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Patient Safety Learning

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  1. Patient Safety Learning
    Thousands of women may be missing out on a diagnosis of type 2 diabetes because the thresholds are geared towards men, research suggests.
    Scientists assessed test results from more than one million patients across the country and concluded that the bar for diagnosis might be set too high for women. They calculated that, if thresholds were lowered slightly, an extra 35,000 women under the age of 50 in England would be diagnosed with type 2 diabetes — increasing the number in this age group with the condition by 17%.
    Under the present guidelines, those 35,000 women would be given the all-clear and would miss out on the chance of earlier treatment and lifestyle advice, increasing their risk of complications in later life.
    The team, led by doctors at the University of Manchester and including researchers from hospitals nationwide, stressed that their findings were preliminary, and needed further assessment before their hypothesis was confirmed. But, if proved correct, they believe that about 65 young women may be dying of diabetes each year without a diagnosis.
    Read full story (paywalled)
    Source: The Times, 1 October 2023
     
  2. Patient Safety Learning
    Former police officers, including a murder detective, have been hired by NHS hospitals in a move that campaigners have warned risks discouraging whistleblowers.
    The Sunday Telegraph has revealted that retired officers have been employed by a trust currently under scrutiny for its treatment of doctors who raise patient safety concerns.
    One of them has taken up a patient safety incident investigator role worth up to £57,349 a year. Meanwhile a senior detective has been called into multiple trusts on an ad hoc basis to conduct investigations.
    Last night a leading patient group called on the NHS to be transparent about exactly how such personnel are being used, “given the ongoing concerns about how such roles interact with whistleblowers”.
    Paul Whiteing, chief executive of the charity Action Against Medical Accidents (AvMA), said: “We at AvMA welcome any steps taken by Trusts to professionalise the investigation of patient safety incidents. This is long overdue. 
    “But given the on-going concerns about how such roles interact with whistleblowers, to maintain trust and confidence of all of the staff, trusts need to be clear, open and transparent about why they are making such appointments and the role and duties of those they employ to fulfil them, whatever their backgrounds.”
    Campaigners have warned that some NHS trusts deliberately seek to conflate patient safety issues with staff workplace investigations.
    Read full story (paywalled)
    Source: The Telegraph, 30 September 2023
  3. Patient Safety Learning
    The mother of a four-year-old boy with complex needs said she fears he could die waiting for life-changing surgery.
    Collette Mullan made the claim to BBC Spotlight as it examined the scale of hospital waiting lists.
    Northern Ireland has the worst waiting times in the UK, with more than half a million cases queued for an outpatient or inpatient appointment.
    The Department of Health has described current waiting lists as "entirely unacceptable".
    Óisín, from County Londonderry, has a number of health conditions including cerebral palsy, and is currently waiting for two procedures.
    He is fed with a tube that carries his food through his nose into his stomach, but since it was inserted six months ago, his mum Collette said he has struggled to breathe.
    Óisín is now waiting to have the nasogastric tube removed and replaced by a different feeding system which goes directly to his stomach.
    Collette said she was told it could be a three-year wait for the procedure.
    She is concerned that Óisín's cerebral palsy puts him at a greater risk of complications, saying she had been warned there was a danger he could aspirate.
    "He could die. Anything going into his lung really, it could be very dangerous," she said.
    Read full story
    Source: BBC News, 3 October 2023
     
  4. Patient Safety Learning
    A trust has been reprimanded by the Information Commissioner’s Office (ICO) for exposing a domestic abuse victim to risk by disclosing their address to an ex-partner.
    University Hospitals Dorset Foundation Trust is one of only seven organisations in the UK – and the only NHS organisation – to have received a reprimand since July 2022 for a data breach involving a victim of domestic abuse.
    According to new details released by the ICO, University Hospitals Dorset received a reprimand in April this year over a procedure it had in place that, when sending correspondence by letter, would include the full addresses of all recipients of that letter without their consent to do so.
    In the case that was referred to the ICO, the subject of the data breach had their full address revealed to their ex-partner despite previous allegations of abuse, which has created a “risk of unwanted contact which will remain”.
    The ICO concluded that, while the subject did not request their address be withheld, it would not be a reasonable expectation that personal information would be shared without prior consent.
    The report raised concerns that UHD did not have a clear policy in place for managing situations where there are parental disputes and that no formal training was provided to administrative staff for dealing with such circumstances.
