Suffolk Doctor MP raises concern about physician associates after near-fatal mistake
Dr Dan Poulter told the Commons he had to “directly intervene” last year, when a health professional did not properly treat a paracetamol overdose
Last updated 8th Feb 2024
Physician associates need better training and regulation, a Tory MP said as he shared his experience of a mistake by one which could have proved fatal.
Conservative former health minister, Dr Dan Poulter, raised concerns about physician associates (PAs), as he told the Commons he had to “directly intervene” last year when one of the health professionals did not properly treat a paracetamol overdose.
The Central Suffolk and North Ipswich MP, who is a working doctor, said some PAs “lack the self-awareness to understand the limits of their knowledge” as he made the case for better oversight of the role.
PAs, as well as anaesthesia associates (AAs), were introduced in the early 2000s in a bid to ensure enough staff are available to look after patients.
The roles, known as medical associate professions, require less rigorous training than becoming a doctor, and have been subject to heightened scrutiny in recent years because of high profile cases of mistakes being made.
Dr Poulter told the Commons: “There are many examples of poor clinical diagnosis and judgment, for example making initial decisions to send patients with compound fractures home without an X-ray having been performed, and when the patient actually required surgery.
“In my own clinical practice, I have worked alongside some very competent physician associates, but there is a high degree of variability in their training and skills.
“Only last year, I was forced to directly intervene to prevent patient harm following a paracetamol overdose by a patient who attended A&E.
“The physician associate incorrectly informed me that they didn’t require what is called NAC treatment because of their liver function test being normal, in spite of the fact that they were over the treatment line as a result of their paracetamol overdose.
“Of course, at that time, the patient’s liver function tests were normal, they wouldn’t have been for very long, and the consequences of that diagnostic decision by the physician associate could have been fatal.
“A key issue for me is that many physician associates don’t know or lack the self-awareness to understand the limits of their knowledge and practice, but this is perhaps understandable in a health system that fails to adequately regulate and indeed define their scope of practice.”
The Tory MP called on ministers to ensure a “standardised and quality assured training programme” for physician associates and other similar roles, and to ensure the General Medical Council sets up a separate register for regulation of medical associate professions to the register for doctors.
Dr Poulter also said PAs’ “scope of practice” needed to be made more clear to ensure patients are safe in their hands.
Health minister Andrew Stephenson said: “The GMC (General Medical Council) have assured me that whilst they have the draft regulations out there they will be further … consulting on them later this year.”
He added: “Whilst at the moment there is significant variability in the system, I very much hope the regulations which we passed through this House on January 17 help provide that clarity and help give the GMC the powers it needs to be able to ensure that the training provided to physician associates is of the appropriate quality for the role that we’re expecting them to undertake in our NHS.”