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Daily Mail
14-05-2025
- Health
- Daily Mail
Actress's parents take fight to the courts after daughter, 30, died when 'physician associate' she wrongly believed was a doctor misdiagnosed her
The parents of a 30-year-old actress who died after a 'physician associate' she wrongly believed was a doctor misdiagnosed her twice are taking their case to court. Emily Chesterton died only three weeks after her 30th birthday in 2022 when a clot in her lungs was mistaken for anxiety and a strain. She believed she had been seen by her GP at her surgery in London but it was a physician associate who prescribed her propranolol, medication for anxiety. Emily, from Greater Manchester, but who had moved to London to pursue a career in acting, collapsed later that evening. Although she was rushed to hospital, her heart had stopped beating, and doctors could not save her life. A coroner concluded Emily could have been saved if she had been to A&E and given treatment for a pulmonary embolism. Her parents, Marion and Brendon Chesterton, are now launching a legal fight against the General Medical Council (GMC) demanding more regulation. Doctors are fully licensed medical professionals who diagnose, prescribe, and perform surgeries independently after years of training. Her parents, Marion and Brendon Chesterton, are now launching a legal fight against the General Medical Council (GMC), with Anaesthetists United, saying that PAs, and anaesthesia associates (AA) should be properly regulated Physician associates support doctors by carrying out many clinical tasks but must work under a doctor's supervision and typically cannot prescribe or operate. Their role helps ease pressure on healthcare systems, though it remains a topic of debate. Ms Chesterton's symptoms included calf pain, a swollen and hot leg, shortness of breath and she was finding it increasingly difficult to walk. After reaching out to the practice the first time, the PA recommended she take paracetamol, but her condition became worse and at one point was having difficulty walking and was breathless and lightheaded, her mother told the BBC. She claims the second appointment her daughter was diagnosed with calf sprain, long Covid and anxiety but her calves were not examined and never made clear she was not a doctor. Ms Chesterton actually had a blood clot in her left leg, which led to her dying of a pulmonary embolism. Her father, Brendon, said everyone he had spoken to had told him that a pain in the calf was 'medical 101' that it was a clot. 'We've said the name (physician associate) is rather grand,' he said. 'A physician associate sounds even better than junior doctor. The name itself we objected to. We were told nothing could be done about the naming of them. But it suggests someone who is highly trained and highly competent. Marion and Brendan Chesterton say their daughter, Emily, would still be alive if a physician associate had sent her to A&E rather than misdiagnose her blood clot symptoms as 'anxiety' 'But people I've talked to, they say a pain in the calf is like medical 101. Everyone should realise that that is indicative of some kind of clot. She didn't notify that.' The GP practice where Emily was seen, the Vale Practice in Crouch End, has since stopped employing PAs. Backed by the British Medical Association, the Chesterton family is launching a legal battle with the General Medical Council, accusing it of a failure to uphold its legal duties. They claim the lines between doctors and non-doctors have become blurred, putting patients at risk. They're asking the GMC to issue a scope of practice document laying out exactly what each role can do to ensure patient safety and clarify expectations. Speaking outside the Royal Courts of Justice, Marion Chesterton said: 'To lose a child is so painful, it is not the right order of this world. 'However, to lose a child and then discover it was avoidable is the worst pain ever. 'We do not want anyone else going through the torture we have endured. Physician associates and anaesthesia associates must be regulated thoroughly, they must be properly supervised.' Mrs Chesterton said: 'We're here to honour our daughter, to make sure that this doesn't happen to any other family. No more Emilys. 'We're here to ask the GMC to do their job and regulate, it's been assigned to them by Parliament, so they've got to do the job. 'If I didn't do this. I'd just lie down in a ditch somewhere and let the world pass me by. I've had to do it because I was so angry. 'When I found out that PAs weren't regulated I was absolutely devastated, I thought "this, this is wrong".' At the start of the hearing on Wednesday, Mrs Justice Lambert said: 'This case is not just about regulation of assistants, it is about regulation of the medical profession, and that is how I see it.' Thomas De La Mare KC, representing the Chestertons and Anaesthetists United, told the court: 'At its heart, this case is critically about risk and about the regulation response to risk.' In written submissions, he said the GMC is 'failing to fulfil its regulatory role on an ongoing basis and this court should find that that is unlawful'. Mr De La Mare also said the GMC had failed to produce guidance or set standards either for the doctors supervising associates, or for the associates themselves. It has further failed to 'gather sufficient information to address the question of how it should regulate associates, then lawfully address and answer that question', the court was told. Mr De La Mare continued: 'The GMC's foundational premise, never consulted upon, that the system for regulating doctors would be appropriate for regulating associates, was and is fundamentally flawed.' In written submissions, Rory Dunlop KC, for the GMC, said the argument for a defined scope of practice raises the question of whether it would be in the public interest to impose such 'rigid' limits on PAs and AAs. Saying the court has no 'expertise or experience' in this field, he continued: 'There might be benefits to public safety of imposing limits of the kind that claimants suggest. 'However, there might also be harm to public safety in imposing such limits, e.g. such limits would prevent PAs and AAs from developing their skills, in a suitable supervised setting, and might inhibit some PAs and AAs from doing work they could be competent to do. 'If so, that would have a negative impact on the stretched resources of the NHS and the capacity of doctors to deal with more complex patient issues. 'That, in turn, would have a negative impact on patient safety by making it less likely that patients can get the timely treatment they need.' He added that no party in the proceedings considers that the GMC is the body best placed to define the scope for PAs or AAs. The hearing before Mrs Justice Lambert is due to conclude on Thursday with a decision expected in writing at a later date.
