AN actress died just three weeks after the true cause of her “anxiety” and leg pain was identified.
Emily Chesterton passed away as a result of a blood clot, which wasn’t picked up in two separate appointments.
Emily ChestertonEmily Chesterton died after having two appointments with physician associates[/caption]
Emily ChestertonThe 30-year-old complained of leg pain, shortness of breath, difficulty walking and swelling and was prescribed anti-anxiety medication and told to take painkillers[/caption]
The 30-year-old visited her doctor’s surgery on October 31, 2022, to discuss the discomfort she felt in her left calf.
She believed she had seen a GP but she was actually assessed by a physician associate (PA) – a newer type of medical role that involves significantly less training.
Emily, who was also suffering from shortness of breath, was advised to take paracetamol.
On November 7, she saw a second PA, who diagnosed her with a calf sprain, long Covid and anxiety.
After discussing the fact she was struggling to walk more than a few steps and her leg was swollen and hot, Emily was prescribed propranolol – a beta blocker for heart problems, anxiety and migraines.
During neither appointment did the PAs make it clear they were not doctors.
Emily, a musical theatre performer from Greater Manchester who had moved to London, collapsed later that evening and was rushed to hospital.
She died several hours later due to a blood clot in her left leg which triggered a pulmonary embolism – when a clot gets stuck in an artery in the lung.
A coroner concluded her life could have been saved if she had been “immediately referred to a hospital emergency unit”.
Emily’s parents Brendan and Marion are now raising concerns about a new government scheme to employ more PAs across the NHS.
Marion told the BBC: “All patients should have the right to know who is treating them and have the choice to see a fully-qualified doctor.
“If I had my time over, I would have taken her straight to A&E. That is the biggest regret of my life.
“My advice to anyone is always ask who you are seeing.”
She suggested that “doctor’s assistant” would be a more accurate title than physician associate.
She was very empathetic and felt other people’s pain – that’s what made her such a good singer and actress
Marion
There are around 4,000 PAs in England, but ministers hope to increase this to 10,000 by 2036 to plug widespread staff shortages across the NHS.
PAs “support doctors in the diagnosis and management of patients”, according to the NHS careers website.
They usually complete a bioscience-related degree before undertaking a two-year integrated master’s course.
Registered healthcare workers, like nurses or midwives, can also apply to become PAs.
Most PAs work at GP surgeries and in A&E, and are supposed to be “under the supervision of a doctor”.
While they carry out similar roles, they don’t have the same medical training so are not direct substitutes.
To become a GP, you complete four to six years of medical school before a two-year foundation training programme.
You can then apply to GP speciality training, which takes a minimum of three years, and pass several assessments.
The Faculty of Physician Associates makes it clear that PAs “are not doctors” and “do not replace medical roles”.
A new law, passed on February 26, will see PAs go on the General Medical Council (GMC) register and be regulated like other medical professionals.
There are concerns from the British Medical Association (BMA) that this will blur the lines between PAs and doctors.
What is a physician associate?
A PHYSICIAN associate works alongside doctors in GP surgeries or hospitals to diagnose or treat patients.
Unlike doctors, people in these jobs do not hold a medical degree.
However, PAs do have to undergo two years of intense training for the role.
They are usually science graduates or can be allied health professionals, such as nurses or midwives.
PAs can:
Take medical histories from patients
Ask patients about their symptoms
Perform physical examinations
Diagnose illnesses
See patients with long-term chronic conditions
Perform diagnostic and therapeutic procedures
Analyse test results
Discuss treatment plans
Develop management plans
Provide health promotion and disease prevention advice for patients
But they should always be supervised by doctors.
PAs are not currently regulated by a medical body, like many other healthcare professionals are.
They can, however, join a voluntary register with the Royal College of Physicians.
With no obligatory register, any who malpractice cannot formally be struck off, for example.
However, under a planned new law, PAs will be regulated by the General Medical Council (GMC).
Not everyone is happy about this, though.
The British Medical Association (BMA) believes this could lead to patients confusing the different roles, which could have “tragic consequences”.
There are about 3,200 PAs working in GP surgeries and hospitals in England, with 10,000 more planned in the next decade or so.
Emily’s GP surgery, The Vale Practice in Crouch End, said it was “deeply saddened” by her death and now only provides appointments with GPs, nurses and pharmacists after a “thorough” review.
It added that staff have been told to ensure that “a patient understands their role at the start of each appointment”.
Marion previously described her daughter as “very sensitive, caring, creative, and generous”.
“She was a beautiful soul, really, inside and out,” she added.
“She was very empathetic and felt other people’s pain – that’s what made her such a good singer and actress.
“It used to send us to tears when she sang.”
A Department of Health and Social Care spokesperson said at the time: “The NHS Long Term Workforce Plan makes clear that physician associates and other associate positions can provide vital support in providing medical care and anaesthetic services to patients and can help reduce pressure on doctors, freeing up their time to focus on tasks only they are qualified to do.”
A spokesperson for the NHS added: “Patient safety lies at the heart of the NHS long-term workforce plan and the role of physician associates are a vitally important part of our staffing mix, with over 3,000 members of staff working in this role across the health service in England.
“Physician associates are qualified and trained health professionals usually with a bioscience-related degree, working alongside fully trained doctors as part of the care team.”
Lily BarnesThe actress died due to a blood clot in her left leg which triggered a pulmonary embolism[/caption]