The Government is planning to bring Physician Associates (PAs) under the regulation of the General Medical Council (GMC). This is the same organisation that sets the standards of patient care and professional standards that qualified doctors need to meet.
Whilst there is support for a planned increase in the number of PAs, there are concerns that their title and the increased use of PAs may be confusing for patients. Not least because it may not be clear that they are not doctors.
| What is a Physician Associate?
The NHS introduced Physician’s Assistants (now known as Physician Associates) in 2004. The aim was that they would support, rather than replace, doctors.
PAs work under the supervision of medically qualified doctors. Their job includes taking medical histories, performing physical examinations, and developing treatment plans.
Unlike doctors, PAs do not have a medical degree, or the years of postgraduate training that GPs and hospital doctors must go through. Instead, they have often completed a science degree followed by a further two years’ training.
| Expansion of PAs
Along with introducing PAs to regulation under the GMC, the Government also aims to expand the training and employment of PAs across the NHS.
There are currently around 4,000 PAs across England, but the Government hopes to increase this to 10,000 by 2036. The Government hopes that increasing the number of PAs will increase productivity within the NHS and assist in filling the gaps in services from the current staff shortages across the NHS. The worry is that they will be asked to do more and that we will be seen by a PA rather than by the doctor or one of his associates.
| Case of Emily Chesterton
Concerns about the understanding of the differences between doctors and PAs and the importance of a patient being seen by a medically qualified doctor, have been raised in recent inquests. These include the investigation into the death of 30-year-old Emily Chesterton.
Emily had called her GP practice complaining of pain in her calf, which had become hard. She had a face-to-face appointment with a PA (who she believed was a doctor). He recommended that she take paracetamol, but she got worse. She went back to her doctors, again seeing a PA, who diagnosed a calf sprain, long Covid and anxiety. All without examining her calves or making it clear that she was not a doctor.
Emily believed that she was being seen by a GP.
Emily died shortly after her consultation because of a blood clot that stopped the blood flow to an artery in the lung.
At her inquest, the Coroner concluded that had Emily been immediately referred to an emergency care unit, she would have been likely to survive.
Sadly too late for Emily, the GP practice has since confirmed that it now only provides appointments with GPs, nurses and pharmacists. Further, all staff have been told to make sure that a patient understands the role of a PA at the start of any discussions.
| What next for PAs?
Whilst PAs play an important role in supporting the NHS, all patients should have the right to know who is treating them and have the choice to see a fully qualified doctor.
Changing the name back to Physician’s Assistant may make things clearer. However, it is always a good idea to check who your appointment is with and to ask to see a doctor if you have any concerns.
Your health is important. While most of us will get the treatment we need, mistakes happen. And if you haven’t been referred to the right level of medical professional for advice and tests or haven’t been listened to; have been given the wrong treatment or your condition has been misdiagnosed, Debra and her team are experts in medical negligence claims. For an initial chat with the team, call us on 0800 988 7756.
