BMA launches authorized motion towards regulator on doctor associates
The doctors’ union is set to launch legal action against the medical regulator amid rising concerns about the use of physician associates.
The British Medical Association said it needs to act before the ‘uncontrolled experiment’ of using lesser qualified staff ‘leads to more unintended patient harm’.
It said there has been a ‘dangerous blurring of lines’ for patients between doctors and assistant roles, with some people unaware who is treating them.
And it warned this will be made worse if the General Medical Council (GMC) ploughs ahead with its plan to extend its regulatory powers beyond doctors to also cover PAs.
The NHS is rolling out a mass expansion in the use of PAs, despite concerns that patients are being put at risk by workers with insufficient training.
The BMA said the General Medical Council needs to act before the ‘uncontrolled experiment’ of using lesser qualified staff ‘leads to more unintended patient harm’. Professor Philip Banfield, chairman of the council at the BMA (pictured), told the union’s annual meeting in Belfast: ‘Today I want to announce that we are taking legal action against the GMC’
Emily Chesterton, pictured, was just 30 when she died in 2022 after a PA failed to spot a blood clot. The actress was seen twice by the same PA, who told her she had anxiety and long Covid. Her parents say that at no point during the appointment was Emily made aware the person she was seeing was not a GP
She died in November after she suffered a cardiac arrest. A coroner concluded her life could have been saved if she had been sent to A&E. The GP practice where Ms Chesterton was seen, the Vale Practice in Crouch End, has now stopped employing PAs. Her parents are now warning of the dangers patients can face amid plans to expand the use of PAs
Norman Jopling, 79 from North London, suffered a serious brain bleed after a PA mistakenly told him that his painful headaches were nothing to worry about. His wife Maureen, right, accused the NHS of ‘trying to cut corners’ by allowing PAs to carry out ‘complicated tasks they’re not qualified to perform’
More than 3,500 are already deployed in England, with plans to train 1,000 more each year to take the total up to 10,000 within 12 years.
The workers do not go to medical school but are usually expected to have either a science degree or a clinical qualification before they embark on a two-year postgraduate course to train to become a physician associate.
However, some universities offering the course have admitted to accepting students with first degrees in the likes of geography, human resources and English literature.
From December 2024, the GMC will become the regulator for physician associates and anaesthesia associates — known collectively as Medical Associate Professions (MAPs).
MAPs have been under increased scrutiny following the death of Emily Chesterton in November 2022.
The 30-year-old had been under the impression that she was seeing a GP, but was actually seen twice by a PA who failed on both occasions to spot that her leg pain and breathlessness was a blood clot, which ultimately travelled to her lungs.
Leading medics, including the Royal College of GPs, have called for a halt of the recruitment of physician associates while concerns are addressed.
Professor Philip Banfield, chairman of the council at the BMA, told the union’s annual meeting in Belfast: ‘Today I want to announce that we are taking legal action against the GMC.
‘We’re taking this action because of the dangerous blurring of the lines between doctors and MAPs specifically with challenging their frankly unsafe use of the term ‘medical professionals’ when they’re referring to people who are not doctors.
‘This legal action is supported by our colleagues, the grassroots movement Anaesthetists United who will be pursuing a complimentary legal challenge.
‘We have had enough of the Government and the NHS leadership eroding our profession.
‘We are standing up for both doctors and patients to block this ill thought through project before it leads to more unintended patient harm.
‘It’s not too late to row back from this uncontrolled experiment in dumbing down the medical skills and expertise available to our patients.’
Demonstrators, including doctors, gathered outside Parliament in protest against handing over responsibilities to Physician Associates on February 26, 2024. Pictured, Dr Robert Laurenson (third left), Co-Chair of the BMA Junior Doctors Committee, taking part in the protest
The BMA has previously argued the GMC is not the right regulator for MAPs, claiming that the move will ‘undermine and devalue’ the medical profession while confusing patients.
In the BMA’s letter for action, it states that it is seeking to challenge the GMC’s decision to apply its central guidance for doctors — Good Medical Practice — equally to physician associates and anaesthesia associates once they are regulated by the GMC.
The BMA is also contesting the GMC’s use of the term ‘medical professionals’ as a collective description for doctors, physician associates and anaesthesia associates.
The BMA is launching a judicial review claim against the GMC over its use of this term, which it says should only ever be used to refer to qualified doctors.
Professor Banfield later added: ‘PAs are not doctors, and we have seen the tragic consequences of what happens when this is not made clear to patients.
‘Everyone has the right to know who the healthcare professional they are seeing is and what they are qualified to do — and crucially, not to do.
‘Doctors are “the medical profession”.
‘To describe any other staff as medical professionals not only undermines doctors and the rigorous training journey they have been on, but also confuses patients, who rightly associate the two terms as one and the same.
‘The central and solemn responsibility of the GMC is to protect the public from those who are not registered qualified doctors, pretending to be doctors.
‘It has become increasingly clear that broadening the term ‘medical professionals’ to include those without medical degrees has had the effect of making this task far harder, when recent experience has now shown that this represents a dangerous blurring of this critical distinction.’
Dr Richard Marks, co-founder of Anaesthetists United, added: ‘Doctors and their patients are united over their opposition to the outgoing Government’s plans for replacing doctors with Associates.
‘Taking legal action seems to be the only way forward.’
A GMC spokesperson said it was taking on responsibility for the regulation of PAs and AAs in line with legalisation was passed by the UK and Scottish governments.
It added: ’Regulation will help to assure patients, colleagues and employers that PAs and AAs are safe to practise and can be held to account if serious concerns are raised.
‘As a multi-professional regulator, we will recognise and regulate doctors, PAs and AAs as three distinct professions.
‘PAs and AAs don’t have the same knowledge, skills and expertise as doctors.
‘They are not doctors but they can, and do, play important roles within multidisciplinary teams when appropriate and effective clinical governance and supervision are in place.
‘We know from several years of ongoing engagement with patients and the public, doctors and stakeholders that they do expect PAs and AAs will, like doctors, work to high professional standards.
‘We will continue to work with patients, professionals, Royal Colleges, the BMA and others towards the delivery of safe and effective regulation for these groups.
‘We note the BMA’s correspondence on a range of issues and further note that no legal proceedings have been issued at this stage.’
An NHS England spokesperson said: ‘The NHS has been clear that medical associate professions are not a substitute for doctors but are trained roles to support doctors to do their jobs with appropriate supervision.’
