Physician Associates Must Not Treat Patients Not Seen by a GP

“Physician associates must not treat patients who have not been seen by a GP” is the new guidance by the Royal College of General Practitioners (RCGP) released this week (10^th October 2024). This comes after plans to extend physician associate roles within the NHS was overwhelmingly rejected by doctors during a survey conducted by The British Medical Association. In the survey, 87% of doctors believe that physician associates can sometimes be a risk to patients.

Physician Associates, who are not doctors, are healthcare professionals who work under the supervision of a named doctor such as a GP. They usually work in acute medicine, GP practices and Emergency Medicine. They are not regulated in the UK, and there is only a voluntary register to monitor them. Their role is to “support doctors in the diagnosis and management of patients” and about 3,500 work across GP surgeries and hospitals. In the survey conducted by The British Medical Association, 86% of doctors believe that the public don’t understand the difference between physician associates and doctors.

Dr Richard Marks, co-founder of Anaesthetists United said: “We think the public would be shocked that, not only are there no national rules saying what associates can and can’t do, but they’re not even planning on introducing any, so we want to set that straight.”

There have been medical negligence compensation claims that have been publicised in the news, due to patients being misdiagnosed by a physician associate whom they had believed was a GP. These included situations where patients have been misdiagnosed which has led to serious illness and even death which may have been prevented if diagnosed correctly.

The RCGP guidance includes a scope of practice, which says physician associates should not see a patient who has not been triaged by a doctor first and should only undertake work delegated to them by their GP supervisor.

The RCGP guidance released this week, includes:

• Name badges – Staff must wear “clearly visible name badges”, and PAs must ensure patients understand their role and the fact they are not a doctor when they introduce themselves.
• Staff directories – health care practices should have a list of multidisciplinary team members on their website, with a description of each of their roles and a protocol when booking appointments to explain to patients who they will see, with an option for them to discuss who they would like to see.
• Supervision – Physician associates must always work under the supervision of a named doctor. All named supervisors must have training in education and supervision prior to taking on the role.

Jenna Kisala, solicitor in our medical negligence team, said “It is confusing in hospital who is what and they don’t wear badges telling you what they are or what that means. And it feels uncomfortable to tell the very nice person helping you ‘I want a real doctor to see me’ especially when you’re not well and not in a place where you can advocate for yourself.

“It’s a very positive step to see that the RCGP and BMA is joining that action and supporting it because they also want there to be clarity on the role of a physician associates so patients can make an informed decision about their care”.

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