Review author Prof Gillian Leng talked to doctors, patients and the public to collect evidence on the safety and effectiveness of the roles of PAs and AAs.
She said a clear vision “was largely missing” when they were introduced in 2000 and there was no national plan for how the new roles would fit into existing teams, resulting in growing “confusion about the roles’ purpose and remit”.
“Where capacity was limited in local services, gaps in medical posts were sometimes covered by PAs, without taking into account their more limited training or ensuring that supervisors had the necessary understanding of the roles and the time and skills required to provide appropriate oversight,” Prof Leng added.
She also listened to families of relatives who died after being treated by PAs, believing them to be qualified doctors.
Emily Chesterton was told the calf pain she was experiencing in October 2022 was a sprain but it was in fact a blood clot. She died, aged 30, after being seen twice by a physician associate.
Susan Pollitt, 77, was being treated by a PA in hospital two years ago after a pump was left in her stomach for 15 hours longer than it should have been. She died from an infection two days later.
Her daughter Kate says the family have never blamed the PA involved but want more clarity.
“As a family, when you’ve got someone in hospital, you don’t think straight because you’re just worried about your relative,” she says.
“Even though people are telling you who they are, you’re not registering it. So I do think it needs to be made clear, with the uniform and the badges and the name. So we do welcome that,” Kate says.
In other cases, patients said they were satisfied after seeing a PA and felt listened to, the review says.