    Read full story (paywalled)
    Source: HSJ, 2 October 2023
  5. Patient Safety Learning
    A group of 67 women from Greenland are seeking compensation from the Danish government over a campaign of involuntary birth control in the 1960s.
    At least 4,500 women, some of them teenagers, were fitted with coils under a programme intended to limit birth rates among the indigenous population.
    An inquiry is due to conclude in 2025, but the women, some of whom are in their 70s, want compensation now.
    They are seeking 300,000 kroner (£34,880; $42,150) each.
    Records from the national archives showed that, between 1966 and 1970 alone, intrauterine devices (IUDs) were fitted into the women, some as young as 13, without their knowledge or consent.
    A commission set up by the Danish and Greenlandic governments to investigate the programme is not due to deliver its findings until May 2025.
    "We don't want to wait for the results of the inquiry," said psychologist Naja Lyberth, who initiated the compensation claim.
    "We are getting older. The oldest of us, who had IUDs inserted in the 1960s, were born in the 1940s and are approaching 80. We want to act now."
    Ms Lyberth said that, in some cases, the devices fitted had been too big for the girls' bodies, causing serious health complications or even infertility, while in others the women had been unaware of the devices until they were discovered recently by gynaecologists.
    She accused the Danish government of the time of wanting to control the size of Greenland's population in order to save money on welfare.
    "It's already 100% clear that the government has broken the law by violating our human rights and causing us serious harm," she said.
    Read full story
    Source: BBC News, 3 October 2023
  6. Patient Safety Learning
    The impact of successive doctors’ strikes is now ‘causing significant disruption and risk to patients’, including to those needing urgent heart and cancer treatment, NHS England leaders have told the BMA in their strongest warnings yet.
    A letter to the union’s council chair on Tuesday evening, leaked to HSJ, said: “We are increasingly concerned that the cumulative impact of this action is causing significant disruption and risk to patients…
    “We are extremely concerned that Christmas Day cover is insufficient to ensure appropriate levels of patient safety are being maintained across local health systems. This is particularly the case in the current period of industrial action, with three consecutive Christmas Day levels of service.”
    Although Christmas Day includes cover for emergency care, the officials said that in practice – with demand above Christmas Day levels, and with successive days and repeated strikes – it was not protecting patients needing urgent care.
    The letter, signed by NHSE leaders including chief medical officer Sir Steve Powis, and chief nurse Dame Ruth May, goes on: “Secondly, we are becoming increasingly concerned that combined periods of industrial action are impacting on our ability to manage individuals who require time-sensitive urgent treatment, for example cardiac, cancer or cardiovascular patients, or women needing urgent caesarean sections.”
    Read full story (paywalled)
    Source: HSJ, 3 October 2023
  7. Patient Safety Learning
    A district general hospital has accused a major teaching trust of ‘failing to adhere to arrangements’ made around the provision of acute stroke services, sparking patient safety warnings in a local integrated care board’s (ICB) risk register.
    Harrogate and District Foundation Trust’s accusation that its neighbour, Leeds Teaching Hospitals Trust, is failing to comply with protocol around acute stroke pathways was published in West Yorkshire ICB’s risk register.
    The ICB’s September risk register also said the “risk to patient safety is significant and probable if the situation remains unresolved”.
    The issues centre on the provision of hyper-acute stroke unit beds, which provide the first two to three days of care for patients with newly diagnosed strokes, and what happens to patients requiring acute stroke care following their initial HASU stay.
    West Yorkshire ICB said in its September’s performance report that the problem had “grown due to two recent clinical incidents,” but added “there is no quick solution to this problem”.
    Harrogate has raised concerns with the ICB in recent months that “a number of patients are not receiving HASU level care at Leeds”.
    Read full story (paywalled)
    Source: HSJ, 3 October 2023
  8. Patient Safety Learning
    Transgender people may be banned from single-sex hospital wards under plans to restore "common sense" in the NHS, the health secretary says.
    Speaking at the Conservative party conference, Steve Barclay announced a consultation on strengthening the protections in place for women.
    NHS guidance issued in 2021 said trans people may be placed on wards according to the gender they identify as. 
    The change would stop that with trans people given their own rooms and areas. But doctors have questioned whether there are the facilities available to achieve that.
