The NHS is recruiting junior doctor associates (PAs) to work with patients despite having no medical training, this newspaper has learned.
There is already growing concern about the growing use of these ‘cut-rate doctors’, who are supposed to help doctors and nurses with routine tasks after two years of training.
But many are being asked to take on clinical tasks far beyond their competencies, and there is growing 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 personal assistants, meaning untrained staff go straight into paid jobs working with patients.
Protesters, including doctors, gathered outside Parliament to protest against the handover to Physician Associates, February 26, 2024.
The Mail on Sunday has discovered that the NHS is rolling out “apprenticeships” for PAs. Protesters hold a banner outside the Houses of Parliament.
The formal clinical training aspect must be completed in your free time, which mostly consists of online seminars.
The documents suggest there could be 200 of these PAs working in the NHS by early 2025.
Last night doctors reacted with horror to the news, saying the Government needs to be “held to account” before patient safety can be further compromised.
“This is going too far,” says Dr. Helen Fernandes, co-president of the Physicians Association. ‘It’s complete madness. Many patients and doctors will be horrified to learn about these PAs, many of whom will have never set foot on a ward or clinic before. It baffles me how anyone could think this could be safe for patients.
‘If properly monitored and regulated, PAs can help doctors provide safe, high-quality care. We would appreciate it.
‘But there is also the question of whether patients, who are often unaware they are being treated by a non-doctor, will be told they can see a trainee.
“The Government must be held accountable and organizations have already called for AP recruitment to stop.”
A job advert for a PA trainee to work in GP surgeries, published last year by Midlands Partnership NHS Trust, reveals that the candidate could receive a salary of up to £32,934 a year (just slightly less than the salary average of a qualified nurse) and would be expected to carry out the same tasks as a fully trained personal assistant.
The job description says these include, under supervision, performing physical examinations, taking medical histories, and caring for patients with emergency or routine health problems.
University Hospitals North Midlands has recruited 13 trainees to its acute medical unit who would work in cardiology.
It is understood that the apprenticeship programs are an NHS England initiative and that the training will be delivered by ten universities. Only two programmes, Keele University and Plymouth University, have already started.
The latter course, described as “an innovative pathway” to becoming a PA, involves just four weeks on campus during the 30-month course for “intensive clinical skills training and assessment”.
The Mail on Sunday was the first to raise the alarm about the dangers of APs last year and is waging a campaign to stop The Physician Associates.
The Government wants to hire around 10,000 personal assistants by 2038 to ease pressure on the NHS. The current number stands at 2,500.
Dr. Robert Laurenson (center), co-chair of the Young Doctors Committee, participates in the protest
Doctors reacted with horror to the news last night, saying the Government needs to be “held to account” before patient safety can be further compromised.
When APs are used as originally intended, studies suggest they can improve the care that primary care physicians provide to patients.
But last year the Ministry of Health told how Colleen Howe, 34, died from aggressive breast cancer following delays in her treatment when a PA misdiagnosed her lump as a blocked milk duct.
And Norman Jopling, 79, also suffered a serious brain haemorrhage after an associate wrongly told him his painful headaches were “nothing to worry about”.
In a Lords debate, Baroness Brinton, a Liberal Democrat, said last month that doctors had reported “70 cases of avoidable patient harm and near misses caused by AP”, including “deaths, missed diagnoses which caused terminal illnesses, sepsis and heart attacks.
A spokesperson for NHS England said: “Physician associate placements are secure roles and all training is carried out under the supervision of fully qualified mentors.”
‘Trainees will gain the same qualifications and mandatory standards of competency as students entering associate medical courses. They do not replace doctors in any way; as set out in the NHS Long Term Workforce Plan, they offer an alternative role in the associate doctor profession and improve access to healthcare roles.’