Physician associates union takes government to court over planned role changes
A union will take the Government to court over its decision to implement recommended changes to the roles of physician associates (PAs) within the NHS, the United Medical Associate Professionals (UMAPs) has said.
It follows findings by a Government-ordered report that PAs have been used as substitutes for doctors despite having significantly less training.
The review chaired by Professor Gillian Leng, who is president of the Royal Society of Medicine, said PAs should be banned from seeing patients who have not been reviewed by a medic to prevent the risk of “catastrophic” misdiagnoses.
On Sunday, UMAPs has sent letters to the health secretary and NHS England expressing their intent to make a judicial review claim, the union said.
They are urging the government to reconsider what the union described as a “complete overhaul” of their profession, and have accused Streeting of playing into the hand of the British Medical Association (BMA) as resident doctors strike over pay.
Stephen Nash, general secretary of Umaps said: “The Leng Review found no hard evidence that physician associates are unsafe or ineffective.
“Nevertheless, Wes Streeting has accepted the Review’s recommendations to completely overhaul our job roles, without so much as consulting Umaps as the recognised trade union for PAs and AAs.
“That is both unfair and completely irrational.
“We are incredibly concerned about how these changes will impact patients’ access to care, particularly during the ongoing BMA strikes.”
A five-day walkout by resident doctors in England is under way, with members of the BMA manning picket lines across the country.
The Government has until August 1 to indicate whether or not it will reconsider its decision, the union said.
More than 3,500 PAs and 100 AAs are working in the NHS and there have been previous calls for an expansion in their number.
But a general lack of support for both roles from the medical profession, plus high-profile deaths of patients who were misdiagnosed by PAs, led to the review.
In her report, Leng concluded there were “no convincing reasons to abolish the roles of AA or PA” but there is also no case “for continuing with the roles unchanged”.
She said more detail was needed on which patients can be seen by PAs and national clinical protocols will now be developed in this area.
“Prior to these changes, PAs undertook approximately 20 million appointments a year,” Mr Nash added.
“Now, every day we hear from employers who are struggling to manage patient loads because PAs and AAs are no longer allowed to carry out the jobs we are trained to do.
“Yet the health secretary has seemingly not carried out any assessment of how the Leng recommendations will affect NHS backlogs.
“It is hard to see Streeting’s decision as anything other than an attempt to mollify the increasingly radical BMA, which has spent the last few years waging a vindictive and highly coordinated campaign against Medical Associates.
“Now he has played right into the BMA’s hand, preventing qualified medical professionals from treating patients properly so that their strikes bite even harder.”
Sneha Naiwal, a partner at Shakespeare Martineau which is leading the case for UMAPs, said: “This case is not about resisting change, but about ensuring that change is lawful, evidence-based, and respectful of the professionals who have long served on the front lines of patient care.
“Physician associates deserve a meaningful voice in shaping their future, not to be sidelined by decisions taken without full and open engagement.
“The claimants are concerned that the current approach could undermine a vital part of the clinical workforce and increase pressure on NHS services, to the detriment of patients and staff alike.”
Six patient deaths linked to contact with PAs have been recorded by coroners in England.
One high-profile death involved Emily Chesterton, 30, who died from a pulmonary embolism.
She was misdiagnosed by a PA on two occasions and told she had anxiety.
A Department of Health and Social Care spokesperson said: “The Government launched this review to make sure patients get the highest quality care, have clarity about who is treating them, and have confidence in the health system.
“Gillian Leng is one of the UK’s most experienced healthcare leaders and has delivered a comprehensive report.
“The health secretary has agreed to implement the recommendations of her report in full, prioritising safety and reassuring patients that, when they seek medical advice for a range of symptoms, they will be seen and diagnosed by a qualified doctor.”
By Mathilde Grandjean, PA