A lack of distinction between fully-trained doctors, physician associates (PAs) and anaesthesia associates (AAs) allegedly poses “a real danger” to patients.
The doctors’ union took its regulator to court this week over the “dangers” of a catch-all “medical professionals” term being applied to doctors and their less-qualified colleagues.
Dr Jatinder Hayre, a practicing doctor in the Midlands, writer and medical campaigner, said the rocketing number of PAs is a source of real concern – with patients who think they’re seeing a GP risking meeting “unregulated and unqualified” associates instead.
As the number of doctors in the NHS dwindles – due to “training bottlenecks, people going abroad and choosing other careers entirely” – a PA recruitment drive is on track to create 10,000 roles by the end of the decade, Dr Hayre said.
The British Medical Association (BMA) is pursuing two cases against the General Medical Council (GMC) for the term “medical professional” to only be applied to doctors and to clarify PA and AA skillsets to the public – namely their lack of formal training.
Emily Chesterton, 30, died in 2022 after seeing a PA she thought was a GP and being misdiagnosed as a result. She was told her ankle pain was only due to a sprain when it was actually a blood clot which spread to her leg and lung, ultimately taking her life.
A separate case is also being brought against the GMC by Anaesthetists United alongside Ms Chesterton’s parents, seeking to define clear boundaries on the practices PAs are allowed to carry out. A Crowdfunder has been set up for the legal action, which is expected to be heard at the High Court in May.
The NHS ordered hospitals around England to stop substituting PAs for doctors on shifts after The Telegraph published data showing that the phenomenon was happening at over 30 hospitals around the country.
Rotas from the hospitals in question showed PAs and AAs picking up doctor shifts when their colleagues were off sick – despite having up to four years less training than their senior counterparts, and being required to always work under supervision.
“We can’t blame patients for not knowing who they’re seeing,” Mr Hayre told Express.co.uk. “Of course they’re going to assume that their appointment is with someone who is fully qualified – that’s not a radical concept.
“I think the problem is greater than that and the focus on recruiting more and more PAs, essentially people who aren’t fully qualified, is a scandal.
“I think the current court case is long overdue, and the practical implications will be limited,” he added.
“But hopefully it will represent a symbolic win and a path forward. It will force people to acknowledge that PAs aren’t, and cannot be, doctor substitutes.”
Mr Hayre also suggested there “could be many more Emily Chesterton’s out there”, warning that patients may be “playing Russian Roulette with their lives by placing it in the hands of a PA”.
Jenni Richards, the BMA’s lawyer, told the court that the GMC’s lack of clear distinction between the different roles “pose[s] significant concerns for public understanding of, and confidence in, the medical profession” as well as “[giving] rise to real patient safety concerns”.
The findings of the Government’s review into PAs, led by Professor Gillian Leng, is expected to be published in the spring, with insights into the role played by the health workers in comparison to junior and senior doctors.
An NHS spokesperson said: “While we have always been clear that physician associates are not replacements for doctors, there are clear and ongoing concerns which we are listening to carefully and taking action to address – the Leng Review will gather insight from across the NHS, so that we have the evidence we need to tackle this issue head on and find a way forward that is the right one for patients and our staff.”
A spokesperson for the GMC said: “We have made it very clear [that] we will recognise and regulate doctors, PAs and AAs as three distinct professions.
“We have been consistent in saying that PAs and AAs must clearly communicate who they are, and their role in the team. We also expected them to always work under supervision and to practise within their competence.
“The registers on our website are clearly marked, so as to distinguish between the three professions we regulate. A prefix is used for PA and AA reference numbers, which provides a clear distinction between those two professions and doctors. In addition, each profession type is prominently labelled on our public-facing registers, and in search functions. This means that when patients search our registers it will be very clear whether an individual is a doctor, a PA or an AA.
“In preparedness for regulating PAs and AAs, we extensively and formally consulted with the BMA. From as early as 2021 we made the BMA and others aware of our intention to apply our core professional standards to doctors, PAs and AAs, and received no objections from them at all.
“The term ‘medical professionals’ is not a protected title, and it is an appropriate way to describe all the professional groups we now regulate.”
A written judgement for the High Court hearing, which took place on February 12 and 13, is expected at a later date.
This story originally appeared on Express.co.uk
