Physician associates after two deaths

Summary

• Critics say patients cannot tell physician associates from doctors, and want limits on their work.
• The case for the roles is that the Leng review found no convincing reasons to abolish them. The Faculty of Physician Associates says PAs must sit a national exam that assures competency at the point of qualification.
• Emily Chesterton died of a pulmonary embolism in November 2022. A physician associate at her GP practice saw her twice without referring her, and the inquest record says she should have been immediately referred to a hospital emergency unit.
• Susan Pollitt died at the Royal Oldham Hospital in July 2023. A physician associate inserted a drain that stayed in for 21 hours, against six hours in local guidance. The inquest found she died "as a result of an unnecessary medical procedure contributed to by neglect".
• The Leng review, published on 16 July 2025, recommended the title physician assistant and no work with undifferentiated patients outside national protocols. It did not propose a national scope of practice, and the government accepted all its recommendations.
• The regulator has overseen the role since 13 December 2024. Both challenges in the High Court have failed. From 13 December 2026, using the title without registration is a criminal offence.

Dig deeper

• The coroner's report on Susan Pollitt listed five matters of concern, including no regulatory body and no national framework for training and competence.
• The regulator replied to the Pollitt report that its regulation would address several of the issues raised. The Faculty of Physician Associates called regulation welcome and overdue.
• The BMA argued that calling doctors and associates "medical professionals" was inconsistent with the statute. The High Court dismissed that on 17 April 2025, and the Court of Appeal dismissed the appeal on 20 February 2026.
• The High Court dismissed the Anaesthetists United claim on all grounds on 5 September 2025. It held that the decision not to set national limits was rational.
• In March 2026 the government consulted on a draft Order that also asked how to put the Leng recommendations into effect.
• The Leng review said the dispute was heightened by industrial action, the resident doctor strikes, and worry about resident doctors' training and jobs.

Ethical issues

Interview questions

• What do you know about the physician associate role and the Leng review?
• What happened at the inquest into Susan Pollitt, and what did the coroner ask to change?
• You are a resident doctor. A physician associate asks you to take over a patient they have assessed, and you are not sure they saw the whole picture. What do you do?
• Should physician associates be renamed physician assistants, and what would the change do for patients?
• What did the court decide in the Anaesthetists United case, and why might a judge be reluctant to order a regulator to set limits on a profession?
• Why might a role that saves doctors' time still raise concerns about cost?
• Should a patient be told when the person treating them is not a doctor? Why?