Latest news with #EmilyChesterton
The Independent
05-08-2025
- Health
- The Independent
Great Ormond Street Hospital criticised by NHS watchdog for using doctors' assistants to fill surgical rota
Great Ormond Street Hospital (GOSH) has been criticised by the NHS watchdog for using doctors' assistants to fill its surgical rota. GOSH, one of the world's leading children's hospitals, had resorted to using physician associates (PA), now called doctors' assistants, to fill gaps for registrars due to short staffing, the Care Quality Commission (CQC) found during an inspection in October 2024. In addition to concerns over the use of PAs to cover during times of short staffing, the CQC found that the trust also had a shortage of nurses trained to carry out tracheostomies, leaving only one trained nurse available to work during some shifts. Widespread controversy over the use of physician associates by the NHS was subject to a national review earlier this year, following the death of Emily Chesterton in 2022. She died from a pulmonary embolism after being misdiagnosed twice by a physician associate, who she believed to be a doctor, at her GP surgery in north London. Following the Leng review into the use of PAs, the government accepted the recommendations, which included that PAs should be renamed and only see patients in limited circumstances. The CQC's inspection of GOSH, the results of which were published last month, was triggered by concerns over the care of hundreds of children by orthopaedic surgeon Yaser Jabbar, who was accused of carrying out botched surgeries. Last year, GOSH launched a review of the care of 723 children treated by Mr Jabbar, following concerns raised by parents and the Royal College of Surgeons. Of the cases reviewed so far, 22 children were found to have come to harm, including amputations which might have been avoided and injuries that left them with lifelong pain. The CQC's inspection report does not make statements about the surgeon's case; however, its inspection of the department cited concerns over 'governance' and 'surgical accountability and oversight' at the trust. The report said: 'A key area of risk identified was the safe staffing levels within surgical services. Reports indicated that physician associates (PAs) were being used to fill registrar rota gaps. 'When this took place, they reported directly to a named consultant and could seek additional clinical support from senior registrars or fellows as required. Additionally, there were concerns regarding the availability of tracheostomy-trained nurses, with incidents where only one trained nurse was present during shifts, limiting safe break coverage.' In response to concerns around staffing, the trust began a recruitment drive, with new nurses in training and temporary staff cover arranged where required. However, at the time of the assessment, gaps remained in some key areas, particularly within ear nose and throat and urology services. In response to the CQC's concerns around staffing, a spokesperson for Great Ormond Street Hospital said patient safety was its top priority. It said: 'Physician associates are a valued part of our multidisciplinary team – they are assigned daytime shifts within a specific physician associate roster and are always supported by at least one consultant. In the event of sickness, the entire team adapts to provide the necessary cover to ensure we provide the best possible patient care. 'This is always with appropriate supervision and in line with Trust policy.' The news comes as the government faces ongoing strikes from resident doctors across England over pay and a lack of specialist training posts for doctors, following a five-day walkout last month that saw thousands of staff take action. The British Medical Association, which represents resident doctors, has previously used pay comparisons between PAs and resident doctors as part of its argument on why pay for its members should be raised. Last week, the BMA also warned that thousands of resident doctors, formerly called junior doctors, would not get specialist training jobs once they finish their initial two years training, with around 30,000 doctors competing for 10,000 posts.
