BMA calls for immediate ban on NHS recruiting physician associates amid fears ‘cut-price doctors’ with just two years of training are harming patients
The rapid expansion of the medical ‘associate’ role within the NHS is putting patients at risk and must be stopped immediately, doctors have warned.
Healthcare leaders want doctors and nurse anesthetists to play a greater role in the NHS over the next fifteen years to meet rising healthcare demands.
They are less qualified than doctors and do not have a medical degree, but are increasingly diagnosing and treating patients in hospitals and GP practices.
The British Medical Association called for a recruitment freeze, highlighting a number of recent cases where patients did not always know they were being treated by a PA and ‘suffered tragic harm’.
It says the new recruits “infringe on the role of doctors” and that the dangers they pose should not be seen as a “price worth paying” for quickly solving a labor shortage.
Emily Chesterton, pictured, was just 30 when she died last year after a PA failed to detect a blood clot. The actress was seen twice by the same PA, who told her she was suffering from anxiety and long Covid-19. Her parents say that at no point during the appointment was Emily informed that the person she was seeing was not a GP. Emily died in November after going into cardiac arrest. A coroner concluded that her life could have been saved if she had been sent to the emergency room
Norman Jopling, 79, from north London, suffered a severe brain haemorrhage after a PA wrongly told him his painful headache was nothing to worry about. His wife Maureen (right) accused the NHS of ‘cutting corners’ by allowing PAs to carry out ‘complicated tasks for which they are not qualified’.
Actress Emily Chesterton, 30, died of a blood clot late last year after a PA dismissed her symptoms as anxiety and gave her pills instead of referring her to A&E.
She thought she had been seen by a GP at her practice in North London, but had actually been seen twice by a member of staff.
The BMA’s UK Council, which represents doctors from across Britain, has now passed a motion calling for the moratorium on patient safety grounds.
They want the pause to last until the government and the NHS have put in place safeguards to ensure medical professionals are properly regulated and supervised.
However, some junior doctors have taken to the Internet in recent months to complain that PAs are paid more than they actually do, are scheduled to work more social hours, and are taken up spots in training programs they haven’t been able to participate in.
Professor Phil Banfield, chairman of the BMA board, said: ‘There should be no doubt that when a patient goes to a doctor, he or she goes to a doctor.
“This role blurring and patient confusion must stop now.”
There are more than 3,500 PAs registered in the UK, as well as 150 anesthetists (AAs) and 6,800 nursing assistants.
PAs and AAs typically complete a three-year bachelor’s degree, followed by a two-year postgraduate degree.
Healthcare leaders want doctors and nurse anesthetists to play a greater role in the NHS over the next fifteen years to meet rising healthcare demands. They are less qualified than doctors and do not have a medical degree, but are increasingly diagnosing and treating patients in hospitals and GP practices
A geographical map shows the distribution of PAs across the UK
They are currently unregulated, but work is underway to expand the role of the General Medical Council, which regulates doctors, to include MAPs.
Professor Banfield said: ‘Doctors across the UK are increasingly concerned about the relentless expansion of the medical profession, which has been brought into sharp focus by terrible cases of patients suffering serious harm after receiving the wrong care from MAPs.
“Now is the time for the government to listen before it is too late.
‘We are clear: until there is clarity and material certainty about the role of MAPs, they should not be recruited into the NHS.
‘We have always been clear that MAPs can play an important role in NHS teams, and that doctors will continue to value, respect and support the individual staff they work with.
‘But the roles and responsibilities of MAP are not clearly defined.
‘We are seeing more and more cases where MAPs infringe on the role of physicians; they are not doctors, they do not have a medical degree and do not have the extensive training and depth of knowledge that doctors have.
The number of qualified PAs in England, Northern Ireland, Scotland and Wales in 2021, according to the Royal College of Physicians
A report from the Royal College of Physicians shows that PAs practice in 46 specialties. These include urology, surgery, cardiology and mental health
Critics are very concerned about the riskier tasks that some PAs now perform, such as pelvic examinations and insertion and removal of the contraceptive IUD.
“As physicians, we are concerned that patients and the public do not understand what this could mean for the level of experience and expertise in care they receive.”
He added: ‘The General Medical Council is the exclusive regulator of doctors in Britain.
‘Adding staff who are not doctors and do not have a medical degree to the GMC register calls into question the competence and qualification of the entire medical profession.
“The government can see this as a price worth paying for a shortcut to solving the workforce crisis they have presided over. We know different.
‘GMC regulation of MAPs will only increase the confusion and uncertainty faced by patients.
‘Ministers may hope that by using secondary legislation, which may not even require the vote of MPs, they can avoid raising the alarm.
‘But patients want doctors to remain doctors, under the supervision of a special body, and they have the right to have confidence in the expert medical care they receive.
“There should be no doubt that when a patient goes to a doctor, he or she goes to a doctor. This blurring of roles and confusion caused to patients must stop now.”
Last month, NHS England’s national medical director, Professor Sir Stephen Powis, said there was ’emphatically no plan to replace doctors in the NHS’.