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Survey: Physician associates pose ‘significant’ patient risk

15th December 2023 by NASGP

Survey: Physician associates pose ‘significant’ patient risk

The majority of doctors feel physician associates and anaesthesia associates pose a ‘significant’ risk to patient safety, a BMA survey of 18,000 doctors has found.

Some 87% reported that the way PAs and AAs currently work in the NHS was always or sometimes a risk to patient safety.

The BMA also reports that over 10,000 doctors have so far written to their MP to urge them to oppose this damaging change.

One GP told the BMA: “I work as a long term locum in a GP practice. Part of my role is to supervise [the PA] – [they] are without doubt the most worrying person I have ever had to supervise in over 30 years as a GP. Their basic knowledge is poor, they are unable to present a coherent history and examination, unable to formulate a differential diagnosis. Patients frequently believe they have seen a doctor. I will no longer sign off on any prescription for the PA without reassessing the patient myself. It is only a matter of time before a patient comes to serious harm at their hands.”

The day after survey results were published, the Government announced that the GMC would regulate both roles.

LocumDeck, NASGP’s booking platform, includes a setting for each practice for locums to express their level of willingness to supervise non-GPs.

Views were sought in November after Prof Kamilla Hawthorne, the RCGP chair, warned listeners of the GP Online podcast that PAs must work within ‘red lines’ in October.

Commenting on the survey results, BMA chair of council Prof Philip Banfield said: “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… The creeping expansion of these roles and their central part in the Government’s workforce plan for the NHS has been undertaken against the advice and warnings of an entire profession.”

Dr Richard Fieldhouse, NASGP chair, said: “The level of concern expressed by so many doctors around these two roles is unprecedented. Some GPs are worried that it may even be a political stunt to stave off headlines of a crisis in primary care before the next election, only for it to raise the ugly head of its long term consequences for the next government.

“These concerns are not simply around clinical supervision; it’s more about clinical safety – both in the community and in secondary care. Our patients, including our own family members, are being treated by entirely well-meaning and dedicated staff that are given a mandate to perform a role that even they don’t realise they are not qualified to do.

“Until there is a nationally recognised qualification for our devoted physician associate colleagues, and a regulatory authority, we must all be taking extra time and effort to properly interpret their findings and support their management.”

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"I was introduced to the local locum chambers several months ago when I made a career move from partnership. I now combine salaried and locum roles. The chambers provides helpful support, leadership, advice and governance and reduces professional isolation. This combination of support reassures me and helps me provide safe and consistent care to patients within the community . There is a useful, innovative online portal - LocumDeck - which helps me access local work and which has efficient systems for reconciliation of finance including pensions. I would highly recommend joining a locum chambers for any GPs starting out in the locum world ."

Dr Adrian Richardson, GP

Dr Adrian Richardson, GP

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