An open letter signed by more than 13,000 doctors has been sent to the leaders of the major political parties ahead of Thursday’s election, warning of the risk to patients if concerns around the deployment of Medical Associate Professions (MAPs) in the NHS continue to be ignored.
In the letter, sent today to party leaders Sir Ed Davey, Sir Keir Starmer and Rishi Sunak, BMA members express “grave concern” about a “patient safety scandal” that has not yet been sufficiently addressed by any political party or policymaker.
The letter points to widespread evidence of MAPS routinely being substituted for fully trained doctors on hospital rotas and the worrying trend in general practice funding that has led to physician associates (PAs) working, in practical terms, as GPs.
“NHS trusts are recklessly breaching safety requirements for MAPs relating to levels of supervision, and prescribing laws are being ignored. To date, there has been no sanction against any employer acting in this way,” the letter continues.
The letter further makes six keys asks of a new government, including a safe scope of practice, an end to the replacement of doctors on rotas and an independent enquiry into how widespread this practice has become.
Prof Phil Banfield, chair of BMA council, said:
“Doctors in their thousands are today demanding that the party leaders take notice of the patient safety scandal threatening to engulf the NHS. Policymakers have been asleep at the helm for years, letting us drift directly into a dangerous situation where the skills of doctors are being demeaned, devalued and even replaced. We will not let the new government formed on Friday say it was not warned.
“We have always said MAPs have a part to play in NHS teams, through assisting doctors so that they can undertake the work for which we are uniquely trained. This is not how their deployment has proceeded in reality. Instead, doctors in many places find their own time compromised by the requirements of supervising MAPs. Doctors are being replaced on rotas by MAPs around the county, leading to alarming situations where patients are being treated by unqualified staff. In general practice, at a time when patients are desperate to see their GP, the money that could be used to employ them is instead reserved for PAs and other less-qualified staff, leaving many GPs struggling to even find work.
“Politicians must turn this policy disaster around. We need visible accountability, transparency and a proper scope of practice that can reassure patients they are always being seen by the right professional with formally assessed qualifications, skills and expertise for the task. After an election campaign dominated by the parlous state of the NHS any new government will be looking to reassure the public that the NHS is safe in their hands. Doctors today have made very clear one way they can do that.”
Notes to editors
The letter can be found here.
The key asks in the letter are:
- Implementation of a national safe scope of practice for MAPs underpinned by robust evidence and regulation.
- Amending the Anaesthesia Associates and Physician Associates Order 2024 so that MAPs are regulated by a more suitable regulator using titles that protect patients from being misled.
- An end to widespread doctor replacement and unemployment.
- An urgent review of the long-term workforce plan to determine how MAPs can be safely utilised to the benefit of patients and healthcare systems, as well as the numbers required, underpinned by evidence.
- A halt to any current plans to provide MAPs with prescribing responsibilities.
- An independent inquiry to determine how widespread doctor substitution has become, and how this scandal has been allowed to develop without sufficient regard for patient safety.
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.