The families of two patients who died after receiving care from physician associates (PAs) have joined a group of doctors in a legal challenge against the GMC.
Anaesthetists United – a group representing anaesthetists of all grades – is bringing a legal case against the regulator which calls for clearer distinctions between doctors and PAs or anaesthesia associates (AA).
So far, the group has raised almost £118,000 of its £250,000 target, with the Doctors’ Association UK (DAUK) now making up a substantial portion of the donations.
Over the last weekend, DAUK made a ‘significant donation’ of £30,000, saying it ‘underscores the medical profession’s deep-seated concerns over patient safety and professional standards’.
DAUK also called on royal colleges to ‘follow its lead’ by giving financial support to the case, and highlighted that this is ‘not an isolated action but part of a broader united front in the medical community’.
It comes as last week, the RCGP voted to change its stance on physician associates, declaring that they should have no role in GP practices.
The GMC will start to regulate PAs and AAs from the end of this year, following successful passage of legislation through Parliament in February.
On Sunday, Anaesthetists United announced that its case against the GMC had been ‘joined by two families who have suffered tragic bereavements following care delivered by Physician Associates’.
This includes the family of Emily Chesterton, a 30-year-old patient at a North London GP practice who died at the end of 2022 after seeing a PA.
The group of doctors said the support from bereaved families, revealed in the Mail on Sunday, is a ‘significant development’ and ‘underscores the gravity of the case’.
The families will prepare statements which will give evidence to the court in this case, according to Anaesthetists United.
Their crowdfunding page said: ‘We extend our deepest sympathy to them for their loss, and we are grateful for their courage and bravery in stepping forwards. It is critical that everyone understands just what inadequate standards, supervision and lack of regulation can lead to.’
When announcing its donation to the legal challenge, DAUK chair Ms Helen Fernandes said the GMC’s approach to regulating PAs is ‘fundamentally flawed’.
She continued: ‘It risks blurring the lines between fully qualified doctors and support staff, potentially misleading patients and compromising care quality.
‘We categorically back Anaesthetists United in demanding clear, enforceable guidance on the scope of practice for these roles.’
What the legal challenge aims to achieve
- Clear and enforceable guidance from the GMC on the ‘privileges of members’ admitted to Associate practice, defining what they can and cannot do (their Scope of Practice) and clear rules on levels of supervision. This can be delegated to the appropriately-empowered Medical College/Faculty;
- The current ‘Good Medical Practice’ guidance replaced by two separate sets of guidance for the two separate professions, and;
- An end to the use of the ambiguous term ‘Medical Professionals’ used to describe two separate groups misleadingly.
Source: Anaesthetists United
A GMC spokesperson said the regulator has responded to the Anaesthetists United’s lawyers after being informed of their ‘intention to seek a judicial review’.
The spokesperson continued: ‘We have made it very clear we will recognise and regulate doctors, PAs and AAs as three distinct professions.
‘We have also been consistent in saying that, as their regulator, we will expect PAs and AAs to always work under some degree of supervision and to practise within their competence. They will have a responsibility to clearly communicate who they are, and their role in the team.
‘To register with us, PAs and AAs will also need to show that they have the knowledge, skills, and experience to treat patients safely, and that there are no outstanding concerns about their fitness to practise.
‘Bringing PAs and AAs into regulation will help to assure patients, colleagues and employers that they are safe to practise and can be held to account if serious concerns are raised.’
In June, the BMA announced it was taking legal action against the GMC over its plans for PA regulation, and particularly about the use of the term ‘medical professionals’ in relation to PAs and AAs.
However, the GMC rejected the BMA’s legal challenge, claiming the grounds for judicial review are ‘not even arguable’.
The regulator ran a consultation from March until May this year which sought views on how it will regulate PAs – but the results have not yet been published.
It would be a landmark if they could persuade RCP to donate too. They seem very influential in this sphere.
Of course, part of the difficulty is that whilst a very small number of patients have died after seeing a PA; the vast majority of patient deaths occur after the patient saw a GP and/or a hospital doctor.
Sticking absolutely within one’s competence requires a significant amount of “knowing what you don’t know”, which is intrinsically limited in someone who has done lesser training and experience. And since the whole concept of PAs was apparently to produce cheaper professionals by giving them less training, they have less opportunities to learn about what they might not know enough about to be competent. It is an inherent flaw, which some individuals have overcome, but the vast majority were trained to not know about.
Misery everywhere so theres a whip-round for ‘the legal profession’ . Churches lie empty, a country seemingly dying and the vultures grow fat
I hope the families can exert political pressure to dissuade Mr Sweeting who is hell bent to fix the ‘broken’ NHS and shove up PAs -ahem I mean put PAs in every practice. Certainly, we cannot expect RCGP to stand by the stand they have taken. After all, how will they appointed to the next honours list or govt post if they did.