Responding to revelations from Channel 4 News that over 109 doctors’ shifts in hospital trusts had still been covered by physician associates (PAs) between April and September, Prof Phil Banfield, chair of BMA council, said:
“This is an appalling situation. PAs do not have the clinical expertise, experience, or training to cover doctors’ shifts and should never, ever be asked to do so. The fact that so many NHS trusts continue to flagrantly disregard NHS England’s specific instruction earlier this year that PAs should never replace doctors leaves patients at risk, with no organisation taking responsibility or accountability. The implications for patient safety cannot be ignored given that hospital bosses continue to blur the lines between doctors and less qualified staff. This is unacceptable.
“Trusts should not need to be told that there are medical tasks that only a fully trained doctor can do. From our own surveys and feedback from thousands of doctors, we know these findings by Channel 4 News are the tip of a very big iceberg; not all Trusts in England replied to their investigative questions, and we hear daily of PAs working far beyond their competency. We need Government to hold a full and frank inquiry, without delay, into how often doctors' shifts or clinical work are being covered by medical associate professionals, what harms may have come about as a result, and how often staff are being asked to work beyond their competencies without support or supervision.
“We also need an immediate pause in recruitment of PAs until we can be assured that the practices described here are no longer being taken. The Channel 4 investigation demonstrates exactly why we must have a nationally agreed scope of practice - what PAs can do and what they can’t do – so that hospitals cannot ignore safe standards of care or blur the lines putting both PAs and patients at risk of avoidable harm. The failure to train, fund and retain enough doctors for rising numbers of patients is not an excuse to take short cuts with patient safety.
“We’ll be writing again to NHS England making clear that if the concerns that have been raised not just by Channel 4 News and the BMA, but now by numerous Royal Colleges, are not addressed, the serious risk to patients will continue.
“The suggestion from the Government of a rapid review will hopefully provide some clarity on how PAs can assist doctors, however a review alone is not enough. We need action now to end the practice of organisations using PAs in situations where a doctor’s skills and expertise would deliver safer care. Have no doubt, if the Government and the NHS won’t act, doctors will.”
Ends
Notes to editors
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.
Notes to editors
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.