Doctors have launched a campaign to curb the use of unregulated assistants being deployed as a “short-term fix” to plug gaps in the NHS workforce.
Medics say that the health service is turning more and more to “associate” practitioners because they are much quicker and cheaper to train.
They have warned patients, often unaware when they are seen by such staff, that they are not being treated by a qualified doctor.
Associates do not go to medical school, and instead do two years of post-graduate training on top of a degree in a subject like biomedical sciences.
Ministers have unveiled ambitious plans to increase the number of them working in the NHS by almost fourfold to 12,000 by 2036-37.
Currently there are about 3,000 physician associates who support doctors in diagnosing and managing patients and 300 anaesthetist associates.
Unlike doctors and nurses, they are not overseen by a dedicated independent regulator.
Alarm
For several years the Government and General Medical Council, which oversees doctors’ standards, have been discussing plans for associates to be regulated by the GMC, but the watchdog says this will not happen until “the second half of 2024 at the earliest.”
Senior medics have now sounded the alarm on their expanding use and said the NHS should put more money into training fully-fledged practitioners.
They have set up a group called Anaesthetists United and are piling pressure on the Royal College of Anaesthetists into opposing the plans.
“The Government is trying to solve the NHS workforce crisis, not by recruiting and retaining more doctors, but by training cheaper replacements,” it said.
“They wouldn’t do this in other safety-critical industries, why in medicine?
“We are calling for anaesthesia associates to be properly supervised and we’re not prepared to see individual hospitals opt-out of proper supervision just to save money.
“Patients need to be made aware when they are being anaesthetised by a non-doctor.”
The group is now set to trigger an extraordinary general meeting of the Royal College of Anaesthetists after securing the signatures of almost 500 worried doctors.
Regulatory system
Richard Marks, a consultant anaesthetist at the Royal Free hospital in North London, said associates need to be brought under the oversight of an independent regulator.
“As a doctor, you are registered with the GMC and in order to get onto and stay on the medical register you have to do a lot of things,” he told The Sunday Telegraph.
“There definitely needs to be some sort of regulatory system for individual medical associates, so the public has the assurance that they are properly qualified and are still fit to practise.”
He also warned that associates had been through “much narrower” training which raised concerns about “how people manage the 1pc of the time when things go wrong”.
“It’s like flying a plane. Most of the time it’s alright but it’s when things go wrong that you see the difference,” he said.
Dr Marks said hiring associates rather than training fully-fledged doctors was a “short-term fix” to the NHS’ staffing problems.
He added: “Patients are often confused about the terminology. They have a right to know who is looking after them, especially when they are asleep and unaware.”
There have also been concerns raised about the use of physician associates in place of fully qualified doctors, including at GP surgeries.
Emily Chesterton died last November after she was misdiagnosed by a physician associate who she mistakenly thought was a GP.
Blood clot
The 30-year-old, who lived in London, was seen twice by an associate and told that her calf pain was an ankle sprain when she actually had a blood clot.
A coroner ruled at her inquest that she should have been sent to A&E straight away and that if she had been then it is likely she would have survived.
Her mother, Marion, told the BBC that she “didn’t know she hadn’t seen a doctor” and that more regulation is needed around associates to guarantee patient safety.
“Physician associate sounds grander than a GP,” she said.
“If I had known earlier that she had not seen a doctor, I would have marched back to the surgery or gone straight to hospital.”
In June last year an investigation by BBC Panorama found that the UK’s biggest chain of GP practices was allowing associates to see patients without adequate supervision.
A spokesman for the Department of Health said: “Our Long Term Workforce Plan will deliver the biggest training expansion in NHS history and recruit and retain hundreds of thousands more staff.
“Patient safety remains of the utmost importance, which is why we are working with the General Medical Council to regulate physician associates and anaesthesia associates.
“We are clear that the role of associates is to support doctors, including GPs, and not to replace them. This supports the government’s plans to grow the multidisciplinary NHS workforce.
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Doctors sound the alarm at the surge in use of unregulated assistants by the NHS - The Telegraph
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