
Physician associates union takes Government to court over planned role changes
The review chaired by Professor Gillian Leng, who is president of the Royal Society of Medicine, said PAs should be banned from seeing patients who have not been reviewed by a medic to prevent the risk of 'catastrophic' misdiagnoses.
On Sunday, UMAPs has sent letters to the Health Secretary and NHS England expressing their intent to make a judicial review claim, the union said.
They are urging the Government to reconsider what the union described as a 'complete overhaul' of their profession, and have accused Mr Streeting of playing into the hand of the British Medical Association (BMA) as resident doctors strike over pay.
Stephen Nash, general secretary of Umaps said: 'The Leng Review found no hard evidence that physician associates are unsafe or ineffective.
'Nevertheless, Wes Streeting has accepted the Review's recommendations to completely overhaul our job roles, without so much as consulting Umaps as the recognised trade union for PAs and AAs.
'That is both unfair and completely irrational.
'We are incredibly concerned about how these changes will impact patients' access to care, particularly during the ongoing BMA strikes.'
A five-day walkout by resident doctors in England is under way, with members of the BMA manning picket lines across the country.
The Government has until August 1 to indicate whether or not it will reconsider its decision, the union said.
More than 3,500 PAs and 100 AAs are working in the NHS and there have been previous calls for an expansion in their number.
But a general lack of support for both roles from the medical profession, plus high-profile deaths of patients who were misdiagnosed by PAs, led to the review.
In her report, Prof Leng concluded there were 'no convincing reasons to abolish the roles of AA or PA' but there is also no case 'for continuing with the roles unchanged'.
She said more detail was needed on which patients can be seen by PAs and national clinical protocols will now be developed in this area.
'Prior to these changes, PAs undertook approximately 20 million appointments a year,' Mr Nash added.
'Now, every day we hear from employers who are struggling to manage patient loads because PAs and AAs are no longer allowed to carry out the jobs we are trained to do.
'Yet the Health Secretary has seemingly not carried out any assessment of how the Leng recommendations will affect NHS backlogs.
'It is hard to see Mr Streeting's decision as anything other than an attempt to mollify the increasingly radical BMA, which has spent the last few years waging a vindictive and highly coordinated campaign against Medical Associates.
'Now he has played right into the BMA's hand, preventing qualified medical professionals from treating patients properly so that their strikes bite even harder.'
Sneha Naiwal, a partner at Shakespeare Martineau which is leading the case for UMAPs, said: 'This case is not about resisting change, but about ensuring that change is lawful, evidence-based, and respectful of the professionals who have long served on the front lines of patient care.
'Physician associates deserve a meaningful voice in shaping their future, not to be sidelined by decisions taken without full and open engagement.
'The claimants are concerned that the current approach could undermine a vital part of the clinical workforce and increase pressure on NHS services, to the detriment of patients and staff alike.'
Six patient deaths linked to contact with PAs have been recorded by coroners in England.
One high-profile death involved Emily Chesterton, 30, who died from a pulmonary embolism.
She was misdiagnosed by a PA on two occasions and told she had anxiety.