    And the move would have to meet the legal threshold set by the Equality Act, which allows trans people to be excluded from single-sex spaces if there is a proportionate means of achieving a legitimate aim, such as privacy or safety.
    Mr Barclay said he wanted to make sure the "dignity, safety and privacy" of all patients was respected, while the rights of women are protected.
    Read full story
    Source: BBC News, 3 October 2023
  9. Patient Safety Learning
    Thousands of people unaware they have type 2 diabetes could be diagnosed and avoid serious complications if screening was introduced in emergency departments, a study suggests.
    The prevalence of the disease has risen dramatically in countries of all income levels in the last three decades, according to the World Health Organization. More than 400 million people have been diagnosed, but millions more are estimated to be in the dark about the fact they have the condition.
    A study that took place in an NHS trust in England suggests 10% more cases could be picked up with the use of a simple blood test. Screening could also pick up 30% more cases of pre-diabetes – a serious condition where blood sugar levels are higher than normal.
    The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany.
    “Early diagnosis is the best way to avoid the devastating complications of type 2 diabetes, and offers the best chance of living a long and healthy life,” said Prof Edward Jude, of Tameside and Glossop integrated care NHS foundation trust.
    Read full story
    Source: The Guardian, 3 October 2023
  10. Patient Safety Learning
    The NHS has too few staff to prepare for a pandemic surge, while its ageing buildings and social care’s weak ‘resilience and capacity’ would also undermine its response, NHS England has warned.
    A new NHSE submission to the Covid-19 public inquiry says funding pressure from 2010 has undermined the health service’s “resilience” and that “resilience and capacity issues in social care are national issues which must be addressed from the centre”.
    The document was posted unnoticed on the inquiry website last month. No current or former NHSE leaders have so far given evidence to the inquiry. It is the first time NHSE has clearly set out that understaffing and underinvestment compromised the service’s readiness to deal with the pandemic.
    Referring to the NHS’s ability to create “surge capacity [with] flexible staff and equipment which can be pivoted into different roles”, it goes on: “It is only possible to train staff to work more flexibly into different roles/environments if they can be freed up to attend training and refreshers. 
    “This requires ‘surplus’ staff numbers on rotas, which is not currently possible in relation to many staffing groups across the NHS.”
    Read full story (paywalled)
    Source: HSJ, 3 October 2023
  11. Patient Safety Learning
    Doctors missed a man’s stroke which led him to suffer another one and go temporarily blind.
    The man said that the experience had changed him from ‘an outgoing social person, to a sheltered man living in fear that he is not being looked after competently’.
    The 75-year-old visited his GP in Darlington complaining of dizziness, light-headedness, and a numb foot. 
    He had experienced a stroke and should have been immediately sent to hospital. But doctors missed the signs, diagnosed him with a ‘dropped foot’ and requested an urgent MRI scan. However, due to an administrative error the referral wasn’t made and the scan never happened.
    A month after visiting the GP, the man suffered a blinding headache and diminished vision. He saw an ophthalmologist who referred him to a specialist team.
    He had suffered another stroke. He also paid for a private scan which confirmed the first stroke happened a month earlier.
    Distressingly, the man lost vision in his right eye, which he was told could be permanent. Fortunately, his sight returned eight weeks later.
    His daughter, who described the experience as ‘horrendous’, complained to the Parliamentary and Health Service Ombudsman (PHSO) about her father’s care.
    The PHSO found that the initial symptoms were signs of a problem with nerve, spinal cord, or brain function. Doctors should have suspected a stroke and immediately sent him to hospital. If that had happened, the second stroke and sight loss would likely have been avoided.
    Ombudsman Rob Behrens said:
    “Having a stroke and then being told you could be permanently blind must have been incredibly frightening. The impact on the man, and his family who supported him through the ordeal, will have been deep and long-lasting.
    “Mistakes like these need to be recognised and acted upon so that they are not repeated.”
    Read full press release
    Read case file
    Source: PHSO, 4 October 2023
  12. Patient Safety Learning
    The number of doctors seeking help for mental health issues has risen by more than three quarters within two years, according to figures from a specialist treatment service for NHS staff. For one GP, the relentless stress of the job led to him taking three months off work with burnout.
    David Triska is no stranger to high-pressure situations. As an army medic, he served two tours of Afghanistan.
