Latest news with #physicianassociates
Telegraph
6 days ago
- Business
- Telegraph
Physician associates to be renamed
Physician associates are to be renamed by the NHS to clarify their role as doctors' assistants following widespread public confusion. Wes Streeting, the Health Secretary, ordered a review into the role following a series of patient safety incidents involving physician associates (PAs), which included the deaths of people who thought they had been treated by a doctor. Prof Gillian Leng, the president of the Royal Society of Medicine, is yet to write her report but it is understood changing the PA title will be a key recommendation when it is finalised later this month. Doctors have been raising concerns about the growing number of PAs in the workforce for a number of years with around 3,500 currently employed and the NHS planning to treble this within the decade. Unlike doctors, PAs have no medical degree and must only undergo a two-year postgraduate course following a non-medical undergraduate degree. They are paid more than resident doctors – formerly known as junior doctors – at the beginning of their careers, which has been a key argument from the British Medical Association (BMA) as they reballot members on strike action over pay. Mr Streeting is expected to accept Prof Leng's recommendation for a title change, with it likely to revert to a 'physician assistant', which is what the role was called when it first emerged more than 20 years ago and more accurately describes the job of assisting doctors. Mistaken identity The Telegraph has revealed a series of scandals involving PAs either causing patient harm, acting beyond what they are qualified to do or being used in place of doctors. Earlier this year, a dossier of more than 600 incidents compiled by the BMA revealed egregious examples of PAs and anaesthetist associates (AAs) misdiagnosing cancer, impersonating doctors and illegally prescribing medication and ordering scans. PAs have also been implicated in several high-profile patient deaths. Emily 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 later travelled from her leg to her lung and killed her. Her parents recently began a legal challenge against the General Medical Council, which regulates doctors and now associates, alongside a group called Anaesthetists United. Earlier this year, a coroner said the PA who diagnosed Pamela Marking with a nosebleed, before she died aged 77 at East Surrey Hospital in 2024, 'had a lack of understanding of the significance of abdominal pain and vomiting, and had undertaken an incomplete abdominal examination'. A Department of Health and Social Care source told the Guardian: 'It's clear there's a legitimate problem of patients not knowing who they are seen by, which is their basic right. It is likely the review will make recommendations to address this problem, including changing the titles of PAs.' A spokesman for the department said: 'The Secretary of State asked Professor Gillian Leng to produce an independent review into PAs and AAs that will provide certainty to patients and staff across the NHS. 'We will consider its findings in full once it has been completed.'
The Guardian
7 days ago
- General
- The Guardian
Physician associates to be renamed to stop them being mistaken for doctors
Physician associates in the NHS will be renamed to stop patients mistaking them for doctors after a review found that their title caused widespread confusion. Thousands of physician associates who work in hospitals and GP surgeries across the UK take medical histories, examine patients and diagnose illnesses but are not doctors. However, Prof Gillian Leng, whose government-ordered review is looking into whether they pose a risk to patients' safety, has concluded that they must be given a new name, so patients they treat are not misled into thinking they have seen a doctor, according to sources with knowledge of her thinking. Doctors who fear the term has created widespread confusion among the public and risks undermining trust in the medical profession will regard ditching it as a major victory. Wes Streeting, the health secretary, is expected to accept Leng's recommendation and instigate the change, which could lead to physician associates being renamed 'physician assistants' or 'doctors' assistants'. She will also specify in her final report, due later this month, that those who perform those roles must make clear to patients that they are assistants, not fully fledged medics. Physician associates have been implicated in several high-profile patient deaths. Earlier this year, a coroner found that in February 2024 a physician associate (PA) in the A&E at East Surrey hospital had misdiagnosed 77-year-old Pamela Marking as having a nosebleed when she had a small bowel obstruction and hernia that required emergency surgery. She returned to the hospital two days later but she died soon after. In her prevention of future deaths report the coroner, Karen Henderson, warned that the term 'physician associate' was 'misleading to the public' and that there was a 'lack of public understanding of the role'. PAs have been causing alarm among doctors for years. They have prompted a number of legal challenges and calls, from the British Medical Association and several medical royal colleges, for their recruitment and rollout across the health service to be paused while their implications are assessed. The parents of 30-year-old Emily Chesterton, who died in 2022 after a PA on two occasions failed to spot that she had a blood clot, recently began a legal action at the high court in London against the General Medical Council, which regulates doctors. There are about 3,500 PAs and 100 anaesthesia associates – their equivalents in anaesthetics – working in the NHS in England. But NHS England's plan to treble the number of PAs to 10,000 by the mid-2030s now looks in doubt. Ministers are due to publish an updated NHS long-term workforce plan in the summer. Evidence collected by Leng since she began her review in November has vindicated the concern shared by many medical bodies that patients often struggle to distinguish a physician associate, who has done two years of postgraduate training, from a fully trained doctor with a medical degree. In May, Leng said she had seen evidence showing that 'patients [are] likely to misconceive PAs to be a doctor'. In addition, focus groups organised by the Patients Association had found that 'patients were unaware of what a PA was'. Sign up to Headlines UK Get the day's headlines and highlights emailed direct to you every morning after newsletter promotion A third research study found patients 'misconceived PAs to be doctors', while a fourth cited by Leng underlined how confused the public were about the work PAs did and limits of their roles. 'Patients were not able to identify what or who a PA was,' it said. When Streeting appointed Leng to undertake the review he said that while many PAs provided good care there were 'legitimate concerns over transparency for patients, scope of practice and the substituting of doctors'. A Department of Health and Social Care source said: 'It's clear there's a legitimate problem of patients not knowing who they are seen by, which is their basic right. It is likely the review will make recommendations to address this problem, including changing the titles of PAs.' 'The secretary of state asked Prof Gillian Leng to produce an independent review into PAs and AAs that will provide certainty to patients and staff across the NHS. 'We will consider its findings in full once it has been completed.'
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."
