BMA reporting portal submissions: patient safety - advanced practice roles (22 September 2026)

Summary

Advanced Practitioners (APs) are healthcare professionals deployed in a variety of heterogeneous roles around the NHS; they bring skills and knowledge from their various background professions to their work, and patients can benefit from that experience in the right role. The healthcare team benefits from different perspectives and skill sets being present. However, around the NHS there is wide variation in how AP roles are designed and deployed, what the staff in those roles are expected to do, and who regulates them.

The medical profession is increasingly concerned that some APs are being asked to do things that only doctors should be doing. This blurring of roles is often driven by understaffing of medical rotas or misunderstanding of what different professions are for. It leads to risks to patients where critical decisions and interventions that should be made by a doctor are made by others.

In response to growing concerns within the medical profession about how NHS employers are utilising and deploying advanced practitioners, the BMA launched a new reporting system in January 2026 to understand its depth and breadth. In April a series of Freedom of Information requests by the BMA revealed that half of hospitals in the UK deployed advanced practitioners to cover doctor rota gaps and included these staff on medical rotas. Those who admitted to directly replacing doctors with differently qualified staff told the BMA, in a series of admissions, that this practice should not happen, but that it does in response to service pressure.

Please continue to use the BMA reporting portal to share your experiences without identifying any other healthcare professional or patient: Doctor substitution reporting portal

Further reading on the hub:

• BMA Reporting Portal Submissions: Physician Associates and Anaesthesia Associates