands-on experiences working with people. But we know there is more to do to ensure that all patients get the level of care they expect and deserve. That's why we are making over £4.6bn of additional funding available for adult social care."
In conclusion, homegrown social workers trained through apprenticeships could be a key to freeing up NHS beds. While apprenticeships are valuable, there is a need for more funding for traditional degrees to address the retention problem in the profession. The government's additional funding for adult social care is a step in the right direction, but more needs to be done to ensure that all patients get the level of care they expect and deserve.
