Anger at doctor staff who have little training and are treating NHS patients in roles far beyond their remit as evidence of care mounts and causes misdiagnoses and deaths

Trainee doctors (PAs) are being employed by the NHS to work with patients despite having no medical training, this newspaper has learned.

There are already growing concerns about the escalating use of these ‘cheap doctors’ – who are required to assist doctors and nurses with routine tasks after two years of training.

But many are being asked to take on clinical roles far beyond their competence, and mounting evidence suggests this has harmed patients and led to misdiagnoses and even deaths.

But The Mail on Sunday has now discovered that the NHS is rolling out ‘apprenticeships’ for PAs – meaning untrained staff will go straight into paid work working with patients.

The Mail on Sunday has now discovered that the NHS is rolling out ‘apprenticeships’ for PAs. Protesters hold a banner outside the Houses of Parliament

The formal clinical training aspect will be completed in their spare time – which usually involves online seminars.

Documents show that 200 of these PAs could be working in the NHS by early 2025.

Doctors reacted with horror to the news last night, saying the government must be “held to account” before patient safety could be further compromised.

“This is a step too far,” said Dr. Helen Fernandes, co-chair of the Doctors Association. ‘It’s complete madness. Many patients and physicians will be shocked to hear of these PAs, many of whom have never entered a department or clinic before. I’m baffled as to how anyone could think this could be safe for patients.

‘If PAs are properly supervised and regulated, they can support physicians in delivering high-quality, safe care. We would welcome that.

‘But the question is also whether patients, who often do not know that they are being treated by someone who is not a doctor, are told that they can go to a student.

‘The government must be held to account, and organizations have already called for a halt to the recruitment of PAs.’

A vacancy for a PA apprentice to work in GP practices, posted last year by Midlands Partnership NHS Trust, reveals that the candidate could receive a salary of up to £32,934 per year – only slightly less than the average salary of a qualified nurse – and a fully trained PA would be expected to perform the same duties.

The job description states that this includes performing physical exams, taking medical histories and seeing patients with emergency or routine health issues.

University Hospitals North Midlands has taken on 13 apprentices in its acute medical unit who will work in cardiology.

It is understood the apprenticeships are an initiative of NHS England and the training will be delivered by ten universities. Only two programs – at Keele University and the University of Plymouth – have already started.

The latter’s course, described as ‘an innovative pathway’ to becoming a PA, covers just four weeks on campus during the 30-month ‘intensive training and assessment of clinical skills’ course.

The Mail on Sunday first raised the alarm about the dangers of PAs last year and is running a campaign to curb Rein In The Physician Associates.

The government wants to recruit around 10,000 PAs by 2038 to ease pressure on the NHS. The current number is 2,500.

Dr. Robert Laurenson (center), co-chair of the Junior Doctors Committee, participates in the protest

Doctors reacted with horror to the news last night, saying the government must be ‘held to account’ before patient safety could be further compromised

When PAs are used as originally intended, studies suggest they can improve the care primary care physicians provide to patients.

But last year the MoS told how 34-year-old Colleen Howe died from aggressive breast cancer after delays in her treatment when her lump was misdiagnosed as a blocked milk duct by a PA.

And Norman Jopling, 79, also suffered a serious brain haemorrhage after a co-worker wrongly told him his painful headache was ‘nothing to worry about’.

In a Lords debate last month, Liberal Democrat peer Baroness Brinton said doctors had reported ’70 cases of avoidable harm to patients and near misses caused by PAs’, including ‘fatalities, missed diagnoses causing terminal illness, blood poisoning and heart attacks cause’.

An NHS England spokesperson said: ‘Apprenticeship for junior doctors is a safe role, and all training is carried out under the supervision of fully qualified mentors.

“Students must complete the same mandatory credentials and competency standards as students entering a physician assistant course. They do not replace doctors in any way – as set out in the NHS Long Term Workforce Plan they provide an alternative role in the junior doctor profession and improve access to healthcare roles.”