The Irish Sun
16-07-2025
- Health
- The Irish Sun
Our actress daughter, 30, died days after twice being misdiagnosed by ‘substitute doctor'
THE family of an actress who died after being misdiagnosed twice by "substitute doctors" have slammed a Government-backed review. Emily Chesterton's parents said the report was a "missed opportunity" after their daughter, 30, , which wasn't picked up in two separate appointment s. 5 Emily Chesterton visited her doctors on two occasions with calf pain and shortness of breath – but was misdiagnosed Credit: Lily Barnes 5 Emily Chesterton (front right) with her mother Marion, father Brendan, and sister Jasmine Credit: PA Emily visited her doctor's surgery in north London twice in the space of a week between October and November 2022 to discuss discomfort in her left calf. She mistakenly believed she had seen a GP, but she was actually assessed by two physician associates (PA) - a newer type of medical role that involves significantly less training . Both PAs failed to recognise the blood clot, instead prescribing the musical theatre performer, from Greater Manchester, paracetamol and medication for anxiety. She collapsed and died hours after her second appointment, with the undiagnosed clot in her leg triggering a pulmonary embolism - which occurs when one of the arteries in the lung is blocked. Today, a Marion and Brendan Chesterton welcomed the recommendations, which they claimed would have prevented Emily's death if they had been in place when she became ill. But they also called for further action to be taken to stop PAs prescribing drugs to patients. Marion told Most read in Health "But we feel it's a missed opportunity. It could have gone all the way there and cleared things up totally. "Our daughter died. She was prescribed a drug that she should not have been prescribed. "And it had absolutely catastrophic circumstances. She died for goodness sake." The Leng Review pointed to the fact that PAs - of which there are more than 3,500 working in the NHS - were being misused as substitutes for doctors. Junior Doctors Announce Five-Day Strike in July Amid Ongoing Pay Dispute Emily first visited her local surgery on October 31 complaining about pain in her calf and shortness of breath. She was advised to take On November 7, a second PA diagnosed her with a calf sprain, After discussing the fact she was struggling to walk more than a few steps and her leg was swollen and hot, Emily was prescribed propranolol - a beta blocker for heart problems and anxiety. She reassured her concerned parents that she had been seen because neither PA had made it clear they were not doctors. Mr Chesterton added: "She never knew. "If she come out and said I've seen someone called the physician's associate I'm sure we would have insisted that, you know, let's go back and insist that you see a doctor." The Leng Review recommended that PAs are renamed to "physician assistants" to identify them "as a supportive, complementary member of the medical team". Presnting her findings, Professor Leng said: "Relatives feel strongly that confusion between the PA role and that of the doctor was an important contributory factor in their relatives' deaths. "They were clear that, had they known a doctor had not been consulted, they would have responded differently and sought further help. 5 Emily mistakenly reassured her concerned parents that she had been seen by a doctor Credit: Not known, clear with picture desk What is a physician associate? A PHYSICIAN associate works alongside doctors in GP surgeries or hospitals to diagnose or treat patients. Unlike doctors, people in these jobs do not hold a medical degree. However, PAs do have to undergo two years of intense training for the role. They are usually science graduates or can be allied health professionals, such as nurses or midwives. PAs can: Take medical histories from patients Ask patients about their symptoms Perform physical examinations Diagnose illnesses See patients with long-term chronic conditions Perform diagnostic and therapeutic procedures Analyse test results Discuss treatment plans Develop management plans Provide health promotion and disease prevention advice for patients But they should always be supervised by doctors. PAs are not currently regulated by a medical body, like many other healthcare professionals are. They can, however, join a voluntary register with the Royal College of Physicians. With no obligatory register, any who malpractice cannot formally be struck off, for example. However, under a planned new law, PAs will be regulated by the General Medical Council (GMC). Not everyone is happy about this, though. The British Medical Association (BMA) believes this could lead to patients confusing the different roles, which could have "tragic consequences". There are about 3,200 PAs working in GP surgeries and hospitals in England, with 10,000 more planned in the next decade or so. "Sadly, no one can turn back the clock, but I have listened to their experiences to help make improvements for the future . "The NHS now has more types of role than any other healthcare system in the world, and care must be taken to ensure that these roles are understood by the public and by staff." According to the NHS careers website, PAs "support doctors in the diagnosis and management of patients". They usually complete a bioscience-related degree before undertaking a two-year integrated master's course. Registered healthcare workers, like nurses or Most PAs work at GP surgeries and in A&E, and are supposed to be "under the supervision of a doctor". While they carry out similar roles, they don't have the same medical training so are not direct substitutes. To become a GP, you complete four to six years of medical school before a two-year foundation training programme. Read more on the Irish Sun You can then apply to GP speciality training, which takes a minimum of three years, and pass several assessments. The Faculty of Physician Associates makes it clear that PAs "are not doctors" and "do not replace medical roles". 5 The Leng Review has called for large scale changes to the role of physician assistants Credit: Getty 5 Emily Chesterton (right) died from a pulmonary embolism after being misdiagnosed Credit: PA
