Trust accused of ‘highly inappropriate’ physician associates policy

A union has criticised a hospital trust for “jeopardising patient safety” by issuing “highly inappropriate” instructions for resident doctors to approve prescription requests from physician associates.

The British Medical Association has written to University Hospitals Plymouth Trust to raise “serious concerns about the apparent unsafe and unprofessional working arrangements” between resident doctors and physician associates at the trust.

The letter comes after a leak on social media appeared to show resident doctors at one of UHP’s departments being instructed to set up a rota to sign off requests for prescriptions and imaging investigations made by a physician associate. The BMA has called for these instructions to be “urgently rescinded”.

Guidance from the General Medical Council states that physician associates cannot prescribe medication, even if they held prescribing rights in a previous role.

The letter to UHP’s interim chief executive Mark Hackett, from BMA council chair Phil Banfield, said the instructions “contain highly inappropriate directions to resident doctors which, if acted upon, would cause them to breach professional standards set by their regulator, risk their professional indemnity, and jeopardise patient safety.

“The rules on prescribing are clear, physician associates are not qualified or legally entitled to prescribe. This is not ‘due to a number of issues’ (as claimed in the instructions) that can somehow be circumvented by the trust – it is a necessary legal restriction put in place to protect patient safety.

“Our guidance (and that of the GMC) is clear that no resident doctor should automatically prescribe medications or request ionising radiation on behalf of another practitioner…. That resident doctors have been asked to organise a rota implementing such unsafe practices speaks volumes about the way they are viewed by their employer”.

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Source: HSJ, 19 June 2025