Physician associates face being struck off if they mislead patients to think they are doctors

Physician associates (PA) face being struck off if they mislead patients into thinking they are doctors under new guidance.

The workers will be regulated for the first time from next week by the General Medical Council (GMC), which has updated its guidance at the 11th hour to include deliberately misleading patients about their role as “serious misconduct”.

It comes after doctors criticised the decision not to make misleading the public a serious offence in the initial plans – which it is considered for doctors – during a consultation.

Plans to expand the use of PAs across the NHS have caused controversy over the last year with a series of patients coming to harm after being cared for by a PA.

Emily Chesterton, a 30-year-old actress, died after she was twice misdiagnosed by a PA as having an ankle sprain, when she actually had a blood clot that travelled from her leg to her lung. She had thought she was seeing a GP.

Under the new guidance any PA who does not declare that they are not a doctor, or allows a patient to believe they are being cared for by a doctor, will face a fitness-to-practise hearing.

If found guilty they will face a suspension or permanent ban from practising.

Last year, The Telegraph revealed how Ben Peters, 25, was sent home from A&E by a PA who thought his chest pains and vomiting were a panic attack and gastric inflammation. He died later that night from a rare heart complication that led to a fatal haemorrhage.

Last month, it was revealed that a woman who was being treated by a PA had died in July 2023 because a drain had been mistakenly left in her abdomen for 21 hours – 15 hours longer than permitted.

The inquest into Susan Pollitt’s death revealed the 77-year-old had died because of “unnecessary medical procedure contributed to by neglect”.

The Telegraph has also previously revealed the inappropriate and widespread use of PAs to carry out tasks that are only permitted by qualified doctors, which have included covering doctors’ shifts, prescribing medicines and ordering X-rays without supervision.

There are currently about 3,700 PAs and anaesthetic associates (AAs) working across GP surgeries and NHS hospital trusts in England.

They do not require a medical degree and must only study a two-year postgraduate course.

‘Legitimate concerns’

The NHS plans to dramatically increase the number of PAs working in the health service over the next decade, but last month, Wes Streeting declared that a review would be carried out because of “legitimate concerns”.

The PA register run by the GMC, which until now had exclusively regulated doctors, will be voluntary for two years. After December 2026 it will become an offence to practise in the UK without a GMC license.

The report, which was published on Thursday, also made other changes to the GMC’s initial proposals on regulating PAs.

It will also require two instead of one GMC case examiners to make decisions on fitness-to-practise cases involving PAs or AAs.

There will also be a specific requirement for course providers to ensure student PAs and AAs inform any patients that they are involved in their care.

Charlie Massey, the GMC chief executive, said: “Regulation is a vital step towards strengthening patient safety and public trust. It will provide assurance to patients, employers and colleagues that physician associates and anaesthesia associates have the right level of education and training, meet the standards we expect, and can be held to account if serious concerns are raised.

“This was, by its nature, a very technical consultation. But the feedback we have received has been extensive and helpful. We are grateful to everyone who took the time and effort to participate. By doing so they have, unquestionably, improved the regulation of these professions.”