BMA reveals “shocking” accounts of unsafe substitution of doctors which put patients at risk

The BMA has published a series of “disturbing” reports warning that patient safety is being repeatedly put at risk when those patients are looked after by less-qualified advanced practitioners (APs,) rather than doctors.  

Earlier this year the BMA revealed that nearly three quarters of doctors reported that advanced practitioners, staff who originally trained as nurses, paramedics, pharmacists, midwives or other professional roles, are routinely replacing doctors in their workplaces. In FOI responses to the BMA, half of hospitals in the UK admitted to using advanced practitioners to cover doctor rota gaps and including these staff on doctors’ rotas. The BMA believes this places staff without the necessary medical training in difficult and inappropriate positions with clear risks to patient safety.

With concerns rising over the deployment of advanced practitioner roles, the BMA launched a new tool in January for doctors to share their experiences directly. Doctors have since reported hundreds of patient safety incidents. These include a case where an advanced practitioner failed to arrange vital testing and referral for a child with meningitis and another in which advanced practitioners missed a cancer diagnosis, resulting in a patient “losing out on 6 weeks of time to get her affairs in order before dying.”

Responding to the accounts now made public, Dr Tom Dolphin, chair of BMA council, said:

“These are shocking accounts of patients being let down by the system. Patients are being put at risk of harm or even death because hospital managers are putting advanced practitioners and others into roles that should be filled by doctors, as this report and multiple inquests suggest.

"We have made clear, over and over, that there are times when patients must be seen by a doctor and this testimony lays out why in extensive, excruciating detail. Patients with missed diagnoses, patients with severe conditions given nothing but mild pain relief and sent on their way, and patients facing end of life conditions being offered totally substandard care: they all deserved so much better

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Source: BMA, 22 September 2026