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Telegraph
4 hours ago
- Telegraph
NHS chief accuses BMA of ‘extortion'
The head of the NHS attacked the British Medical Association (BMA) for demanding 'extortionate pay' amid a strike row. Sir Jim Mackey, the NHS chief executive, criticised the doctors' union in a message to NHS hospital trust leaders. Junior – now resident – doctors have entered the last of a five-day strike that began on Friday. The BMA has rejected 18 emergency requests by NHS hospitals for striking doctors to cross the picket line and help. Hospitals are able to make emergency requests for help to striking doctors – called 'derogations' – to help stop patients coming to harm, such as in emergency departments and cancer care. However, Sir Jim said that of the 18 rejected requests, the BMA would only support half of these 'if extortionate pay rates were offered to striking doctors'. In a message seen by The Telegraph, he said they had worked to 'overhaul the process for patient safety mitigations' with nine requests approved by Sunday night. But he added: 'Unfortunately, despite all requests being made and verified by senior medics, 18 have been rejected by the BMA, with half of those rejections saying the BMA would support only if extortionate pay rates were offered to striking doctors.' He encouraged NHS bosses to keep putting them forward where they were needed. The exemptions are requested by senior NHS medics in exceptional circumstances to protect patient safety and must be agreed on a case-by-case basis by BMA leaders, including chairman, Dr Tom Dolphin. As of Sunday evening, there had been 47 requests for 125 doctors, according to the BMA. Some are pending or were withdrawn. The resident doctors are demanding a 29 per cent pay rise to return them to 2008 levels of pay. They have been awarded a 28.9 per cent pay rise since Labour came into power, including a 5.4 per cent rise for this financial year. Nurses, who are expected to overwhelmingly vote to reject their 3.6 per cent pay rise, could also ballot to take industrial action later this year. One emergency request rejected by the BMA was for a resident doctor to carry out biopsies on men with suspected prostate cancer at Milton Keynes Hospital. The doctor subsequently volunteered to return to work and was praised by Wes Streeting, the Health Secretary, for their 'bravery'. He said it 'ensured these men got the care they deserve'. Of the requests granted by the BMA, one was for a doctor to return to work on a neonatal ward caring for new born babies in Nottingham City Hospital. The BMA said it was launching a separate, related dispute with the Government over 'training bottlenecks'. A survey of 1,053 resident doctors finishing their foundation training found that 52 per cent had not secured a job for next month. After two years of foundation training, resident doctors begin speciality training to become consultants or GPs. The BMA said this year there had been more than 30,000 doctors applying for just 10,000 posts. Dr Ross Nieuwoudt and Dr Melissa Ryan, BMA resident doctors committee co-chairs said:'It's absurd that in a country where the Government says bringing down NHS waiting lists is one of its top priorities, not only is it not prepared to restore doctors' pay, but it also won't provide jobs for doctors ready, willing and capable to progress in their careers. 'Commitments from the Government to address this don't go far enough or are too vague to convince us that they understand the gravity of the situation, so we're making clear that, alongside pay, we are entering a dispute and demanding action so that no UK-trained, capable, doctor is left underemployed in the NHS.' It comes as health workers represented by the trade union, Unite, voted to reject the 3.6 per cent pay award for this financial year. Some 89 per cent rejected the deal, with the union saying it was prepared to take strike action. It represents a range of NHS staff including paramedics, healthcare assistants, and cleaners. Sharon Graham, Unite general secretary, said: 'When it came into power this Government was clear that the NHS was broken. But staff are still leaving in droves and morale is still at an all-time low. The NHS can't be repaired while the Government continues to erode pay and drastically cut NHS budgets.' Health workers in the GMB union have also rejected the pay deal while the Royal College of Nursing is due to announce a ballot of its members this week.


The Guardian
8 hours ago
- The Guardian
The right wants to kill off the NHS. Striking doctors are playing into their hands
There were no pickets when I set out at the weekend to talk to striking doctors. Not even at St Thomas' hospital, a prime site opposite the Houses of Parliament, or at Guy's at London Bridge. 'It's a bit sparse,' said the duty officer from the British Medical Association, the doctors' union. The British Medical Journal (owned by the BMA but with editorial freedom) ran the headline: 'Striking resident doctors face heckling and support on picket line, amid mixed public response.' Public support has fallen, with 52% of people 'somewhat' or 'strongly' opposing the strikes and only 34% backing them. Alastair McLellan, the editor of the Health Service Journal, after ringing around hospitals told me fewer doctors were striking than last time, which isn't surprising given that only 55% voted in the BMA ballot. Managers told him these strikes were less disruptive than the last ones. But even a weaker strike harms patients and pains a government relying on falling waiting lists. 