I believe the NHS apprenticeship scheme for 16-18-year-olds is a fantastic idea in principle. It can give prospective healthcare employees a taste of where their career could take them and what experiences they could encounter.
With the post-Francis media backlash, the NHS needs more than ever to attract bright, engaged, enthusiastic young people - it will need them if it is to survive.
But we have heard claims this week that trainee healthcare assistants working on this scheme in a few trusts are not being employed in the spirit of the original apprenticeship idea (page 2).
It seems trusts may be using apprentices, some under 18, to fill gaps in their rotas, paying the cheaper minimum wage to younger, unqualified staff to keep their costs down.
Some apprentices have been reported to be performing clinical and caring jobs without supervision. Washing patients, checking for skin changes and helping them to eat takes patience, skill and sensitive communication. And at 16 or 17, untrained workers without the supervision of a registered nurse may be putting themselves and their patients at risk if they do not understand the implications of what they are doing. They may miss early signs that a patient is deteriorating, or fail to alert staff to a problem.
Cutting corners and costs by delegating aspects of essential nursing care to healthcare assistant apprentices conflicts with the Francis report
Cutting corners and costs by delegating aspects of essential nursing care to apprentices conflicts with the Francis report. It is likely to jeopardise the standing of the profession in the public eye, nurses’ ability to do their jobs - and most importantly, patient safety and experience.
Any trusts abusing the scheme are also jeopardising the enthusiasm of the future workforce. Some apprentices have apparently had to perform last offices for deceased patients. This can be a difficult experience first time even for student nurses, but they are older, likely to be more emotionally mature, and will have the support of their university lecturer and placement mentor.
Maturity adds a lot to the experience of those new to the profession - and without such insight, anyone performing these nursing duties will find their ability to do the tasks and to cope diminished.
This scheme should not be used as a way of gaining cheap labour. It should be used to inspire, attract and enthuse. If not, it will alienate current nurses, and deter some potentially excellent nurses from ever seeking to join the profession.
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Jenni Middleton, editor
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