Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more


'Abuse of apprentice schemes risks safety'


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.

● Follow the latest news on our Speak Out Safely campaign on Twitter at @NursingTimesSOS and

Jenni Middleton, editor Follow me on Twitter @nursingtimesed


Readers' comments (4)

  • Do any prospective apprentices at 16 have to work for a year as a HCA before being accepted?

    Unsuitable or offensive? Report this comment

  • Surely apprentices should have some structure into their course, being signed off for what they have achieved, and to what standard, under supervision.... And have some mentorship of some sort. If Trusts are abusing this system, they should be brought to task at a national level, and the responsible heads rolling .... out of the NHS!!

    Unsuitable or offensive? Report this comment

  • I'm not sure this is really about apprentices. Isn't this a case of poor supervision of HCAs, it just so happens that these ones happen to be apprentice HCAs?

    Unsuitable or offensive? Report this comment

  • Hasn't it always been the way with some wards/managers.
    I remember as a student nurse, being counted in the numbers working EVERY weekend and bank hols on some placements to save on with everywhere facing cut backs some people will always exploit staff and at the expense of good care will cut corners.
    We have an apprentice at work-and we are trying to give her a fair deal, working with learning and the opportunity for future jobs if she makes the grade. She also has a support worker mentor and a nurse supervisor.

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.