    But mounting workloads at his village GP surgery left him feeling "hollowed out and spent". Simple tasks, like unlocking his car or making a meal, became a challenge - an experience he describes as leaving him feeling "like a husk of a human".
    "At that extreme point, I couldn't see why I needed to be here anymore," Dr Triska said.
    He is not alone. Since the year ending March 2021, there has been a 77% rise in the number of doctors seeking help for mental health issues, according to figures shared with the BBC by a confidential support service for NHS staff.
    More than 5,600 doctors used the NHS Practitioner Health programme in England in 2022/23, with about a third having thought about taking their own lives.
    Read full story
    Source: BBC News, 5 October 2023
  13. Patient Safety Learning
    People who seek help for mental health issues should be asked about problem gambling in the same way they are asked about drugs, smoking and alcohol, new guidance has suggested.
    According to the National Institute for Health and Care Excellence (NICE), those who visit an NHS health professional in England for depression, anxiety or thoughts about self-harm or suicide because of a possible addiction, such as alcohol or drugs, could be at a greater risk of harm from gambling.
    NICE said questions should be asked about patients’ gambling habits to ensure they could cope with their thoughts and urges. In new draft guidance, it suggested patients should be encouraged to assess the severity of their gambling by using a questionnaire available on the NHS website. Those who scored eight or higher should seek support and treatment from gambling services.
    Read full story
    Source: The Guardian, 5 October 2023
  14. Patient Safety Learning
    The use of non-medics in clinical roles is leading to deaths and missed diagnoses, senior doctors have warned.
    Hundreds of doctors have signed an open letter to the leadership of the Royal College of Physicians (RCP), urging them to take a stand over the rollout of physician associates (PAs).
    PAs are a newer type of medical role that involves significantly less training than doctors receive. The NHS has used PAs since 2003 but concerns have emerged in recent months about them taking on more advanced work than is appropriate.
    NHS England set out plans earlier this year to expand their numbers significantly amid ongoing staff shortages.
    Now an open letter to the RCP’s council, to date signed by 46 fellows of the college and 194 other doctors, sets out concerns ranging from patient safety and liability to the fact that newly qualified PAs can earn more than newly qualified doctors.
    They say: “There have been several high-profile incidents in which serious illness was missed by a PA when undertaking a role that would normally be filled by a doctor. In some cases, avoidable deaths have resulted.
    “Given that some of these conditions required more advanced training than the PA had received, the implication is that rare avoidable deaths are a price society must pay for the replacement of medical staff with non-medical staff. We believe this trade-off must be debated widely not just by doctors but also by the lay public.”
    Read full story (paywalled)
    Source: The Times, 5 October 2023
  15. Patient Safety Learning
    Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows.
    Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades.
    It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure.
    Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram.

    Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers.
    Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system."
    “The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added.
    Read full story (paywalled)
    Source: The Times, 5 October 2023
  16. Patient Safety Learning
    The ambulance sector has signed up to a consensus statement in a bid to tackle misogyny and improve sexual safety for its staff and patients.
    The statement – which chief allied health professions officer for England Suzanne Rastrick launched at this week’s Ambulance Leadership Forum – commits the service to a “cultural transformation”.
    Several ambulance trusts have been criticised for a culture which includes “highly sexualised banter” in recent years, with reports highlighting sexual harassment, often of younger female staff.
    The statement’s guiding principles include: a focus on protecting staff from misogyny and inappropriate sexual behaviour; removing barriers to speaking up and supporting those affected; and working towards an inclusive culture where staff understand misogyny and come to work feeling “sexually safe”.
    Read full story (paywalled)
    Source: HSJ, 5 October 2023
  17. Patient Safety Learning
    The NHS ombudsman has told a health trust chief to withdraw “not accurate” remarks about him amid an alleged attempt to play down up to 1,000 avoidable patient deaths.
    Rob Behrens wrote to Stuart Richardson, the head of the Norfolk and Suffolk mental health NHS trust, over remarks he made about him to Norfolk county council’s health scrutiny committee.
    The councillors on the committee were questioning Richardson over claims reported by the BBC’s Newsnight programme that his trust had “watered down” a report into what are thought to be the avoidable deaths of up to 1,000 patients.
    The changes between different versions of the document toned down criticism of the trust’s leadership, a move that drew criticism from Behrens and bereaved relatives.
