Health and Social Care Secretary Wes Streeting has ordered a review into the role of physician associates in the NHS, amid growing concerns in the medical profession about patient safety.
The review will be led by Professor Gillian Leng, an expert in evidence-based healthcare and former chief executive of the National Institute for Health and Care Excellence (NICE), and look into how the role affects patient care and safety and support physician associates provide to wider healthcare teams, including GPs.
Streeting said that many physician associates provide good care and ‘free up doctors to do the things only doctors can do’.
‘But there are legitimate concerns over transparency for patients, scope of practice and the substituting of doctors. These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and physician associates feeling demoralised.’
- Persistent understaffing of NHS a serious risk to patient safety
- NHS in ‘critical condition’ after years of underfunding, warns Darzi report
- Underperforming NHS hospitals to be revealed in league tables, says Wes Streeting
There are about 3,500 physician associates working in hospitals and GP surgeries in England. The number is due to increase to about 10,000 by 2037 under the new NHS long-term workforce plan. Physician associates can take a patient’s medical history, conduct physical examinations, analyse test results, diagnose illnesses and help draw up the plan for managing a person’s condition. They undergo two years of medical training, far less than doctors.
However, medical professionals expressed concern that physician associates’ limited medical knowledge may negatively affect patient safety and care. The Academy of Medical Royal Colleges wrote to Streeting in September calling for a review of the role amid ‘mounting concern’ from doctors after a couple of incidents that made the headlines, especially the death of Emily Chesterton in 2022.
The 30-year-old actor died after a physician associate at a GP surgery in north London misdiagnosed her on her two occasions. Emily had been under the impression she was seeing a GP, but the physician associate failed to spot that her leg pain and breathlessness was a blood clot, which ultimately travelled to her lungs. A coroner later ruled that she ‘should have been immediately referred to a hospital emergency unit’, where she would likely have been treated for pulmonary embolism and would have survived.
Professor Leng welcomed the ‘comprehensive review’ as crucial to ‘promote patient safety and strengthen the NHS workforce’.
‘This will cover recruitment and training, scope of practice, supervision and professional regulation. As I conduct this review, I am looking forward to speaking to a broad range of stakeholders and to gathering evidence from the UK and abroad so that we can reach a shared understanding of these roles and their place in wider healthcare teams,’ she said.