NHS associates role could 'cost lives', study says

Allowing physician associates to take on the responsibilities of NHS doctors "costs lives", an expert from the University of Oxford has said.

Physician associates (PAs) can work in GP surgeries and hospitals.

They are not authorised to prescribe medication, but they can order certain scans, take medical histories and conduct physical examinations.

The Royal College of Physicians and the British Medical Association are among those who have raised concerns about the use of the roles.

Prof Trisha Greenhalgh, lead author of new research on the issue, said not a single study had looked at whether PAs or anaesthetic associates (AAs) in the NHS are safe.

PAs and AAs are seen as a crucial component of staffing in the health service, according to the current NHS workforce plan for England.

There have been claims that the scope of the role is not clear, that patients are not always aware of the status of PAs, and that their differentiation with doctors is becoming blurred.

Speaking to BBC Radio 4's Today programme, Prof Greenhalgh said the only research that had been done - which included only a handful of PAs - has focused on settings where associates were seeing very low-risk patients under close supervision.

"So it's not really very surprising that there weren't any safety incidents identified," she said.

"But that doesn't mean that these roles are safe and, in fact, to conclude that they're safe from the basis of the evidence we've got is an error of reasoning that is likely to cost lives."

Pressed on this issue, Prof Greenhalgh said: "We've got coroner's reports, which are formal legal reports issued to prevent future deaths, and what they say is we need some major changes in the way that physician associates and anaesthetic associates are being deployed."

PAs have hit the headlines in recent years over a spate of patient deaths linked to misdiagnosis.

They are graduates - usually with a health or life sciences degree - who have undertaken two years of postgraduate training.

In November, the government launched a review of the role of PAs and AAs led by Professor Gillian Leng, president of the Royal Society of Medicine.

Her report is expected to be published in spring.

A Department of Health and Social Care spokesperson said: "The Secretary of State has launched an independent review into physician and anaesthesia associate professions to establish the facts and make sure that we get the right people in the right places providing the right care.

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