    For example, the auditors, Grant Thornton, removed references included in the first version to the trust’s governance being “poor, … weak [and] inadequate”, after discussions with trust bosses. The trust and Grant Thornton said the changes were part of a normal factchecking process.
    Referring to the changes, Behrens had told Newsnight that “the differences in the texts at key points are so huge that this is not just a bureaucratic drafting issue”.
    Read full story
    Source: The Guardian, 5 October 2023
  18. Patient Safety Learning
    Two healthcare workers who exchanged vile texts while needless drugging sick people to ‘keep them quiet’ have been found guilty of ill-treating patients.
    Senior nurse Catherine Hudson, 54, was found to have regularly tranquillised patients unnecessarily for her own amusement and to have an ‘easy’ shift.
    While Charlotte Wilmot, 48, an assistant practitioner, wrote vile texts encouraging her to carry out the dangerous acts, with complete disregard for the consequences.
    Preston Crown Court heard the pair worked on the stroke unit at Blackpool Victoria Hospital and had carried out needless sedations between 2017 and 2018.
    Restrictions on prescription drugs were so lax in the stroke unit that staff would help themselves and self-medicate or steal drugs to supply to others, the court heard.
    Drugs such as Zopiclone, a powerful medicine used to treat insomnia, were often stolen and used to drug multiple patients.
    Police launched an investigation in November 2018 after a student nurse raised concerns about the treatment of patients in the stroke unit.
    A number of staff members were arrested during the course of the investigation and their mobile devices were seized.
    Read full story
    Source: The Independent, 6 October 2023
  19. Patient Safety Learning
    Only 60% of patients who have had hospital treatment for food anaphylaxis were prescribed medicine to tackle another reaction, a study has found.
    The study of some 130,000 NHS records where food allergy was mentioned showed 3,589 patients received "unplanned hospital treatment" for anaphylaxis.
    Of those, only 2,152 were prescribed adrenaline auto-injectors (AAI) at least once.
    Two leading allergy specialists have produced guidance to raise awareness.
    Clinical scientist Dr Paul Turner from the National Heart & Lung Institute at Imperial College London, who carried out the study, and Prof Adam Fox, consultant paediatric allergist at Evelina London Children's Hospital, said they hoped the leaflet they have produced would save lives.
    It is designed to help patients, parents, families, grandparents, friends and nannies so they feel empowered and more confident when looking after a person with food allergies.
    Read full story
    Source: BBC News, 6 October 2023
  20. Patient Safety Learning
    The boss of a large acute trust has accused a private provider of ‘overpromising and underdelivering’ after significant problems emerged with a local arrangement which have piled further pressure on its waiting list.
    Mid and South Essex Foundation Trust recently discovered at least 1,000 cases were being returned to the trust from independent provider Omnes Healthcare following “complications” with a pathway for ear, nose and throat patients.
    CEO Matthew Hopkins told a board meeting last Thursday: “I think other parts of the country, like us, are seeing independent sector providers in some cases overpromising and underdelivering. The consequence of that is what we’ve seen in the ENT example.”
    The contract is managed by Mid and South Essex Integrated Care Board, which told HSJ it was “very sorry that some patients may have been waiting longer than they should have been” because of the problems.
    Read full story (paywalled)
    Source: HSJ, 6 October 2023
  21. Patient Safety Learning
    Staff without medical training who fill gaps in the NHS workforce must tell patients they are “not a doctor” when introducing themselves, under new guidance.
    The advice has been issued to “physician associates” (PAs), a type of clinical role that requires less training than doctors receive, amid a row over their use in the NHS.
    PAs complete a two-year postgraduate qualification, but no medical degree, and can diagnose and treat patients. They can work in A&E or GP surgeries.
    NHS England has set out plans to expand the number of PAs to deal with staff shortages, with a workforce of 10,000 PAs wanted over the next decade. The plan has been met with opposition from doctors’ leaders, who say the growing use of PAs instead of fully qualified doctors is leading to missed diagnoses and deaths.
    Guidance published by the Faculty of Physician Associates, a part of the Royal College of Physicians, said that PAs must not mislead patients into thinking they are doctors.
    Read full story (paywalled)
    Source: The Times, 6 October 2023
  22. Patient Safety Learning
    Mental healthcare in England has become “a national emergency”, with “overwhelmed” services unable to cope with a big post-Covid surge in people needing help, NHS bosses say.