'When you're operating on the margins, it takes very little disruption to send waiting lists up again,' McLellan said. Strikes are costly, since consultants have to be paid to fill shifts, which is typically more expensive. One hospital manager asked me wryly: 'Have you tried paying for an out-of-hours emergency plumber or electrician?' This time Jim Mackey, the head of NHS England, is playing it tough. He told medical directors on Monday to warn doctors that anyone striking on one of their 12 compulsory training days would forfeit their qualification – and not to let strikers take up locum shifts on non-strike days to make up for the money they've lost. No more Mr Nice Guy. Everyone employed by the NHS will get an above-inflation pay rise this year, which is less than the 5.4% (comprising a 4% rise and a consolidated £750 payment) that resident doctors will receive. Nurses and ambulance crews have just voted overwhelmingly against a pay award of 3.6%. That was only a consultative ballot, leaving plenty of time for negotiations that might avoid holding a full strike ballot. Consultants are now balloting too. These looming demands make it vanishingly unlikely that Wes Streeting will give even more money to striking resident doctors, who have already received the top NHS offer. Mackey plays the hard man, but Streeting's emollience is over. He seems indignant and offended by the BMA. His first act as health secretary was to end the resident doctors' 44 days of strikes between March 2023 and July 2024 with a generous 22% pay rise, even while the rightwing press accused him of bowing to 'union paymasters'. Making peace was his welcome political signal that the party of the NHS was setting about repairing Tory damage. There was hope for goodwill and patience from healthcare workers. So the BMA coming back for more within a year was a shock, and a slap in the face for Streeting. The BMA is kicking a government that had been well-disposed towards it. With Tory and Liberal Democrat peers attempting to block the government's radical employment rights bill, Labour's enemies will relish this timely assistance from the strike. A piece on CapX, a comment site owned and produced by the Centre for Policy Studies, called the striking doctors 'Scargills in white coats' with 'blood on their hands', which is of course the literal truth, given what they do at work (Tom Dolphin, the new BMA chair, is a consultant anaesthetist who works in trauma surgery; his job involves 'a fair amount of stabbings, occasional shootings, assaults [and] falls from height'). Keir Starmer has warned that the strikes 'play into the hands' of those who do not want the NHS to 'succeed in its current form'. Vultures are circling: Nigel Farage talks of private insurance; the International Monetary Fund, in its great unwisdom, recently suggested the better-off should pay for NHS services; while the piece on CapX echoed the right's glee at the strike: 'The problem here isn't just that the BMA is populated by socialist thugs, it's that the NHS is a socialist system.' The NHS is ever ready to rescue us all, regardless of status – that is why doctors and nurses top public respect charts, and why they have much to lose as the public turns against them. 'When the BMA asks, 'What's the difference between a Labour government and a Conservative government?', I would say a 28.9% pay rise and a willingness to work together to improve the working conditions and lives of doctors,' Streeting said in vain last week. In a timely contrast, Kemi Badenoch has declared that the Tories would ban doctors' strikes, putting them under the same restrictions that apply to police officers and soldiers. Both sides in this strike are obdurate. 'This could be a marathon. We could be doing this until Christmas or maybe beyond,' the deputy chief executive of NHS England has glumly warned. Streeting says the negotiation door is always open, but the BMA says there's no point without cash on the table. Bad blood between them springs from the negotiations: talks were going well until the BMA resident doctors' committee told its co-chairs that it could not approve the government's deal because it did not address the BMA's demand that resident doctors receive a 29% pay rise over the next few years. Yet Streeting's offer tackled serious grievances: years of bad planning left 20,000 resident doctors without specialist training places, stuck in a bottleneck that he promised to resolve. The BMA damaged people's sympathy for the doctors by absurdly comparing their pay to that of a coffee barista. Resident doctors can expect to be on a steep annual trajectory, averaging £43,400 in year one and £51,600 in year two; as new consultants they will get £105,000, while GP partners earn as much as £160,000. The word in the corridors is that the BMA is losing support across the NHS and among its own members, Nick Hulme, the CEO of the East Suffolk and North Essex NHS foundation trust, told me. He said some of his consultants had this week resigned from the BMA. So has the fertility pioneer Robert Winston. History may reassure the BMA that the public will always trust doctors over politicians. This time, the public backs those trying to cut waiting lists more than the strikers who are adding to them. Polly Toynbee is a Guardian columnist


The Guardian
10 hours ago
- The Guardian
The right wants to kill off the NHS. Striking doctors are playing into their hands
