The safety of patients in Scotland’s hospitals is at risk as NHS chiefs resort to employing hundreds of cut-price doctors to plug staffing shortages.
Serious concerns have been raised over plans to plug holes in the health service’s workforce with physician associates, a role that requires only two years of training.
New figures reveal 250 Physician Associates are already working across the health service with recommendations at least 40 more are trained each year to boost the struggling workforce.
But the British Medical Association is demanding any further recruitment of Medical Associate Professionals (MAPs), which include Physician Associates, Anaesthesia Associates, Surgical Care Practitioners and Advanced Critical Care Practitioners, until serious concerns over patient safety are addressed.
Others fear that an increasing reliance on MAPs will create a ‘two tier’ health system.
Dr Iain Kennedy, chair of the British Medical Association in Scotland, said: ‘It is worrying to see indications of MAPs as a potential alternative workforce option or solution to the issues in Scotland NHS with shortages of doctors.
The BMA has raised concerns over plans to plug holes in the health service’s workforce with physician associates
‘To be clear, the only solution to our medical workforce crisis is proper investment in doctors.
‘Only doctors are medical professionals.
‘We do not believe there should be any further recruitment of MAPs until the clear concerns on scope creep and patient safety are resolved.’
The findings come in a landmark report by a Scottish NHS Commission into the future of MAPs.
MAPs carry out a variety of tasks including assessments and minor procedures, in GP surgeries and hospitals, after completing a two-year university training course.
Scottish Government-appointed experts say the expansion should go ahead despite ‘tension’ with other staff groups.
The Commission also said they are needed to cope with a shortage of doctors and nurses and a growing number of patients.
Its report states: ‘To ensure sustainability of healthcare for the future, NHS Scotland must plan to deal with increasing demands on services from an ageing population.
‘This has been worsened by shortages in some professions and specialties and the disruption caused by the COVID-19 pandemic which resulted in an unprecedented backlog of elective care.’
The Scottish Government has committed to increasing the NHS workforce by 1,500 to cut waiting lists.
The report says this ‘requires innovative solutions’ given staff shortages in nursing and medicine, ‘such as increasing the workforce’ of Medical Associates.
It adds: ‘MAPs are a potential alternative workforce option building in flexibility and resilience to teams; contributing to the increase in clinical capacity essential to meet the identified current and future demand.’
Scottish Conservative health spokesman Dr Sandesh Gulhane said: ‘Under the SNP, GP numbers have fallen to dangerously low levels and now they are trying to use physician associates to fill the gaps – despite them only having undertaken a two-year training course.
‘Many medical experts are unclear on the role that PAs provide and are concerned that relying more heavily on them could create a two-tier health system.’
The report warns of ‘tension within some professional groups and aligned protectionism’.
The role of physician associates has come under the spotlight amid long-running complaints from the BMA.
It says the roles are ‘poorly defined’ and the associates could end up doing work they are not trained to do. They also there can often be confusion amongst patients and their families as to whether they have seen a physician associate or doctor.
The doctors’ regulator the General Medical Council will become the regulator of physician associates (PAs) and anaesthesia associates (AAs) in December 2024.
But the BMA has launched legal action against the GMC over how it plans to do this in what the BMA has said is ‘the dangerous blurring of lines for patients between highly-skilled and experienced doctors, and assistant roles.’
In Scotland, MAPs are trained at the University of Aberdeen although more universities may offer the course in future.
Entry requirements for the two-year course are a degree in a health-related medical science subject such as pharmacy or physiotherapy.
A Scottish Government spokesman said: ‘Medical Associate Professionals are an important part of the NHS Scotland workforce and will continue to contribute to the Scottish Government’s priority of developing a sustainable system that ensures people get the right care, at the right time, and in the right place.
‘Scottish Ministers are clear that any future growth in these valued roles should be gradual and evidence-based, informed by the work of our national Medical Associate Professionals Programme Board.’
