Physician associates: DAUK co-chair discusses concerns on national radio

The co-chair of the Doctors’ Association UK has renewed his call for an immediate pause on the rollout of physician associates (PAs) during an interview on national radio.

Dr Matt Kneale said there were “massive public safety concerns” across the health profession at the rapid expansion of PA and anaesthesia associate (AA) roles.

Speaking to Tom Swarbrick on LBC, Dr Kneale said the public did not understand the roles and that they would not be treated by a doctor if seen by a PA.

“In the case of Emily Chesterton, which is tragic, her mother said they had no idea she wasn’t seeing a doctor and if they were aware they would have made her see one.

“They’re not doctors. They do far less training, we’re talking 1,500 hours over a couple of years compared to almost 6,000 hours for a doctor.

“We’ve got massive concerns across the profession.

“It’s purely a safety issue.

“At DAUK, we’ve collected hundreds of examples of patient harm and the BMA found 84 per cent of doctors have concerns.

“We need to do something urgently

“And rather than roll this out at pace, which is what the Government plans to do with its Long Term Workforce Plan, we need to put an immediate pause on this and reassess.”

Safety issue

Dr Kneale added: “If we’re going to argue that this is effective and safe to do then why on earth are doctors studying for five or six years?

“So clearly it isn’t safe.

“To do your job as a doctor you need a fundamental understanding of anatomy, physiology, all sorts of stuff.

“Unfortunately, we have collected examples of PAs who are essentially operating or assisting operations in theatre and learning anatomy on the job. How is that at all a safe thing to do?

“It cannot be and any reasonable person who hears this from the first instance thinks this is an outrageous idea.”

Dr Kneale said that Government plans for the General Medical Council (GMC) to regulate PAs and AAs would only confuse the public.

“Doctors do make mistakes and that’s tragic,” he said. “It’s really upsetting for us and the public when mistakes happen, but that’s with all the expertise and education that we have.

“If we’re having people making mistakes without that expertise, that’s a scandal in itself.

“We expect more for our public and for the protection of the public.

“We’re complaining about the General Medical Council (GMC) taking over as the regulator, which is what the Government wants to do, we think that blurs the lines further.

“You take the case of Emily Chesterton, she didn’t know she was seeing a physician associate, well how is this going to help when they’re regulated under the GMC?”

PAs employed instead of doctors

Dr Kneale said that PA and AA roles were being expanded at the expense of doctors, particularly in general practice.

But he said there were enough trained doctors to fill the roles if there was the support and funding from the Government.

“General practice has a different set of issues to hospital practice but PAs, and other allied professionals, are being expanded at pace in general practice and that’s at the expense of more doctors,” he said.

“Relatively, they’re pausing the recruitment of new GPs, but they’re expanding and funding significant numbers of PAs and other healthcare workers into general practice.

“We and the BMA are encouraging people to ask if I am seeing a doctor in these consultations.”

He added: “There is no shortage of doctors. There’s not enough jobs for doctors but there are plenty of doctors willing to work.

“One example will be anaesthesia. We had 2,000 people apply for jobs in anaesthesia this year and only about 500 or so got a job, but the Government wants to introduce 2,000 anaesthesia associates.

“It makes no sense.

“If you want a doctor to do the job, they exist. What doesn’t exist is the backing and the funding for that from the Government.

“We need to see a commitment from the Government to support doctors and the medical profession rather than going for this piecemeal, rushed approach that’s proven to be unsafe from our own data.”