Doctors to sue NHS watchdog ‘for failing to rein in cheap medics’ linked to recent deaths – in an unprecedented case over the NHS’s reliance on doctor employees

A group of senior doctors are planning to sue the General Medical Council in an unprecedented attack on the NHS’s growing reliance on physician associates (PAs).

They argue that PAs – clinicians who have only two years of healthcare training and are expected to work alongside physicians and primary care physicians – are increasingly being used to fill healthcare workforce shortages.

The group, Anesthetists United, has raised more than £50,000 to take the GMC to court, claiming its plan to regulate so-called ‘cut-price medics’ fails to set clear rules on what PAs are can and cannot do.

PAs are supposed to have limited responsibilities, including taking patients’ medical histories, performing basic physical examinations and analyzing test results, all of which must be performed under the supervision of a physician.

Some PAs may also assist in the sedation of patients prior to surgery, and are known as nurse anesthetists (AAs).

However, doctors argue that the staffing crises are causing hospitals to “bend the rules” to allow PAs to work unsupervised in roles outside their expertise.

Over the past year, there have been reports of PAs asking for prescriptions, discharging patients from the hospital without a doctor’s approval, and even participating in brain surgeries.

There have also been cases where mistakes by PAs have led to patient deaths.

Doctors involved in the legal action say they want the GMC – the independent regulator of doctors in Britain – to clearly define the boundaries of employees’ roles to prevent them from carrying out complex medical tasks that put patients at risk could bring.

Anesthetist Dr Richard Marks, who leads the group, told The Mail on Sunday: ‘No one actually knows what a junior doctor is.

“Their scope of practice is not clearly defined, and I think that’s intentional.

‘It’s essentially a green light for health bosses in local trusts to push them into whatever role they want.

“But how can you regulate a profession if there are no clear boundaries defining the boundaries of their role?”

The NHS plans to recruit around 10,000 PAs by 2038 to ease pressure on the NHS and free up time for doctors and nurses.

However, this is strongly contested by doctors who say it confuses the role of doctors with employees.

The British Medical Association, which represents doctors, described it as a ‘slap in the face’ and said the move would not improve patient safety.

The Mail on Sunday first raised the alarm about PAs last year and has since been campaigning against Rein In The Physician Associates.

We told how Colleen Howe, 34, died from breast cancer after delays in her treatment when a lump was misdiagnosed as a blocked milk duct by a PA.

And actress Emily Chesterton, 30, died after a PA mistook symptoms of a blood clot for anxiety, while Norman Jopling, 79, was left fighting for his life after a severe brain haemorrhage was mistaken for a painful headache.

Experts say these tragic failures are often due to PAs being asked by hospital managers to perform tasks for which they are not qualified.

In September 2023, it was reported that a PA told The Physician Associate Podcast that he had participated in brain surgery.

And earlier this year, a Freedom of Information request revealed that PAs at Leeds Teaching Hospitals NHS Trust had ordered more than 1,000 scans, including X-rays and CT scans – a task that only doctors are allowed to do.

The hospital claimed this was due to a ‘system error’ and that no patients were harmed as a result.

Dr. Marks pointed out that many staff were ‘brilliant and very talented’, but added: ‘It does raise questions about patient safety if staff roles cannot be defined.

‘We need this to protect patients, but also to protect employees from forced things that are outside their expertise, which we know are happening.

‘I can’t just tell my anesthetist, who may not have any pediatric experience, to look after a three-year-old, but with PAs they can just switch specialties and there’s no mechanism to limit that.

‘Things will be missed. Things will be ruined.”

Anesthetists United wrote to the GMC in March about its concerns, but was ‘dissatisfied’ with the regulator’s response, saying ‘the only route left’ was a legal route.

After raising more than £50,000 to fund the legal challenge, it has now set a new target of £100,000 to help fight the case in court.

The group also wants the GMC to ensure that PAs are not referred to as ‘medical professionals’ so that patients cannot confuse them with doctors, and that patients are always told when they are being treated by a PA.

“I don’t understand why the GMC doesn’t want to make the regulations more robust,” Dr Marks said.

“They’re setting standards for doctors – why would they allow themselves to cheapen their brand?”

A spokesperson for GMC said: “We are aware of the Anesthetists United campaign. We continue to listen to the opinions of physicians, PAs, AAs and others.”