The NHS should stop recruiting physician associates on paediatric wards because of concerns over safety, children’s doctors say.
The Royal College of Paediatrics and Child Health has called for an immediate ‘pause’ until there are clearer guidelines on how they are deployed.
It follows a ‘comprehensive consultation’ with its members on their views and experiences of physician associates (PAs), who undergo less rigorous training than doctors.
Over 2,000 paediatricians in the UK responded to a survey, with 80 per cent of respondents agreeing or strongly agreeing that ‘PA recruitment should be halted whilst the NHS develops structures for appropriate deployment of PAs’.
Some 94 per cent said the NHS should centrally define a training framework and scope of practice for PAs across their specialty work areas.
The move comes after the Royal College of General Practitioners and British Medical Association also formally opposed their use.
PAs only have to complete a two-year postgraduate course, rather than a medical degree.
Some courses let students join after studying geography, human resources or English literature.
Their role is to ‘support doctors in the diagnosis and management of patients’ and they can be deployed across GP surgeries and hospitals.
The NHS has revealed plans to expand the role as a way of coping with growing demand for care.
However, they have come under scrutiny in recent years following the 2002 death of Emily Chesterton, who suffered a pulmonary embolism at the age of 30 after being misdiagnosed by a PA on two occasions.
Alder Hey Children’s Hospital in Liverpool has sparked controversy for the way it deployed PAs and has since stopped using them in its safeguarding team.
It admitted earlier this year that the Crown Prosecution Service and police did not feel able to rely upon examination reports produced by a PA in cases of physical abuse and neglect.
The RCPCH said: ‘Having a well-supported and skilled multidisciplinary team (MDT) is beneficial for children and young people and supports the robustness of the paediatric workforce.
‘Clarity about the different roles within the MDT is important – for team members, for patients, and for PAs themselves.
‘Clinical directors and service leads should ensure they and their paediatric teams are aware of the supervision arrangements for PAs in their teams.
‘In addition, all health professionals should have a clear training pathway that meets a nationally led and understood scope of practice for that role, which is underpinned by professional regulation.
‘Whilst local training structures might be in place for some PAs working in paediatrics currently, no central structures exist.
‘RCPCH recognises that PAs can provide important contributions to multidisciplinary teams.
‘However, while this work is undertaken, we would once again remind local systems that PAs must not replace the role of paediatricians in the delivery of care to children and young people.’
A Department of Health and Social Care spokesman said: ‘Physician associates play an important role in the NHS, as they have for over two decades, but we are clear they should be supporting, not replacing, doctors and should receive the appropriate level of supervision by healthcare organisations.
‘The NHS has issued clear guidance on the deployment of physician associates, which we expect Trusts to follow.’
