A group of senior doctors is planning to sue the General Medical Council in an unprecedented attack on the NHS's growing reliance on physician associates (PAs).
They claim that PAs – medics who have only two years' healthcare training and are supposed to work alongside doctors and GPs – are increasingly being used to plug staffing gaps in the Health Service.
The group, Anaesthetists United, has raised more than £50,000 to take the GMC to court, claiming that its plan to start regulating the so-called 'cut-price medics' fails to set out clear rules over what PAs can and cannot do.
PAs are supposed to have limited responsibilities, including taking patients' medical histories, performing basic physical examinations and analysing test results, all of which should be carried out under the supervision of a doctor.
Some PAs are also allowed to assist in the sedation of patients prior to surgery, and are known as anaesthesia associates (AAs).
Actress Emily Chesterton, 30, died after a PA mistook the symptoms of a blood clot for anxiety
However, doctors claim that staffing crises mean that hospitals are 'bending the rules' to allow PAs to work unsupervised and in roles beyond their expertise.
In the past year there have been reports of PAs requesting prescriptions, discharging patients from hospital without a sign-off from a doctor and even taking part in brain surgery.
There have also been cases where mistakes by PAs have led to the deaths of patients.
Doctors involved in the legal action say they want the GMC – the independent regulator of doctors in the UK – to clearly define the limits of associates' roles to stop them performing complex medical tasks which could put patients in danger.
Consultant anaesthetist Dr Richard Marks, who is leading the group, told The Mail on Sunday: 'No one actually knows what a physician associate is.
'Their scope of practice has not been clearly defined, and I think that's deliberate.
'It's effectively a green light for health bosses in local trusts to push them into whichever roles they want.
'But how can you regulate a profession when there are no clear boundaries which define the limits of their role?'
The NHS plans to recruit some 10,000 PAs by 2038 to relieve the strain on the NHS and free up time for doctors and nurses.
However, this has been staunchly opposed by doctors who say it confuses the role of doctors with associates.
The British Medical Association, which represents doctors, described it as a 'slap in the face' and said the move would not boost patient safety.
The Mail on Sunday first raised the alarm about PAs last year and has since been running a campaign to Rein In The Physician Associates.
We told how Colleen Howe, 34, died from breast cancer following delays in her treatment when a lump was misdiagnosed by a PA as a blocked milk duct.
And actress Emily Chesterton, 30, died after a PA mistook the symptoms of a blood clot for anxiety, while Norman Jopling, 79, was left fighting for his life after a serious brain bleed was mistaken for a painful headache.
Experts say these tragic failures are often due to the fact that PAs are being asked by hospital managers to perform tasks they are not qualified to do.
A group of senior doctors is planning to sue the General Medical Council in an unprecedented attack on the NHS 's growing reliance on physician associates (PAs)
In September 2023 it was reported that a PA had told The Physician Associate Podcast that he had taken part in brain surgery.
And earlier this year, a Freedom of Information request revealed that PAs at Leeds Teaching Hospitals NHS Trust had ordered more than 1,000 scans, including X-rays and CT scans – a task which only doctors are allowed to do.
The hospital claimed that this was due to a 'system error' and that no patients were harmed as a result.
Dr Marks pointed out that many associates were 'brilliant, and really talented' but added: 'It does raise questions about patient safety if associates' roles can't be defined.
'We need this to protect patients, but also to protect associates from being forced into doing things beyond their expertise, which we know is happening.
'I can't just say to my anaesthetist registrar, who might not have paediatrics experience, to look after a three-year-old, but with PAs they can just switch specialties and there's no mechanism to restrict that.
'Things will get missed.'
Anaesthetists United wrote to the GMC about its concerns in March but was 'unsatisfied' with the regulator's response and said 'the only route left' was a legal one.
Having raised more than £50,000 to fund the legal challenge, it has now set a new target of £100,000 to help fight the case in court.
The group also wants the GMC to ensure PAs are not referred to as 'medical professionals' so patients cannot confuse them with doctors, and that patients are always told when they are treated by a PA.
'I don't understand why the GMC wouldn't want to make regulation more robust,' Dr Marks said.
'They set standards for doctors – why would they allow themselves to cheapen their brand?'
A GMC spokesman said: 'We note the campaign by Anaesthetists United. We continue to listen to views from doctors, PAs and AAs and others.'
