Student doctors told: Skip university to plug NHS staff shortages

Doctors’ union the British Medical Association warn an increase in apprenticeships could jeopardise quality of medical training

Tens of thousands of doctors and nurses are set to be trained via apprenticeships in a major expansion of plans to help fix the NHS workforce crisis.

Amanda Pritchard, the chief executive of NHS England, urged school-leavers to “earn while they learn” rather than undertake a traditional university degree, as part of a radical new plan set to be unveiled by the government in the coming days.

It is understood that around one in 10 doctors and a third of nurses could qualify using this route – a fivefold increase on the 200 medical apprenticeships originally planned under NHS schemes.

But the British Medical Association (BMA) expressed fears that NHS employers would not be able to deliver the high standard of training afforded to medical students at university. And experts raised concerns that the health service would be unable to provide enough experienced doctors and nurses to deliver on-the-job training.

The Independent understands that the expansion of apprenticeship schemes forms a key part of the government’s NHS workforce plan, which is expected to be published imminently.

It comes against the backdrop of a continuing strike by junior doctors over pay and conditions, and as Rishi Sunak refused to repeat the 2019 Conservative pledge to provide 6,000 more GPs by 2024. The Royal College of Nursing has also announced plans to ballot its members on whether to take further strike action later this year.

Speaking to pupils at the Durham Johnston Comprehensive School in Durham on Friday, Ms Pritchard said: “The NHS is looking to expand apprenticeship schemes over the coming years, offering a different route into the NHS, where students can earn while they learn instead of going through the university route.

“This radical new approach could see tens of thousands of school-leavers becoming doctors and nurses, or [working in] other key healthcare roles after being trained on the job, over the next 25 years.”

Ms Pritchard said young people could apply for a medical degree apprenticeship from “next year”, but the Institute for Apprenticeships and Technical Education said the government’s Education and Skills Funding Agency has yet to agree a start date.

According to the institute, the training would last for five years, after which students would apply to the General Medical Council to do their foundation training.

The NHS education and training body, Health Education England (HEE), has said that pay rates for apprentices would be set by individual employers, but that under current rules they would have to be between £7.49 and £10.42 per hour.

According to HEE, as of last year the NHS had enrolled 6,000 trainees onto nursing degree apprenticeships since 2017.

Alison Leary, professor of healthcare and workforce at South Bank University, told The Independent: “Any kind of expansion in trainees or people coming into the workforce requires retention of the existing workforce to teach them.”

In response to the plans, Dr Latifa Patel, workforce lead for the BMA, said there are “huge questions” over how medical apprenticeships would solve the workforce crisis and whether they would offer the same standard of training currently provided to medical students.

Dr Patel said: “We have little evidence on whether the apprentice model will work at scale, and whether employers will want to take the investment risk with no guarantee of a return.

“And apprenticeships may also slow our training capacity in the short term, given the supervision requirements: the medical training pipeline is already stretched to its limits, with lecture halls at capacity, limited numbers of clinical placements, and falling numbers of medical academic staff. Where are the extra resources going to come from?”

The BMA is calling for a “dramatic” increase in traditional medical school places, which are currently capped at 9,500.

Danny Mortimer, the chief executive of NHS Employers, said there is a “real” appetite in the NHS to use apprenticeship schemes more, but that the apprenticeship levy scheme would have to be reformed in order to support the extra costs faced by healthcare employers.

Employers would receive £27,000 per apprentice, according to HEE guidance, but would need to cover any additional costs themselves.

The Department of Health and Social Care declined to comment.