What is the role of Physician Associates and what are the possible implications on Patient Safety?

Currently there are around 2,500 Physician Associates working in the NHS.  According to the Department of Health and Social Care, the NHS plans to increase the numbers to 10,000 by 2037. And the reason behind this move is a serious lack of doctors.

Physician Associates were introduced in 2003 and their training is typically undertaken after receiving an undergraduate degree in a subject related to health – such as biology, psychology or sports science.  The postgraduate training includes two years’ healthcare training so they can assist doctors and nurses in their daily duties, freeing up time for patients.

Their role involves supporting doctors and they are permitted to take medical histories, perform physical examinations and analyse test results, all under the supervision of a doctor.  They can also fill out forms and complete basic checks which can otherwise clog up doctors’ workloads.  

However, staff shortages and overwhelmed GP surgeries has meant Physician Associates are increasingly being called to fill in the gaps, taking on duties above their original remit and far beyond what they are qualified to do, including unsupervised appointments with patients,  diagnosing conditions and making decisions on treatments.

GP chiefs and other doctors are calling for crackdown on Physician Associates in the NHS following a series of life-threatening misdiagnosis, which recently reported in the news  examples of which are:

  • Norman Jopling, 79 from North London, who suffered a serious brain bleed, after a Physician Associate told him that he had painful headaches which were nothing to worry about.
  • Emily Chesterton, who was just 30 when she died last year after a Physician Associate failed to spot a blood clot.
  • A woman reported that her 97-year-old mother, who lives in a Solihull care home, was sent for unnecessary hospital tests by a Physician Associate who she believed for months was a GP.
  • Another woman reported that her husband had been prescribed antibiotics for a suspected chest infection by a Physician Associate. A week later a GP diagnosed him with severe lung disease and sent him for hospital tests which revealed prostate cancer.

Concerns over the use of Physician Associates is not limited to GP Surgeries, as there are also plans to hire about 2,000 Anaesthesia Associates by 2037, who would administer sedative drugs to patients before surgery under the supervision of a Consultant Anaesthetist.

Not only are patients not always made aware that the person they are consulting with is not a trained GP or doctor, but also there are concerns over the fact that they are not properly supervised leading to deaths and misdiagnosis, combined with the fact that that currently Physician Associates are currently unregulated, which means they cannot be held responsible for mistakes.   

Members of the Doctors’ Union the British Medical Association (BMA) have called for the role to be re-named as “Physician Assistant” and for more effort to be made to ensure that Physician Associates are not confused with Doctors.  Will Quince, a Minister of the State Department of Health and Social Care until 13 November 2023 said regardless of the title “we need to make sure they are properly introducing themselves and their role, and making that very clear to patients”.

A Government consultation to decide whether Physician Associates would be regulated by the General Medical Council was completed in May.  If it goes ahead, it would see rules set in place on what Physician Associates were qualified to do and allow the NHS to remove them if proven to have made avoidable errors.   A decision isn’t expected to be made until the second half of 2024.

A link to the BBC Health News Article here:

If you have been affected by any of the issues highlighted in this article, or any other issues relating to injuries (physical and/or psychological) arising out of medical care, please contact our team for an initial no-obligation discussion.

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