A doctors’ union has warned about the implications of the proposed new doctor apprenticeship scheme, warning it could waste GP time and produce ‘inadequately trained’ doctors.

Doctors Association UK (DAUK) said its members have ‘voted unanimously’ to oppose the new scheme which is being worked up by Health Education England and which is aimed at enabling candidates to become doctors without undertaking a traditional undergraduate medical degree.

On the back of reports it will have ‘a heavy primary care focus’ the DAUK warned that GP trainers would not have the capacity to train the apprentices.

DAUK chair Dr Jenny Vaughan said that while the organisation agrees with the aim to diversify and widen participation in medicine, it questions ‘why it is necessary, considering there is a surplus of fully trained final year medical students unable to secure FY1 placements’.

Dr Vaughan added that it could create a ‘two-tier system’, as it is ‘unlikely the same levels of competence will be achieved’ as those undertaking an undergraduate medical degree with the bulk of the scheme spent ‘in service provision’.

And she said: ‘With a near record numbers of students and junior doctors currently in training, the consultants and GPs who provide most of the clinical teaching are already under strain, and we question who will be supervising these trainees and if they really have any more capacity to do so.’

DAUK GP advisor Dr Lizzie Toberty said: ‘This apprenticeship scheme risks spending a lot of time and money to develop inadequately trained doctors. Without a thorough and rigorous grounding in the sciences we risk dumbing down our health system. If patients do not have access to doctors with adequate clinical knowledge their treatment will suffer.’

She added that ‘alarm bells’ have been ringing given the primary care focus of the scheme, adding that there is an inference that general practice does not require the same level of knowledge or skills, as a hospital doctor, signalling a ‘huge underestimation of the role’.

She added: ‘We strongly recommend HEE focus on making current medical school places more affordable and accessible to those from all backgrounds, and develop schemes to allow students to study part time and have jobs alongside their medical degrees – or provide them with bursaries.’

But HEE retorted to the claims, saying that the same medical schools as currently have undergraduate medical students  will deliver this degree apprenticeship  with exactly the same exams and assessments including the MLA  as for the traditional course so there will be no difference in competencies achieved.

It also refuted the claim that there is a shortage of foundation placements, with those placed on waiting lists usually found positions.

HEE deputy medical director for undergraduate education Professor Liz Hughes said: ‘We are working with employers, the Institute for Apprenticeships and Technical Education, Medical Schools Council, the GMC and a number of other stakeholders on developing a medical degree apprenticeship.  

‘A proposal is currently in the early stages of development and there will be significant opportunities to help shape and implement the plans. The expectation is that such an  apprenticeship could make the profession more accessible, more diverse and more representative of local communities while retaining the same high standards of training.’

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The Doctors’ Association UK is pleased that the report agrees with our written submission that the provision for the HSSIB to accredit NHS trusts to do their own ‘safe space’ investigations is an enormous conflict of interest. We are therefore delighted that the report has recommended that the entirety of part 3 of the draft Bill, relating to Trust accreditation, be dropped.

The Doctors’ Association UK is also pleased that the report agrees the value of the HSIB as an independent body, bringing medicine in line with the rail and aviation industries. ‘Safe space’ investigations will allow staff to speak freely and determine what went wrong to prevent similar mistakes happening again. If ‘safe space’ investigations are to carry the confidence of the public, the independence of the HSIB must be assured.

The Doctors’ Association UK’s central campaign is entitled “Learn Not Blame”, and seeks to engender a national conversation about the need for a just culture in the NHS. We are campaigning for a step change in the NHS so that honest error is used to drive learning and change for a safer, better NHS, rather than being a focus for individual blame. The creation of a truly independent body is a welcome step towards this.

We need a culture of learning, not of blame and persecution. We need a culture of compassion and care for all who are served by it and all who work in it. A culture where mistakes and harm are prevented by openness, listening and learning. And where mistakes and harm do happen, change, not blame, is the outcome. A just culture. This is the only way we will see a real improvement in patient safety.

This campaign has been born out of a growing awareness amongst clinicians of how a toxic mix of defensiveness and concern for reputation management above all else can lead to blame-seeking culture. This is bad for doctors and worse still for patient safety.

Most patients and families, when things go wrong in healthcare, just want to know honestly what happened and make sure that the same thing never happens to anyone else. But many people face a brick wall when seeking answers from NHS organisations, and get pushed into an adversarial complaints procedure, or even litigation.

Equally, staff who raise concerns often find themselves the subject of counter-accusations, victimisation and blame, instead of having their concerns acted upon. Staff are forced into a formal whistleblowing procedure, where the ensuing legal action may bankrupt them and ruin their careers.

This campaign aims to bring doctors together to say – enough. This has to stop.

The campaign will encourage individuals to commit to action within their own sphere of influence, and join together as a movement to put pressure on NHS leadership to mirror that change and commit at a Trust or Health Board level to an open, learning and just culture.

Look out for more details coming soon, and how YOU can be the change.

#LearnNotBlame