Doctors say regulation of health care providers is long overdue. Photo: MartinPrescott/E+
The government has ignored experts' warnings about regulating health care professionals (PAs). ) for more than two decades, and now patients are suffering, doctors say.
Warnings about the need for regulation predate the official introduction of PA in 2003.
A leading doctors' union blamed the «indecisiveness of successive governments» for the «extremely dangerous» increase in the number of health workers serving as doctors.
Jeremy Hunt, the then health secretary, told a House of Lords committee in 2016 that the government » fully intends to pass a regulatory reform bill» and it is «a matter of seeking a seat in Parliament», citing the Brexit debate as the reason for the delay. .
Seven years, two consultations and at least two deaths later, PA regulation is still a year away after a series of delays that the Faculty of Junior Doctors themselves have described as «frustrating».
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Regulation will give PAs accreditation to practice and clear powers, which could be revoked if they breach the guidelines, as is the case with other health professions.
Dr Matt Neal, co-chair of the UK Doctors' Association, told The Telegraph that the lack of regulation «poses a significant risk to both patient safety , and for the general standard of care in the National Health System.»
He said oversight of doctors taking responsibility for PAs was not a “sustainable long-term solution.”
Lack of action
“Regulation could and should have been introduced sooner to prevent incidents of harm to patients. The lack of action for more than two decades is worrying and requires urgent action,” he added.
The Department of Health's first consultation, published in 2017, acknowledged that the «risk of harm to patients» from PAs was «high» in three key areas identified by the Professional Standards Authority: intervention, context and accountability.< /p>
This included the example: «do they make decisions that affect individual mortality or morbidity, what degree of autonomy and delegated responsibility do they have from senior professionals?»
In the past six months, there have been two reports of deaths due to a doctor's assistant misdiagnosing treatable but ultimately fatal conditions.
Emily Chesteron, 30, was told her deep vein thrombosis was a distension ligaments, and 69-year-old Peter Marshall was told he had irritable bowel syndrome — in fact it was bowel cancer.
Warnings about the recruitment of physician assistants in the NHS date back to a 2001 study carried out by researchers at St George's Hospital. Hospital Medical School, which is now one of the largest PA instructors.
Published in the British Medical Journal, it assessed the introduction of the «American-style physician assistant.»
It concluded : “It would be a shame to respond to the looming medical staff shortage by creating a mini-medic” and lose the opportunity to simultaneously overcome obstacles to expanding practice and providing continuity of care.”
A separate 2005 study by experts at the University of Birmingham stated that «it is clear that risks to public safety exist if there is not a readily available mechanism to check current professional registration and to pass PA alerts through the NHS, as exists in other countries.» professions.”
And the paper, based on research commissioned by the Scottish Health Executive in 2007 when PAs were being piloted in Scotland, said that “regulation is essential to long-term establishment of this role.”
Protecting the public
It says regulation is needed to “protect the public”, “maintain the boundaries and purpose” of a job and “ensure standardization so that new roles are defined and recognized and skills can be transferred between employers”.
The General Medical Council (GMC) will regulate PAs from the end of 2024, according to current plans.
Dr Naru Narayanan, president of the Association of Hospital Consultants and Specialists, told the Telegraph he was concerned the GMC was planning to bring PAs under «the same code of practice as doctors».
«Governments' indecision on regulation has led to » “scaling up,” where junior specialists are increasingly expected to perform duties that were previously limited to doctors,” he explained.
“This can be extremely dangerous,” he explained. he said, adding that the rules should include a «red line» where the PA's responsibility ends and the doctor's responsibility begins.
A Department of Health spokesman said: «The role of staff is to work with and support doctors so that they can focus on tasks for which they are capable. This supports our ambitions to grow our multidisciplinary NHS workforce, as well as our commitment under the NHS Long Term Workforce Plan to increase the number of doctors in the NHS by 60,000 by 2036/37.
Safety Patients remain a top priority, which is why we are working with the General Medical Council to introduce legislation for junior doctors and anesthetists as soon as possible, which will help provide further clarity for patients and healthcare professionals about the nature of these roles and their respective areas of practice. practices.»
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