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BBC\/Brijesh Patel<\/span><\/div>\n<\/div>\nA man whose wife died after a drain was mistakenly left in her abdomen for 21 hours has condemned the increased use of physician associates (PAs) within the National Health Service.<\/p>\n Susan Pollitt’s inquest concluded her death at Royal Oldham Hospital in July 2023 had been caused by an “unnecessary medical procedure contributed to by neglect”.<\/p>\n Roy Pollitt did not know his 77-year-old wife was being treated by a PA – who are only required to have two years’ medical training – and believes “she would have lived if the NHS had not used cheap labour”.<\/p>\n The coroner who examined Mrs Pollitt’s death highlighted the lack of a national framework covering PAs’ training, supervision and competency assessment.<\/p>\n<\/div>\n Associates were introduced in the NHS 21 years ago with the expectation they would support doctors by delivering basic care.<\/p>\n Over the past two years the number of associates has more than doubled to 3,000.<\/p>\n According to the NHS Long Term Plan, there will be 12,000 physician and anaesthetic associates by 2036.<\/p>\n Fears have been expressed, however, that some have been acting beyond their original remit.<\/p>\n BBC News has seen evidence that in the month of Mrs Pollitt\u2019s death, the NHS trust which oversees Royal Oldham used PAs to cover nearly 20% of doctor shifts in elderly care.<\/p>\n Several organisations, including the British Medical Association (BMA), have voiced concerns about the blurring of professional lines between doctors and associates across NHS trusts and primary care.<\/p>\n Anaesthetists United, a group set up by concerned doctors and consultants, has filed a legal claim against the General Medical Council (GMC) for not, in its view, properly defining associates’ roles and responsibilities.<\/p>\n One of the group’s founders, consultant anaesthetist Richard Marks, said patients were “being put at risk” as a consequence, something that “strikes to the heart of you” as a doctor.<\/p>\n BBC News has also learned that PAs have exceeded their remit in several NHS trusts, including by:<\/p>\n From December, associates will join doctors in being regulated by the GMC.<\/p>\n Significant concerns remain, however, from some within the medical profession.<\/p>\n<\/div>\n Susan Pollitt originally went to Royal Oldham Hospital with a broken arm after suffering a fall at her home in nearby Failsworth, Greater Manchester.<\/p>\n Initially treated in a corridor, the great-grandmother was also diagnosed with an acute kidney injury.<\/p>\n Due to a lack of gastroenterology beds, she was taken to a respiratory ward.<\/p>\n Her daughter Kate Pollitt said staffing levels seemed “very low”, adding that on the night her mother died “it took nearly four hours to find a doctor in the whole of the hospital”.<\/p>\n At Mrs Pollitt’s inquest, dozens of issues with her care came to light.<\/p>\n Not only did the PA leave an abdominal drain – used to remove excess fluid from her body – in for 15 hours longer than permitted, but he also told colleagues to clamp it, increasing the risk of infection.<\/p>\n It has also emerged that, in the previous year, a liver nurse only approved the associate’s competence in using the equipment because she assumed he was a doctor.<\/p>\n Kate Pollitt said: “He thought he was doing right… but he was in a situation where he wasn’t supported.<\/p>\n “There was too much confusion and not enough supervision.”<\/p>\n<\/div>\n The Northern Care Alliance (NCA) NHS Foundation Trust, which runs the Royal Oldham, found Mrs Pollitt would probably have survived had the drain been removed earlier.<\/p>\n Its chief medical officer, Dr Rafik Bedair, said: “We\u2019re saddened Mrs Pollitt didn\u2019t receive the standard of care that she should have done and we remain deeply sorry to her family for this.”<\/p>\n He said the trust owed it to them to “learn from what went wrong and make things safer for patients in the future”.<\/p>\n The NCA serves more than a million people across Salford, Oldham, Rochdale and Bury, as well as providing more specialist services to patients from Greater Manchester and beyond.<\/p>\n Following Mrs Pollitt\u2019s inquest, North Manchester Coroner Joanne Kearsley issued a Prevention of Future Deaths notice due to her concerns about PAs.<\/p>\n The GMC agreed patient safety was at risk without effective safeguards.<\/p>\n Its chief executive and registrar, Charlie Massey, said next month\u2019s regulatory changes would be “a vital step towards strengthening both patient safety and public trust in these professions”.<\/p>\n And he stressed it was down to employers to clearly define roles and, like “all regulated professionals, [associates] will be expected to work within their competence”.<\/p>\n<\/div>\n But consultant anaesthetist Dr Marks warned the lack of a national scope of practice – with clear limits and standards – would still put patients at risk.<\/p>\n‘At risk’<\/h2>\n<\/p>\n
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Family photograph<\/span><\/div>\n<\/div>\n![\"BBC\/Brijesh](\"https:\/\/ichef.bbci.co.uk\/news\/480\/cpsprodpb\/f938\/live\/cdcb5360-9dc4-11ef-935d-3107d1c873e8.jpg.webp\")
BBC\/Brijesh Patel<\/span><\/div>\n<\/div>\n![\"BBC\/Adam](\"https:\/\/ichef.bbci.co.uk\/news\/480\/cpsprodpb\/533c\/live\/5755d080-9dc3-11ef-935d-3107d1c873e8.jpg.webp\")
BBC\/Adam Walker<\/span><\/div>\n<\/div>\n