In the wake of two cases where physician associates (PAs) were involved in patients’ deaths, medical leaders have expressed support for a planned increase in their prevalence throughout the NHS. PAs are healthcare professionals who assist medical teams and cannot prescribe medication nor request imaging scans. AAs are similar professionals but are specifically trained to perform in anaesthetic situations. Both roles require a two-year master’s degree and a supervising doctor on site. The planned increase in PAs is a concern for the British Medical Association (BMA), who feel new legislation blurs the lines between doctors and other medical staff, potentially putting patient safety at risk.
The two cases that brought PA’s roles into question were that of Emily Chesterton and Ben Peters. In Emily’s case, a blood clot was missed in two appointments with a PA whom Chesterton assumed was a general practitioner. After visiting the PA complaining of pain in her calf, Emily was told to take paracetamol. Emily’s condition worsened as she became breathless and light-headed; her mothers alleges the PA only diagnosed her with a calf sprain, anxiety, and long-Covid. It was ultimately discovered that Emily had a blood clot in her leg that led to her dying of a pulmonary embolism, making it likely she would have survived had she been attended to immediately. In Ben’s case, he was presenting with chest pain, shortness of breath, and vomiting and saw a PA at a Manchester hospital but was only diagnosed with a panic attack and gastric inflammation and was not seen in person by a physician. Aortic dissection led to Ben’s death.
The concerns the BMA has with the increasing prevalence of PAs within the NHS is the blurring of lines between their role and that of a general practitioner, leading to potentially dangerous gaps in care and a risk to patient safety. Medical leaders recognize an increase in PAs within the NHS as valuable to medical professionals, but guidelines need to be established to ensure they are deployed safely. Both cases of Emily Chesterton and Ben Peterson highlight the need for the proper deployment and use of PAs and the clear definition of roles within the medical community.
The Academy of Medical Royal Colleges recognizes the importance of increasing PAs in the NHS but has established the need for clear guidelines before their deployment. It is important to clarify the role a PA plays and safeguard the clarity of doctor and patient interactions, preventing dangerous gaps in care. The increase in PAs will provide assistance in medical care throughout the NHS, but it is crucial to manage their deployment and roles carefully. Clear guidelines and definitions for their position must be established to ensure patient safety, to prevent the misdiagnosis of a patient leading to tragedies like those of Emily Chesterton and Ben Peters
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