Following its landmark publication of the first national guide for how Medical Associate Professionals (MAPs) should work safely, the BMA today has published the first guidance for doctors supervising physician associates (PAs) and other medical associate professionals. MAPs must always work under the supervision of doctors, but until now the responsibilities of those doctors have not been made sufficiently clear, allowing dangerous situations to develop in which MAPs could be seeing patients without clear supervision.  

For the first time it is made clear which doctors should be available throughout a MAP’s shift, as opposed to existing practices where in some cases the named supervisors have been unreachable. This represents a major change in practice for some, but is seen as vital if the NHS is to ensure consistency in patient safety across all healthcare settings and end practices where MAPs could work unsafely and effectively unsupervised. 

The guidance includes specific recommendations for both supervising doctors and employers, emphasising the importance of supervising doctors having allotted time for discussions with PAs and to review patients, in accordance with the BMA’s safe scope of practice. Practical recommendations are also included for non-supervising doctors who work with MAPs in their departments or primary care settings. And for the first time it will be clear that only doctors with sufficient seniority and training can safely supervise MAPs.  

BMA chair of council Prof Phil Banfield said: 

“Doctors who supervise MAPs must be confident that any person they delegate to has the necessary knowledge, skills and training to carry out the task being delegated. This has been highlighted by past medical tribunal rulings that show unsafe supervision of MAPs can not only threaten the safety of patients but also the license to practice of the doctors who remain responsible for those patients. They need to be certain what the competencies and defined limits of their colleagues are, and what they should do to make sure all members of the team understand the job at hand.  

“Unfortunately, doctors have been left without clear guidance on how to supervise these staff placed under their care. PAs have been asked to work above their training and competencies without direct access to their named supervisor who would be able to double check clinical findings and plans of management. Nor can that responsibility for supervision just be passed over to those unable to undertake it safely because of their own workloads or those untrained to carry the risk of responsibility for others’ actions.  This is where critical patient safety incidents become more likely and catastrophic mistakes happen. 

“This is the first time such clear guidance has been produced for the NHS and for doctors, and the BMA is once again filling the void left by others by providing a straightforward set of recommendations that can be implemented locally so that doctors and employers are clear about their responsibilities. It is that clarity which will give all staff and the public the confidence that patients are being treated by the right healthcare professionals at the right time.” 

Notes to editors

The document can be found here.

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.