PAs feel they are being scapegoated by ministers to try to placate the BMA and stop doctors’ strikes, The i Paper is told
The BMA doctors’ strike poses the single biggest risk to patient safety, a physician associate (PA) has told The i Paper.
Thousands of resident doctors, previously known as junior doctors, began a five-day walkout on Friday after relations between the Government and British Medical Association (BMA) soured over a dispute about pay.
The walkout follows the publication of Professor Gillian Leng’s review into the physician associate and anaesthesia associates roles within the NHS.
The review acknowledged PAs have been used as substitutes for doctors, despite having significantly less training, and recommended major changes to their role – including banning them diagnosing patients who have not already had contact with a doctor for their illness.
The Health Secretary has accepted the recommendations.
‘The biggest risk to patients is not PAs but doctors’ strikes’
A PA who spoke to The i Paper on condition of anonymity said the review’s response to six high-profile patient deaths associated with PAs was “highly disproportionate”, and could lead to longer waiting times.
“There is a feeling within the PA communities that we are just being scapegoated by the Government to try and placate the BMA to stop their strikes,” she said.
“At this point, I feel like the biggest safety patient safety risk out there at the moment is the strikes in the BMA, not the few 1,000 PAs working across the country.”
The PA, whoi works in secondary care and has been in the role for about a decade, said: “Six deaths due to patients seeing a PA being involved in their care – they haven’t actually been the sole reason for the death – I think that’s highly disproportionate to limit an entire workforce based on that.”
PAs were introduced into the NHS in the early 2000s as a rapid measure to reduce workforce pressures in primary and secondary care, taking on duties such as carrying out blood tests, examinations and even diagnosing patients.
But in recent years a toxic row has erupted between doctors and PAs, with the former raising concerns about the blurring of lines between doctors and assistants.
Although she enjoyed good working relationships with junior doctors in the early part of her career, the PA said there has been a shift.
‘I feel really uncomfortable working alongside junior doctors’
“Since this whole BMA anti-PA agenda has started, I felt really uncomfortable working alongside the junior doctors and every time they rotate, I find it really affects my mental health because I get very anxious about,” she said.
There have been instances where FY1s [junior doctors in Foundation Year 1] have made “snarky comments” and remarked that PA examinations are so easy anyone could pass them, she added, while “social media bullying” was having an impact on her and her colleague’s mental health.
Doctors have also been critical of instances where PAs are paid more than them. PAs can be paid more than newly qualified resident doctors, but doctors have greater earning potential over the course of their career.
The PA claimed she and her colleagues had worse debts because their master’s degrees are not funded. “We have to fork out for those out of our own money,” she said. “I had to use my inheritance from my father that had passed away to fund my university degree.”
To aid patient identification of PAs, the Leng review suggested standardised lanyards or uniforms.
The PA said she always wears a name badge that says she is a physician associate, and patients never refuse her care but are “just very grateful to be seen by someone”.
She added: “I think at this rate, the BMA just wants us to plaster a big sticker on our forehead saying, ‘I’m not a doctor.”
Many PAs believe the release of the review was timed strategically in a bid to appease doctors and avert the strike.
Initially,it had been due to be published in the week commencing 7 July, but was eventually released on 16 July, days after the BMA announced strike action would begin the following week.
‘The hostile situation has made me think I want to leave healthcare’
While the doctors’ walkout is temporary, the PA said she and her colleagues could leave the NHS for good, and this would mean “waiting lists are going to increase”.
She added: “This hostile situation has made me think maybe I want to go in a different route and just leave the healthcare service altogether. If all the PAs in the country left tomorrow, it would make a big difference in the availability of seeing someone on the health service.”
Stephen Nash, general secretary of United Medical Associate Professionals (Umaps), which represents PAs, has raised concerned about how changes will affect patients’ access to care, particularly during the BMA strikes.
“Prior to these changes, PAs undertook approximately 20 million appointments a year,” he said. “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.”
Umaps is seeking a judicial review over the Leng review,
He added that Wes Streeting has “played right into the BMA’s hands, preventing qualified medical professionals from treating patients properly so that their strikes bite even harder”.
An NHS spokesperson said: “Bullying against any staff members is completely unacceptable and should not be tolerated in the NHS, and we would encourage staff to raise concerns with managers and to consider the range of well-being support available.
“The Leng Review concluded that physician assistants play a valued role as part of multidisciplinary teams, and we are now working with the Government and the wider health service to fully consider and implement its recommendations.”