by Unqualified medical students are encouraged to provide clinical support in English hospitals as tens of thousands of young doctors go on strike this month, the Guardian may reveal.
The NHS faces the prospect of unprecedented disruption to services from March 13, when junior doctors went on strike for 72 hours in an increasingly bitter dispute over pay, morale and safe levels of staff.
With hospitals preparing for only the second such action in the NHS’s 74-year history, Guardian understands that several NHS organizations have started asking students if they can help fill staffing gaps.
It comes as senior union activists including Unison and GMB meet to decide whether to call off NHS strike action next week and accept the health secretary’s offer to start pay negotiations.
If other unions decide to join the discussion, the strike action by ambulance and NHS support staff scheduled for Monday and Wednesday next week will not take place. Steve Barclay made a significant concession by proposing to discuss a one-time payment for this year – previously a sticking point in a long-running dispute.
The revelation drew immediate condemnation from physicians’ unions, which raised safety concerns and said that medical students should refuse to take on tasks beyond their competence or ability.
There are also concerns that asking students who are not medically qualified to help sick patients could run into legal difficulties if they make a mistake.
Brighton and Sussex Medical School (BSMS) final year medical students are among those asked if they would be available “to support clinical activities” at a local NHS hospital during the upcoming strikes.
A spokesperson for the East Sussex NHS Health Fund said: “Using student doctors to provide protection during the upcoming strike of junior doctors has never been part of our strike planning.
“We are surprised to hear that a student doctor has found himself in a situation where he thought he could be expected; this should not happen and we will look into the issue.”
Dr Paul Donaldson, general secretary of the HCSA, the union of hospital doctors, said any attempt to put students “in such a stressful situation” was alarming.
“There is a clear risk that they may be asked to do things beyond their skill level and without any compensation to protect them,” he said. “Undoubtedly, proper supervision will be difficult when consultants focus on emergencies and acute cases.”
He added: “Disguising this as a good learning opportunity is just wrong and reflects a cavalier approach to patient safety and their duty of care to students.”
Some universities, including King’s College London, University College London and Queen Mary University London, gained recognition from medical groups after student apprenticeships that were supposed to take place in hospitals on strike days were cancelled.
The British Medical Association (DAUK) has called on all universities in England to cancel internships scheduled for strike days over fears for the safety of patients and staff.
It said there was a “high” risk that students would be asked to “act” and fill in for junior doctors in their absence without professional protection to do so.
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“Instructing students not to fill these gaps is unrealistic and does not take into account the power dynamics between students and clinicians,” DAUK wrote in a recent letter to medical school deans.
“In addition, students do not have the professional security to perform such roles and would put themselves at risk. To prevent these problems from arising, medical students should not be expected to participate in clinical practice during strike action.”
Ray Effah, co-chair of the British Medical Association’s medical student committee, said medical students should not be asked to act as a junior doctor or take on any assignment “that would be outside the normal parameters of their internships” to support trusts during the strike action.
“It is absolutely crucial that medical students work under proper supervision, safely and within their competence and capabilities at all times.
“This includes any periods of pressure experienced by the health service where they are learning, including pressure from other health professionals taking industrial action. The aim of students doing internships is to learn, not to provide services.
“If medical students are asked to undertake any assignment that goes beyond the agreed learning outcome of their practice to manage the effects of industrial action taking place in their trust, they should decline the assignment and notify the BMA, which can advise and support them.”
On Thursday, young doctor leaders met with Barclay in London but then said nothing new had been proposed and described the talks as “disappointing”.
Barclay has repeatedly said he values the work of junior doctors and wants to “continue discussing how we can make the NHS a better place to work for everyone”.
Union activists representing ambulance and support staff will meet on Friday to decide whether to call off the strikes. The Royal College of Nursing (RCN) suspended nurses’ industrial action last week to begin “intensive” talks with Barclay.