Scottish Sun
16-07-2025
- Health
- Scottish Sun
Our actress daughter, 30, died days after twice being misdiagnosed by ‘substitute doctor'
She died just hours after a follow-up appointment at her local surgery 'MISSED OPPORTUNITY' Our actress daughter, 30, died days after twice being misdiagnosed by 'substitute doctor' Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) THE family of an actress who died after being misdiagnosed twice by "substitute doctors" have slammed a Government-backed review. Emily Chesterton's parents said the report was a "missed opportunity" after their daughter, 30, tragically passed away from a blood clot, which wasn't picked up in two separate appointments. Sign up for Scottish Sun newsletter Sign up 5 Emily Chesterton visited her doctors on two occasions with calf pain and shortness of breath – but was misdiagnosed Credit: Lily Barnes 5 Emily Chesterton (front right) with her mother Marion, father Brendan, and sister Jasmine Credit: PA Emily visited her doctor's surgery in north London twice in the space of a week between October and November 2022 to discuss discomfort in her left calf. She mistakenly believed she had seen a GP, but she was actually assessed by two physician associates (PA) - a newer type of medical role that involves significantly less training. Both PAs failed to recognise the blood clot, instead prescribing the musical theatre performer, from Greater Manchester, paracetamol and medication for anxiety. She collapsed and died hours after her second appointment, with the undiagnosed clot in her leg triggering a pulmonary embolism - which occurs when one of the arteries in the lung is blocked. Today, a review into the role of PAs, led by Professor Gillian Leng, has recommended banning them from diagnosing patients who have not already been seen by a doctor. Marion and Brendan Chesterton welcomed the recommendations, which they claimed would have prevented Emily's death if they had been in place when she became ill. But they also called for further action to be taken to stop PAs prescribing drugs to patients. Marion told Sky News: "We're so pleased that this review has been made. "But we feel it's a missed opportunity. It could have gone all the way there and cleared things up totally. "Our daughter died. She was prescribed a drug that she should not have been prescribed. "And it had absolutely catastrophic circumstances. She died for goodness sake." The Leng Review pointed to the fact that PAs - of which there are more than 3,500 working in the NHS - were being misused as substitutes for doctors. Junior Doctors Announce Five-Day Strike in July Amid Ongoing Pay Dispute Emily first visited her local surgery on October 31 complaining about pain in her calf and shortness of breath. She was advised to take paracetamol. On November 7, a second PA diagnosed her with a calf sprain, long Covid and anxiety. After discussing the fact she was struggling to walk more than a few steps and her leg was swollen and hot, Emily was prescribed propranolol - a beta blocker for heart problems and anxiety. She reassured her concerned parents that she had been seen because neither PA had made it clear they were not doctors. Mr Chesterton added: "She never knew. "If she come out and said I've seen someone called the physician's associate I'm sure we would have insisted that, you know, let's go back and insist that you see a doctor." The Leng Review recommended that PAs are renamed to "physician assistants" to identify them "as a supportive, complementary member of the medical team". Presnting her findings, Professor Leng said: "Relatives feel strongly that confusion between the PA role and that of the doctor was an important contributory factor in their relatives' deaths. "They were clear that, had they known a doctor had not been consulted, they would have responded differently and sought further help. 5 Emily mistakenly reassured her concerned parents that she had been seen by a doctor Credit: Not known, clear with picture desk What is a physician associate? A PHYSICIAN associate works alongside doctors in GP surgeries or hospitals to diagnose or treat patients. Unlike doctors, people in these jobs do not hold a medical degree. However, PAs do have to undergo two years of intense training for the role. They are usually science graduates or can be allied health professionals, such as nurses or midwives. PAs can: Take medical histories from patients Ask patients about their symptoms Perform physical examinations Diagnose illnesses See patients with long-term chronic conditions Perform diagnostic and therapeutic procedures Analyse test results Discuss treatment plans Develop management plans Provide health promotion and disease prevention advice for patients But they should always be supervised by doctors. PAs are not currently regulated by a medical body, like many other healthcare professionals are. They can, however, join a voluntary register with the