DAUK supports fatal motion to throw out physician associates legislation

The Doctors’ Association UK (DAUK) is supporting a motion being laid before the House of Lords which aims to kill off plans for the regulation of non-doctors by the General Medical Council (GMC).

Former Green Party leader Baroness Natalie Bennett is set to put down a fatal motion to throw out the draft Anaesthesia Associates and Physician Associates Order 2024.

DAUK has opposed GMC regulation of PAs and AAs and has called for a pause on their recruitment and roll-out.

The association has long-standing concerns that the legislation will blur the roles of doctors and non-doctors, creating a misunderstanding of the role of PAs and presenting a significant risk to patient safety.

It has written to Labour peers urging them to vote against the draft order.

DAUK co-chair Dr Matt Kneale said: “DAUK is strongly opposed to the Anaesthesia Associates and Physician Associates Order 2024 and welcome the fatal motion being moved by Baroness Bennett.

“However, we’re disappointed that Labour has not sought to back the position of putting patient safety first given the very real concerns within the medical profession and among the public about non-doctors.

“There have been many reported instances of PAs operating beyond their competencies and being linked to patient harm.

“We need to pause the recruitment and roll-out of PAs immediately until the scope of their roles is addressed by the GMC, the royal colleges and other stakeholders.

 “The regulation of non-doctors and their roll-out in the NHS is an issue of huge importance to the health of the nation and we urge the Lords to oppose this legislation.”

DAUK this weekend reported the Royal Berkshire NHS Foundation Trust to the police over concerns around negligence leading up to a patient’s death.

It follows a report in the Sunday Telegraph that the family of celebrated film make-up artist Christopher Tucker has urged the coroner to investigate his death amid concerns over his treatment by a PA.

Meanwhile, a recent DAUK survey completed by more than 650 doctors highlighted significant worries about PAs operating beyond their competence and affecting the quality of medical training.

Dr Kneale said: “There is a need for a regulatory framework for PAs away from the GMC register for doctors, which includes guidelines, supervision, accountability and patient safety.

“Patient safety must be paramount, and we believe GMC regulating medical associate professions (MAPs) could compromise that.

“We’ll continue to work with the BMA, GMC, the colleges and other stakeholders to make these roles safer.”

DAUK letter to Labour peers

The Doctors’ Association UK (DAUK) remains opposed to the regulation of anaesthesia associates (AAs) and physician associates (PAs) by the GMC, and are seeking to further challenge matters by asking you to vote against the Draft Order supporting this legislation being debated today in the House of Lords

There is nothing to be gained by the GMC regulating these professions but much to be lost for the public, patient safety standards and the future training of doctors.

Blurring the boundaries between doctors and these allied professions is harmful to patients. The average patient is  unaware of the limitations of the training that PA and AAs undergo, but aware that the GMC expects its regulated doctors to practice to a high standard. A doctor will train for nearly 10 years before they can independently practice as a GP, PAs can after only two years. Anaesthetic doctors remain in training for longer, AAs can work independently with patients, again after a two-year degree.

How does the GMC protect patients if they regulate both professions, how will patients know who is treating them?

While there are many known high profile cases where PA’s errors have caused or contributed to patient harm and death, there is growing evidence of many more instances. GMC regulation will likely open these floodgates wider as currently the GMC has NO structure in place to define standards or scope for PAs and AAs, nor has it ANY experience of doing so. The GMC adopts strict standards and scope from medical schools and the royal colleges which oversee education and qualification of doctors. Passing this legislation today therefore seems perverse. Particularly perverse when there is evidence to prove that these roles are not cost effective, with more NHS funds spent providing less safe care for patients.

There is also published evidence that the training of current and future doctors is being adversely affected. This will impact the clinical excellence the NHS can offer notwithstanding simple quality of care for patients for decades to come if PAs and AAs continue to be prioritised over doctors.

GMC Medical Director of Education and Standards Colin Melville knows this, but nonetheless speaks of consultant PAs leading medical care in the future. Not doctors, leading medical teams, but PAs.

DAUK acknowledges the contribution of PAs and AAs to the care of patients. Patients want access to good, safe medical care. They are welcome assistants to that care, not associates or doctor replacements. We wholeheartedly support regulation of PAs and AAs, but just not by the GMC.