BBC News
14-05-2025
- Health
- BBC News
Emily Chesterton: GMC at High Court over physician associate role
A legal challenge will be heard at the Royal Courts of Justice later on Wednesday about the role of physician associates (PA) in the case has been brought against the General Medical Council (GMC) by retired teachers Brendan and Marion Chesterton, whose daughter Emily died in 2022 after a blood clot was missed in two appointments with a with Anaesthetics United, they are seeking more clarity from the GMC about the scope of the PA role in a bid to improve patient safety amid increasing concern about how PAs and anaesthetic associates (AA) are being deployed in healthcare GMC took over the regulation of physician associates and anaesthetic associates in December. What do physician associates do? Physician associates and anaesthetic associates started working in the NHS in 2003, and it is thought it currently employs more than 5,000 of and AAs qualify after completing a part-funded two-year master's degree. They usually need a bioscience-related undergraduate degree, but that is not always a role includes taking medical histories, conducting physical examinations and developing treatment plans. They are not authorised to prescribe medicines nor to order scans involving ionising radiation, such as X-rays or CT scans. They work as part of a multidisciplinary team with supervision from a named senior doctor. When the government appointed the GMC to regulate PAs and AAs last year, the regulatory body's chief executive Charlie Massey said it would help to ensure they "have the necessary education and training, meet our standards, and can be held to account if serious concerns are raised". 'No more Emilys' Ms Chesterton, from Salford, died after a blood clot was missed in two appointments with a PA whom she had believed was a GP. She was 30 years was seen by the physician associate after she called her GP practice, in Crouch End in north London, complaining of pain in her calf, which had become hard. The PA recommended Ms Chesterton should take her condition became worse. Mrs Chesterton told the BBC that her daughter had "difficulty walking" and "was breathless and lightheaded".She said: "In the second appointment, the PA diagnosed her with a calf sprain, long Covid and anxiety. The PA did not examine Emily's calves, and did not make it clear that she was not a doctor."Ms Chesterton had a blood clot in her left leg, which led to her dying of a pulmonary coroner's conclusion was that she "should have been immediately referred to a hospital emergency unit" and, if she had been seen, it was likely that she would have Chesterton told the BBC: "To lose a child is so very painful. It is not the right order of this world." She added that she hoped the High Court case would mean there will be "no more Emilys". How does GMC regulation work? Government legislation governing PA and AA regulation means GMC registration will not become a legal requirement for PAs and AAs to be able to practise until December that point it will be an offence to practise either role in the UK without registration.A GMC spokesperson said: "Regulation will help to assure patients, colleagues and employers that they are safe to practise and can be held to account if serious concerns are raised."To register with us, physician associates and anaesthesia associates need to show that they have the knowledge, skills and experience to treat patients safely, and that there are no outstanding concerns about their fitness to practise."The GMC said it strongly encouraged those who were not already registered to ensure they do so. There are currently 2,479 physician associates and 109 anaesthetics associates registered with the January, the secretary of state for health and social care started an independent review of the PA and AA roles "to agree recommendations for the future". The Leng review states it will consider "the safety of the roles and their contribution to multidisciplinary healthcare teams". United Medical Associate Professionals (UMAPs), a trade union set up in 2023 to represent PAs and AAs, said in a statement: "We would like to acknowledge the strength and resolve of the Chesterton family. Whilst we may not agree with all of the public positions that have emerged around their case, we admire their determination at a time of profound personal grief."The statement added that PAs were "highly trained healthcare professionals", many of whom had previously held senior roles as nurses, pharmacists or within the clinical continued: "The current judicial review brought by Anaesthetists United against the GMC is of concern, not only because it seeks to impose disproportionately restrictive scope-of-practice conditions on one profession alone, but because, if successful, it would set a dangerous precedent for regulating all clinicians through rigid, written scopes." Mrs Chesterton told the BBC that when she found out her daughter had been seen by a physician associate, she did not know what one was. She said: "To lose a child is absolutely devastating, but to find out your child's death was preventable is heart-breaking."Ms Chesterton's father Brendan said: "It's against protocol that Emily was seen twice by a physician associate for the same issue, and she shouldn't have been prescribing."Her GP surgery, The Vale Practice, told the BBC it was "deeply saddened" by Ms Chesterton's death, and said it now only provided appointments with GPs, nurses and pharmacists after a "thorough" added that staff had been told to ensure that "a patient understands their role at the start of each appointment". 'They should recognise their responsibility' The Chestertons told the BBC that since the GMC took over regulation, the scope of the PA role had not become clearer, despite them being told by the body that "supervision would be more defined".The GMC has said it is not appropriate for it to provide advice on how individual PAs and AAs might develop their skills over time. It said this was "a matter for employers and will vary depending on the clinical context and workforce needs". "We would expect employers to be aware of - and have regard to - relevant guidance on scope of practice produced by the royal colleges and other professional bodies when they are making decisions about deployment." A Department of Health and Social Care spokesperson said: "This is a tragic case and our thoughts are with Emily Chesterton's family and friends."The secretary of state has launched an independent review into [the] physician and anaesthesia associate professions to establish the facts and make sure we get the right people in the right places, providing the right care."Regulation of PAs and AAs by the General Medical Council began in December 2024 to ensure patient safety and professional accountability."For Mrs Chesterton, what she and her husband would like to see happen is straightforward."What we want them (the GMC) to do is to recognise their responsibility," she told BBC London. "They were assigned by Parliament to regulate, so that's what they should be doing and not passing it down to employers."They should be creating a proper scope of practice with a defined structure for supervision for patient safety, so there are no more Emilys."