Royal College of Physicians. With no obligatory register, any who malpractice cannot formally be struck off, for example. However, under a planned new law, PAs will be regulated by the General Medical Council (GMC). Not everyone is happy about this, though. The British Medical Association (BMA) believes this could lead to patients confusing the different roles, which could have "tragic consequences". There are about 3,200 PAs working in GP surgeries and hospitals in England, with 10,000 more planned in the next decade or so. "Sadly, no one can turn back the clock, but I have listened to their experiences to help make improvements for the future. "The NHS now has more types of role than any other healthcare system in the world, and care must be taken to ensure that these roles are understood by the public and by staff." According to the NHS careers website, PAs "support doctors in the diagnosis and management of patients". They usually complete a bioscience-related degree before undertaking a two-year integrated master's course. Registered healthcare workers, like nurses or midwives, can also apply to become PAs. Most PAs work at GP surgeries and in A&E, and are supposed to be "under the supervision of a doctor". While they carry out similar roles, they don't have the same medical training so are not direct substitutes. To become a GP, you complete four to six years of medical school before a two-year foundation training programme. You can then apply to GP speciality training, which takes a minimum of three years, and pass several assessments. The Faculty of Physician Associates makes it clear that PAs "are not doctors" and "do not replace medical roles". 5 The Leng Review has called for large scale changes to the role of physician assistants Credit: Getty
Yahoo
29-04-2025
- Health
- Yahoo
More than 1,000 physician associates could enter NHS workforce each year
More than 1,000 physician associates (PAs) could begin their careers in the NHS every year after regulators approved dozens of courses to teach them. The General Medical Council (GMC) said it had given 36 courses formal approval to teach PAs and anaesthesia associates (AAs). Overall, these courses had capacity for up to 1,059 PAs and 42 AAs to qualify each year. The GMC said that approving training courses would mean that 'patients, employers and colleagues can be assured that PAs and AAs have the required knowledge and skills to practise safely once they qualify'. PAs are graduates – usually with a health or life sciences degree – who have undertaken two years of postgraduate training. They are supposed to support the work of doctors but hit the headlines after the death of Emily Chesterton, 30, in November 2022 from a pulmonary embolism. She was misdiagnosed by a PA on two occasions. According to the NHS, PAs work under the supervision of a doctor and can diagnose people, take medical histories, perform physical examinations, see patients with long-term conditions, analyse test results and develop management plans. Most associates work in GP surgeries, acute medicine and emergency medicine. AAs work as part of the anaesthesia and wider surgical team. There are plans to extend the number of PAs and AAs working in the health service. The GMC, which took over the regulation of PAs and AAs in December last year, said that it had approved 33 PA courses. But four of these – Bradford, Greater Manchester, Queen Mary University of London and Sheffield Hallam – had been approved with 'conditions'. This meant that some concerns were identified during the approval process. But the GMC said each of these courses had a 'targeted action plan' in place to address concerns. It did not approve the course at the University of East London. There are only three courses for AAs – in Birmingham, University College London and Lancaster – which were all approved, the GMC said. 'This is an important milestone in the regulation of PAs and AAs and will provide assurance, now and in the future, that those who qualify in these roles have the appropriate skills and knowledge that patients rightly expect and deserve,' said Professor Colin Melville, the GMC's medical director and director of education and standards. 'As a regulator, patient safety is paramount, and we have a robust quality assurance process for PA and AA courses, as we do for medical schools. We have been engaging with course providers for several years already, and we only grant approval where they meet our high standards.' Danny Mortimer, chief executive of NHS Employers, said: 'The formal accreditation of the courses of study that PAs and AAs must complete is an essential component of regulation and public safety. 'We await the outcome of the Leng Review but recognise that individual NHS organisations also have a responsibility to support PAs and AAs to both use their knowledge safely with patients, and to ensure appropriate professional development and supervision.' Professor Phil Banfield, chairman of council at the British Medical Association, said it was 'difficult to understand' how the GMC could approve the courses when the Leng review into PAs and AAs has not concluded. He added: 'The medical profession has alarming worries about the quality and robustness of these courses, with reports of exams with 100% pass rates. 'We have made doctors' concerns clear in our submission to the Leng review, which includes a call for an independent body of doctors, without links to course providers, to determine proportionate and safe expectations of what can be covered in curricula for assistant roles within a two-year training period.'