    Care is so stretched that thousands of people undergoing a mental health crisis are having to be admitted every year to acute hospitals, even though they are not set up to deal with them.
    Hospital bosses claim mental health in England has been “forgotten” by ministers who are giving priority to tackling the record 7.7m-strong care backlog, access to GPs and ongoing NHS strikes.
    “Mental health has slipped down the government’s set of priorities and patients and services are being forgotten. This is a national emergency which is now having serious consequences across the board, not least for those patients in crisis,” said Matthew Taylor, the chief executive of the NHS Confederation.
    Read full story
    Source: The Guardian, 9 October 2023
  23. Patient Safety Learning
    About 17,500 women in Northern Ireland are to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008.
    Some of these women will be recalled to have new smear tests carried out, BBC News NI can reveal.
    The Southern Trust said that the women affected should receive letters by post from Tuesday.
    It follows a highly critical report commissioned by the Royal College of Pathologists (RCPath).
    It found:
    Several cytology staff were "significantly underperforming". Mechanisms to check their work were flawed. Action taken by management was inadequate over many years. While a majority of negative results issued by the laboratory were correct, a "significant number" of these would likely have been identified as "potentially abnormal" by other laboratories. Read full story
    Source: BBC News, 9 October 2023
  24. Patient Safety Learning
    The NHS in England is facing mounting pressure amid a surge in patients attending A&E departments with minor ailments, health bosses have said.
    Emergency departments, which are designed for serious injuries and life-threatening emergencies only, are seeing an increase in people attending with sore throats, insomnia, coughs and earache.
    Data analysed by the Press Association news agency also shows more people going to A&E with complaints such as hiccups, nasal congestion, backache and nausea.
    Cases where sore throat was the chief complaint rose by 77% between 2021-22 and 2022-23, from 191,900 cases to 340,441. Patients going to A&E with coughs rose by 47%, from 219,388 to 322,500, while attendances for nosebleeds rose by a fifth, from 47,285 cases to 56,546.
    Miriam Deakin, the director of policy and strategy at NHS Providers, said: “The rise in A&E admissions is piling even more pressure on to an already stretched NHS. Persistent strain on primary care services, including GPs and dentists, means patients often resort to A&E when they cannot access timely care elsewhere.
    “Minor ailments such as coughs, earache, fever, nausea and hiccups can and should be managed through more appropriate services such as pharmacies and NHS 111 online. This could ease pressure on emergency departments, whose priority is to deliver urgent care for those most in need. Boosting capacity of staff, beds and equipment in these settings would also significantly help. However, this requires proper funding and support from the government.”
    Read full story
    Source: The Guardian, 10 October 2023
  25. Patient Safety Learning
    Peter Marshall was delighted when he finally got an appointment after calling his GP surgery for several days.
    On the day, he saw a young medic who said his excruciating stomach pain was caused by irritable bowel syndrome (IBS) and suggested over-the-counter peppermint tablets to ease the discomfort.
    And off the 69-year-old retired IT specialist went, happy to have a diagnosis and treatment.
    In fact, Peter hadn't had an appointment with a GP — he had been seen by a physician associate (PA).
    This is a type of healthcare worker whose numbers are about to soar in the NHS in order to reduce the pressure on doctors so that they can concentrate on the most complex and seriously ill patients.
    It all sounds like a great idea. Indeed, PAs are now being employed across areas that are particularly stretched, with around a third of PAs working in GP surgeries and 10% in A&E departments, according to the latest census by the Royal College of Physicians. But they are actually spread across 46 NHS specialties, from urology and surgery to cardiology and mental health.
    In this role, they are permitted to carry out a range of medical tasks, from performing physical examinations, diagnosing patients and analysing test results to running clinics and performing minor procedures — as well as doing home visits — all under the supervision of a doctor.
    However, in the case of Peter Marshall, although he was reassured by his diagnosis, his symptoms were, in fact, a sign of bowel cancer — and he died nine months later, in January this year.
    His sister, who has told Good Health his story, says: 'My brother had no idea that he had seen a PA and not a qualified doctor — he didn't know the word physician associate even existed, no one does.'
    The family, from London, later received an apology from the PA. 'Patients are so desperate to get an appointment with their GP, you are grateful to see anyone and whatever they say, you accept,' she says.
    Read full story
    Source: Daily Mail, 9 October 2023
     

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