There were no pickets when I set out at the weekend to talk to striking doctors. Not even at St Thomas' hospital, a prime site opposite the Houses of Parliament, or at Guy's at London Bridge. 'It's a bit sparse,' said the duty officer from the British Medical Association, the doctors' union. The British Medical Journal (owned by the BMA but with editorial freedom) ran the headline: 'Striking resident doctors face heckling and support on picket line, amid mixed public response.' Public support has fallen, with 52% of people 'somewhat' or 'strongly' opposing the strikes and only 34% backing them. Alastair McLellan, the editor of the Health Service Journal, after ringing around hospitals told me fewer doctors were striking than last time, which isn't surprising given that only 55% voted in the BMA ballot. Managers told him strikes were less disruptive than the last ones. But even a weaker strike harms patients and pains a government relying on falling waiting lists. 'When you're operating on the margins, it takes very little disruption to send waiting lists up again,' McLellan said. Strikes are costly, since consultants have to be paid to fill shifts, which is typically more expensive. One hospital manager asked me wryly: 'Have you tried paying for an out-of-hours emergency plumber or electrician?' This time Jim Mackey, the head of NHS England, is playing it tough. He told medical directors on Monday to warn doctors that anyone striking on one of their 12 compulsory training days would forfeit their qualification, and not to let strikers take up locum shifts on non-strike days to make up for the money they've lost. No more Mr Nice Guy. Everyone employed by the NHS will get an above-inflation pay rise this year, which is less than the 5.4% (comprising a 4% rise and a consolidated £750 payment) that resident doctors will receive. Nurses and ambulance crews have just voted overwhelmingly against a pay award of 3.6%. That was just a consultative ballot, leaving plenty of time for negotiations that might avoid holding a full strike ballot. Consultants are now balloting too. These looming demands make it vanishingly unlikely Wes Streeting will give even more money to striking resident doctors, who have already received the top NHS offer. Mackey plays the hard man, but Streeting's emollience is over. He seems indignant and offended by the BMA. His first act as health secretary was to end the resident doctors' 44 days of strikes between March 2023 and July 2024 with a generous 22% pay rise, even while the rightwing press accused him of bowing to 'union paymasters'. Making peace was his welcome political signal that the party of the NHS was setting about repairing Tory damage. There was hope for goodwill and patience from healthcare workers. So the BMA coming back for more within a year was a shock, and a slap in the face for Streeting. The BMA is kicking a government that had been well-disposed towards it. With Tory and Liberal Democrat peers attempting to block the government's radical employment rights bill, Labour's enemies will relish this timely assistance from the strike. A piece on CapX, a comment site owned and produced by the Centre for Policy Studies, called the striking doctors 'Scargills in white coats' with 'blood on their hands', which is of course the literal truth, given what they do at work (Tom Dolphin, the new BMA chair, is a consultant anaesthetist who works in trauma surgery; his job involves 'a fair amount of stabbings, occasional shootings, assaults [and] falls from height'). Keir Starmer has warned that the strikes 'play into the hands' of those who do not want the NHS to 'succeed in its current form'. Vultures are circling: Nigel Farage talks of private insurance; the International Monetary Fund, in its great unwisdom, recently suggested the better-off should pay for NHS services; while the piece on CapX echoed the right's glee at the strike: 'The problem here isn't just that the BMA is populated by socialist thugs, it's that the NHS is a socialist system.' The NHS is ever ready to rescue us all, regardless of status – that is why doctors and nurses top public respect charts, and why they have much to lose as the public turns against them. 'When the BMA asks, 'What's the difference between a Labour government and a Conservative government?', I would say a 28.9% pay rise and a willingness to work together to improve the working conditions and lives of doctors,' Streeting said in vain last week. In a timely contrast, Kemi Badenoch has declared that the Tories would ban doctors' strikes, putting them under the same restrictions that apply to police officers and soldiers. Both sides in this strike are obdurate. 'This could be a marathon. We could be doing this until Christmas or maybe beyond,' the deputy chief executive of NHS England has glumly warned. Streeting says the negotiation door is always open, but the BMA says there's no point without cash on the table. Bad blood between them springs from the negotiations: talks were going well until the BMA resident doctors' committee told its co-chairs that it could not approve the government's deal because it did not address the BMA's demand that resident doctors receive a 29% pay rise over the next few years. Yet Streeting's offer tackled serious grievances: years of bad planning left 20,000 resident doctors without specialist training places, stuck in a bottleneck that he promised to resolve. The BMA damaged people's sympathy for the doctors by absurdly comparing their pay to that of a coffee barista. Resident doctors can expect to be on a steep annual trajectory, averaging £43,400 in year one and £51,600 in year two; as new consultants they will get £105,000, while GP partners earn as much as £160,000. The word in the corridors is that the BMA is losing support across the NHS, as well as among its own members, Nick Hulme, the CEO of the East Suffolk and North Essex NHS foundation trust, told me. He said some of his consultants had this week resigned from the BMA. So has the fertility pioneer Robert Winston. History may reassure the BMA that the public will always trust doctors over politicians. This time, the public backs those trying to cut waiting lists more than the strikers who are adding to them. Polly Toynbee is a Guardian columnist