Telegraph
16-02-2025
- Health
- Telegraph
Fewer than 10 per cent of physician associates still not regulated
Fewer than 10 per cent of physician associates (PA) are still not regulated despite new laws designed to improve patient safety, the Telegraph can reveal. The vast majority of PAs practising in the UK are signed up to the watchdog's register, data shared with this paper show. The General Medical Council (GMC) began regulating PAs and anaesthesia associates (AAs) in December as part of measures to improve the standards and accountability that the roles are held to. The associates have been asked to register voluntarily for the first two years before regulation becomes a legal requirement in December 2026. But data shared with the Telegraph shows that fewer than one in 10 were registered as of February 14, despite the GMC inviting them all to sign up by the end of January. Just 359 PAs and 13 AAs had joined the register, the figures showed. The regulator said it was in the process of assessing a further 1,242 applications. More than 3,500 PAs are working in the NHS in England and about 100 AAs, with around 150 associates working in Scotland, 220 in Wales, and 80 in Northern Ireland. It means a maximum of 9.1 per cent of PAs and AAs out of the more than 4,050 working for the NHS in the UK are currently being regulated, assuming all those who have signed up are employed. Dr Richard Marks, co-founder of Anaesthetists United, a group of consultant anaesthetists that are bringing a lawsuit against the GMC, said there had been a 'very slow uptake' and that 'patients need safeguards now'. 'Lacklustre and amateur' 'The real issue here is that the purpose of regulation was to impose standards and accountability, and that is going too slowly,' he said. 'Of course, the GMC will say that parliament gave them the slack to do that and that they don't have the power to make it go any faster. That's two more years in which unregulated PAs will continue to see, misdiagnose, and even harm patients without proper oversight. 'Of course employers are free to set whatever stipulations they wish, so you'd hope the employers would try to expedite things. It just feels a bit lacklustre and amateur. Patients need safeguards now, not in 2027.' The PA role, which was formerly known as a physician's assistant, has been in the crossfire since the NHS workforce plan said it would treble their number to 10,000 in the coming decade. 'Medical professionals' Doctors have also criticised the decision of the GMC to regulate PAs at all, and the British Medical Association (BMA) is suing the regulator for its decision to refer to the associates as 'medical professionals' when they have no medical training, which it claims is creating a 'blurring of the lines' between the professions. The GMC says the term is not protected. Anaesthetists United is bringing a claim against the GMC for not setting out a scope of practice for PAs and AAs to work within, which would limit the tasks they can do. The legal case has backing from the parents of Emily Chesterton, who is among the patients to have died after seeing a PA instead of a doctor. Ms Chesterton, a 30-year-old actress, died in 2022 after she was misdiagnosed twice by a PA whom she thought was a GP. She was told she had an ankle sprain when she had a blood clot that then travelled from her leg to her lung and killed her. 'Protect the public' Anaesthetists United is crowdfunding for its legal case, which has the support of the BMA and is scheduled to be heard in the High Court in May. It comes after The Telegraph revealed more fears about the quality of PAs working in the NHS with the GMC now accepting applications from PAs trained in developing nations such as Ghana, Zimbabwe and Bangladesh, despite existing concerns about the profession and the quality of courses in the UK. Any PA trained abroad will have to pass GMC tests to join its register, it said. A GMC spokesman said: 'We take our responsibility to protect the public very seriously, and we are reviewing all applications and all supporting evidence from PAs and AAs to join our register individually. 'Our checks include employer references, ID checks and verification of qualifications. It is vital we are thorough to ensure that only PAs and AAs who meet our high standards are admitted to the register. 'Our priority is to register UK-based PAs and AAs. We have not yet received any applications for registration from PAs and AAs outside the UK.' A Department of Health and Social Care spokesman said: 'The Secretary of State has launched an independent review into Physician and Anaesthesia Associate professions to establish the facts and make sure that we get the right people, in the right place, providing the right care.'
