Almost 90% of doctors think the way physician associates or anaesthesia associates work in the NHS could be a risk to patient safety, survey finds

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Written By Rivera Claudia

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  • Some 86 per cent said patients are not aware of the difference between the roles
  • BMA warns ‘blurring’ of distinction ‘can, and has, led to fatal consequences’

Concerns about the dangers of physician associates have been highlighted in a poll – as the findings also suggested most patients do not know how they differ from doctors.

Almost nine in ten UK doctors (87 per cent) believe the way physician associates (PAs) or anaesthesia associates (AAs) work in the NHS is ‘always or sometimes a risk to patient safety’, the survey showed.

A similar number (86 per cent) said patients are not aware of the difference between the roles.

The British Medical Association (BMA), which conducted the poll of 18,000 doctors, is warning a ‘blurring’ of the distinction ‘can, and has, led to fatal consequences’.

Associates work under the supervision of a doctor and require two years of postgraduate study but no formal medical training. There are around 1,500 PAs working in hospitals and 1,700 in primary care in England.

Some 87 per cent believe the way physician associates or anaesthesia associates work in the NHS is ‘always or sometimes a risk to patient safety’, the survey showed (Stock Image)

A similar number (86 per cent) said patients are not aware of the difference between the roles (Stock Image)

A similar number (86 per cent) said patients are not aware of the difference between the roles (Stock Image)

They are unregulated and assist doctors by taking medical histories, examining patients, making a diagnosis and analysing test results. 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, with plans to boost their numbers to 2,000 over the same period. They assist anaesthetists by reviewing patients before surgery. The Government will lay out legislation today to allow PAs and AAs to be regulated by the General Medical Council (GMC) from the end of next year.

But the BMA has said that using the doctors’ watchdog to regulate PAs and AAs will ‘add further, dangerous confusion to the situation’.

The union said some 10,000 doctors have written to their MPs to ask them to oppose the legislation.

It also cited a separate poll of 2,009 members of the public, which showed 14 per cent had been treated by a PA, 57 per cent had not, and 29 per cent did not know.

Professor Philip Banfield, chairman of the BMA council, said: ‘Doctors in the UK have been growing more and more worried about the consequences of the Government’s plan to expand the number of PAs and AAs in England.

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

The British Medical Association, which conducted the poll of 18,000 doctors, is warning a 'blurring' of the distinction 'can, and has, led to fatal consequences' (Stock Image)

The British Medical Association, which conducted the poll of 18,000 doctors, is warning a ‘blurring’ of the distinction ‘can, and has, led to fatal consequences’ (Stock Image)

‘By blurring the lines and allowing a situation where PAs can act beyond their competence without the public understanding what they are qualified to do, both professions are demeaned and risk losing crucial public trust.

‘At every stage we have been clear that the GMC is the wrong regulator for medical associate professionals: it is the body for regulating doctors, which these staff are not.’

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. Dr Banfield added: ‘By giving the impression that PAs can do what doctors can do, the Government is risking yet more patient safety incidents.’

One doctor told the BMA: ‘Their [PAs] basic knowledge is poor,’ adding: ‘It is only a matter of time before a patient comes to serious harm at their hands.’

Health Education England said the role and clinical duties of PAs and AAs ‘cannot, and will not, be as extensive as those of a doctor’.

So just how qualified are they? 

Physician associates (PAs) and anaesthesia associates (AAs) are healthcare professionals who have been practising in the NHS since 2002 and 2004, respectively.

They require two years of postgraduate study but no formal medical training, unlike doctors who typically complete five years of medical school followed by a two-year hospital placement.

They are intended to increase capacity and improve patients’ access to care by taking on some routine tasks – easing pressure on doctors.

PAs can work autonomously but must always be under the supervision of a fully-trained and experienced doctor.

The adoption of PAs has spread globally and, as of 2022, at least 16 countries have been in various stages of expanding their use of PA-like medical workers.

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