Trainee physician associates (PAs) are being employed by the NHS to work with patients despite having no medical training, this newspaper has learned.
There are already growing concerns about the escalating use of these ‘cut-price medics’ – who are supposed to assist doctors and nurses with routine duties after two years’ training.
But many are being asked to take on clinical duties which go far beyond their remit, with mounting evidence that this has caused harm to patients and led to misdiagnoses and even deaths.
But The Mail on Sunday has now discovered that the NHS is rolling out ‘apprenticeships’ for PAs – which means untrained staff are going directly into paying jobs working with patients.
Demonstrators, including doctors, gathered outside Parliament in protest against handing over responsibilities to Physician Associates, February 26, 2024
The Mail on Sunday has now discovered that the NHS is rolling out ‘apprenticeships’ for PAs. Protesters hold a banner outside the Houses of Parliament
The formal clinical training aspect is set to be completed in their spare time – which mostly involves seminars online.
Documents suggest there could be 200 of these PAs working in the NHS by early 2025.
Doctors last night reacted with horror to the news and said the Government needs to be ‘called to account’ before patient safety could be further compromised.
‘This is a step too far,’ says Dr Helen Fernandes, co-chairman of the Doctors’ Association. ‘It’s complete madness. Many patients and doctors will be horrified to learn of these PAs, many of whom will never have set foot in a ward or clinic before. I’m flummoxed as to how anyone might think this could be safe for patients.
‘If appropriately supervised and regulated, PAs can support doctors to deliver high-quality, safe care. We’d welcome that.
‘But there is also the question of whether patients, who already often don’t know they’re being treated by someone who isn’t a doctor, will be told they may see an apprentice.
‘The Government must be called to account, and organisations have already called for recruitment of PAs to be paused.’
One job advert for a PA apprentice to work in GP surgeries, posted last year by Midlands Partnership NHS Trust, reveals the candidate could receive a salary of up to £32,934 a year – only slightly less than the average salary of a qualified nurse – and would be expected to carry out the same duties as a fully trained PA.
The job description says these include – under supervision – performing physical exams, taking medical histories and seeing patients with emergency or routine health problems.
University Hospitals North Midlands has hired 13 apprentices in its acute medical unit who would be going to work in cardiology.
It is understood the apprenticeships are an initiative from NHS England and the training is to be provided by ten universities. Only two schemes – at Keele University and the University of Plymouth – have already started.
The latter’s course, described as ‘an innovative pathway’ to become a PA, involves just four weeks on campus during the 30-month course for ‘intensive clinical skills training and assessment’.
The Mail on Sunday first raised the alarm about the dangers of PAs last year and is running a campaign to Rein In The Physician Associates.
The Government wants to recruit some 10,000 PAs by 2038 to relieve the strain on the NHS. The current number sits at 2,500.
Dr Robert Laurenson (centre), Co-Chair of the Junior Doctors Committee, takes part in the protest
Doctors last night reacted with horror to the news and said the Government needs to be ‘called to account’ before patient safety could be further compromised
When PAs are used as originally intended, studies suggest that they can improve the care GPs provided to patients.
But last year the MoS told how 34-year-old Colleen Howe died from aggressive breast cancer following delays in her treatment when her lump was misdiagnosed by a PA as a blocked milk duct.
And Norman Jopling, 79, also suffered a serious brain bleed after an associate mistakenly told him his painful headaches were ‘nothing to worry about’.
In a Lords debate, Liberal Democrat peer Baroness Brinton last month said doctors had reported ’70 instances of avoidable patient harm and near misses caused by PAs’, including ‘fatalities, missed diagnoses causing terminal diseases, sepsis and heart attacks’.
An NHS England spokesman said: ‘Physician associate apprenticeships are safe roles, and all of the training is carried out under supervision by fully qualified mentors.
‘Apprentices will undertake the same mandatory degree qualifications and competence standards as students entering physician associate courses. They do not in any way replace doctors – as set out in the NHS Long Term Workforce Plan, they offer an alternative role into the physician associate profession and improve access to healthcare roles.’