Physician associates set to be regulated by same watchdog

Cut-price physician associates with just two years of training will now be regulated by same watchdog as real doctors in ‘dangerous’ move that will ‘blur the line’

  • BMA fear new law will ‘blur the line’ between doctor and associate risking safety
  • Physician associates do two years postgrad study but no formal medical training

Physician associates will be regulated by the same watchdog as doctors under a new law to be passed this week – despite a backlash by medics.

Health officials plan to massively increase the number of associates working in the NHS and say the General Medical Council is ideally placed to regulate them.

But the British Medical Association and Doctors Association UK has warned the ‘dangerous’ move will ‘blur the line’ between doctor and associate and is a risk to patient safety.

They have expressed concerns that patients who see a PA may not be aware they are seeing a less qualified member of staff, citing a number of cases where some have come to harm.

Physician associates work under the supervision of a doctor and assist them by taking medical histories, examining patients, making diagnosing and analysing test results.

The BMA have expressed concerns that patients who see a PA may not be aware they are seeing a less qualified member of staff

The role requires two years of postgraduate study but no formal medical training and is currently unregulated.

The Department of Health and Social Care said regulating PAs through the GMC will ‘boost’ patient safety, relieve pressure on doctors and improve access to care.

However, the Government intends to pass the law using a statutory instrument on Wednesday, meaning it will not face scrutiny in the Commons.

The regulator will set standards of practice, education and training, and operate fitness to practice procedures, with the regulations coming into force at the end of 2024.

There are around 1,500 PAs working in hospitals and 1,700 in primary care in England.

The NHS Long Term Workforce Plan shows that bosses want to increase the PA workforce to 10,000 by 2036/37.

There are also around 320 anaesthesia associates, who work under the supervision of a medically qualified anaesthetist, with plans to boost their numbers to 2,000 over the same period.

They review patients before surgery, initiate and manage medication, administer fluid and blood therapy during surgery, and ensure there is a plan for patients following their operation.

The BMA called on the NHS to freeze the recruitment of physician associates last month, warning the rapid expansion is putting patients at risk

They will also be regulated by the GMC under the new reforms, which include measures to speed up the registration process for retired healthcare staff who want to return to work and a faster fitness to practice process.

Health secretary Victoria Atkins said: ‘Physician associates and anaesthesia associates are already making a great contribution to the NHS, supporting doctors to provide faster high quality care for patients.

‘This new legislation paves the way for these professionals to be held to the same strict standards as doctors, boosting patient safety.’

Last month, the BMA called on the NHS to freeze the recruitment of physician associates, warning the rapid expansion is putting patients at risk.

It said the new recruits are ‘encroaching on the role of doctors’ and the dangers they pose should not be seen as a ‘price worth paying’ for quickly resolving a workforce shortage.

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Actress Emily Chesterton, 30, died of a blood clot at the end of last year after a PA dismissed her symptoms as anxiety and gave her pills instead of directing her to A&E.

She believed she had been seen by a GP at her surgery in North London but had actually been seen twice by an associate.

Professor Philip Banfield, chair of council at the BMA, on Monday said government claims that regulating associates through the GMC will ‘boost’ patient safety is a ‘slap in the face’ for doctors.

He added: ‘The Government is encouraging a false representation.

‘Patients being told that the people seeing them are regulated by the same body that regulates doctors will make them think they are receiving a doctor’s standard of care.

‘But there is no comparison between the two years of a PA’s training and the four to six years undertaken to qualify as a doctor.

‘Patients deserve to know who is treating them and the standard of care they are going to receive.

‘By supporting the impression that PAs can do everything doctors can do, the Government is opening the way to more patient safety incidents along the tragic lines we have already seen.

‘The BMA will continue to oppose this dangerous course every step of the way.’

The Doctors Association UK said more than 650 doctors have shared ‘alarming instances of patient harm’ involving cases where the workers were doing tasks which should have been done by doctors.

Its co-chairmen have now written to the heads of the GMC and the Academy of Medical Royal Colleges, expressing ‘grave concerns’.

Dr Kneale, co-chairman of DAUK, said the plans risk ‘blurring the lines’ between associates and doctors and a new regulator or the Health and Care Professions Council would be a ‘more appropriate’ choice.

Charlie Massey, chief executive of the GMC, said: ‘We’re pleased to support the development of these valuable professionals recognising the important role they play in the medical workforce.

‘Regulation will help increase the contribution PAs and AAs can make to UK healthcare while keeping patients safe.’

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