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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To put that I don’t want to be treated by PAs in my ELCS birth plan?

213 replies

BPquestion · 01/05/2024 22:10

I have recently been following the news, and ‘med Twitter’ about the growing problem of physicians’ associates. It seems there’s an issue with many of them performing outside of their limits of capability, expertise and knowledge. I also understand that they are not currently regulated by a professional body.

I recently read of a PA taking on an anaesthetic role, and another taking on a surgery role.

I am having an ELCS soon. Would I BU to put in the birth plan that I don’t want any PA to be involved in any part of the surgery itself?

OP posts:
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7
MrsElijahMikaelson1 · 03/05/2024 23:49

The ones I know work within orthopaedics; they help in clinics seeing patients; who they then discuss treatment plans with the consultant and then work as a theatre assistant-eg holding the leg mainly and will probably close the wound. They don’t actually do the surgery or joint replacement itself. The ones I know are highly skilled though and know their boundaries.

onlyyarrknhe · 03/05/2024 23:43

MichaelatheMechanic · 03/05/2024 16:11

Isn't that the same for junior doctors though?

I've been through the system twice in the last couple of years and had two quite extraordinary experiences with junior doctors who clearly didn't have a clue what they were doing.

I'm clinical NHS so have a vague idea myself how it all works.

Not meaning to negate your experience but no, it's not the same. You may have had bad experiences with junior doctors - even GPs routinely fob people off, especially women.
However, all junior doctors are regulated and have had to undergo the same several years of rigourous training.
PA's by contrast not only have very limited training, they're also currently not regulated.

I also find it worrying that people are willing to put up with low standards of care and telling people to go private... Is this really what we want? A two tier system where only those who can afford it get acceptable - not even excellent, just acceptable - care?

That's just privatisation by stealth

whenemmafallsinlove · 03/05/2024 23:20

I am a nhs manager. I've worked with three PAs. Two were absolute stars and are now at medical school. Which is absolutely deserved and they will be superb doctors. The other is very sound and works, in a supportive team, to her limits and not beyond them. So on a personal level I have good experiences of PAs. But there is so much out there about people working way above their level. I don't think this is unreasonable OP.

TwelveAngryWhiskers · 03/05/2024 22:57

I am fairly sure that two years into his training neither he nor anybody else would think he was qualified to do a c-section which is not just a cut and stitch proposition.

Which PA is doing a c-section? Where has this idea even come from? The OP hasn’t even been told a PA will be involved her care, never mind that a PA is doing her c-section.

Aussieland · 03/05/2024 22:50

pinkroseleaf · 03/05/2024 13:12

I don't know, they do need to have a 3 year science degree and then do the msc to get the pa degree. Whilst this is 2 years on paper, it is 3 years in reality as it is an intensive full time course with no summer break. So they spend at least 5 years at uni training.

PAs tend to specialise in one area and remain in that area so they do become an expert in one small part. Whereas junior doctors are constantly rotating so they may not have as much experience in that particular area.
But what I would say is that all health care professionals can and do make mistakes, no matter how senior they are.
I am speaking as someone who had a bodged c section performed by a junior doctor.

Yeah their training is NOTHING like as thorough as a junior doctor. And the rotations are essential for making doctors rounded and having an understanding of the whole body.
PAs are dangerous and the government is setting up a Mickey Mouse healthcare service with them.

Spinningroundahelix · 03/05/2024 22:41

I told my specialist my birth plan. Preferably a c-section and lots of drugs! That's exactly what I got. I think he found me a refreshing change from his other thirty something patients who were going to ante natal classes and wanted natural childbirth and birthing pools and sticky mucus covered babies plopped on their stomach. I didn't even mind the flock of students who were urged to gather closer after the obstetrician found something in my nether regions that he declared to be very interesting. To be fair, he probably wanted them to see a potential prolapsed cord which is rare. Afterwards everybody agreed it was a very good thing I'd had a planned section. (I did have some medical indications so it wasn't just like I felt like one.)

And for the people think the PA training is tough I am fairly sure it is nothing to the five years medical training my son is doing on top of his BSc in a medicine related major. I am fairly sure that two years into his training neither he nor anybody else would think he was qualified to do a c-section which is not just a cut and stitch proposition.

hettie · 03/05/2024 22:32

peakygold · 03/05/2024 17:13

I'd be more afraid of a nursing associate to be honest. No degree, huge gaps in training and experience, but NHS management is increasingly putting them in charge of wards. We've gone from Matrons/Sisters, to Staff Nurses and now glorified Clinical Support Workers.

This is simply not true. Find me a ward with a nursing associate 'in charge' and I'll raise you some unicorn shit
They're just a different training route/pipeline like apprenticeship routes etc.
B6 nurses and above with still be in charge of wards..

TwelveAngryWhiskers · 03/05/2024 22:15

Pinkfluffypencilcase · 03/05/2024 22:07

Im finding the same.

Also read the modules - very science heavy.

I studied biomedical science. I and a number of other students in my cohort looked into the available PA masters courses around the country, some of whom went on to study it. All of them required a health science, life science or healthcare degree, such as radiography.

And as a PP said (possibly you @Pinkfluffypencilcase?) it’s more like three years as there’s no break. It’s a very tough course. I decided it wasn’t for me.

Doctors fuck up all the time. I think the OP has been reading too much of the Daily Mail comments section.

Pippa246 · 03/05/2024 22:12

BingoMarieHeeler · 03/05/2024 22:08

Should be fine. I said no students for my last c section. I’d done my bit, having a crowd of trainees gawping at my 3C tear and having a go stitching me, and then again in my disastrous first c section 😅

It’s different with students though - they are still in training so the patient has to consent to their presence but not so with employed staff. There have been cases where trans women nurses are doing cervical smears and patients have asked for a biological woman to do it but been refused.

Pinkfluffypencilcase · 03/05/2024 22:10

Using the fact it’s unregulated as your reason is fair. Not entry reqs.

Pippa246 · 03/05/2024 22:10

Luxell934 · 03/05/2024 17:14

I’m skeptical about where this information is coming from that unqualified health workers are being used to preform cesarian sections???? 🤯

Me too. And if a consultant was “watching over them” then that just proves there are dodgy consultants too and I would question that consultant’s decision making.

Pinkfluffypencilcase · 03/05/2024 22:09

Bradford

Life Science, Biomedical Science, or Healthcare subject from a UK University or overseas equivalent

BingoMarieHeeler · 03/05/2024 22:08

Should be fine. I said no students for my last c section. I’d done my bit, having a crowd of trainees gawping at my 3C tear and having a go stitching me, and then again in my disastrous first c section 😅

Pinkfluffypencilcase · 03/05/2024 22:07

TwelveAngryWhiskers · 03/05/2024 22:03

I have had a look online and I can’t find a university that doesn’t stipulate a health science or a healthcare-related degree as a requirement for entry to the course. So I’m asking you to please direct me to one.

Im finding the same.

Also read the modules - very science heavy.

Pinkfluffypencilcase · 03/05/2024 22:05

queen Mary
2:1 or above at undergraduate level in a Biological, Biomedical or Health Profession degree.

TwelveAngryWhiskers · 03/05/2024 22:03

BPquestion · 03/05/2024 21:58

Yep - the majority of them - take a look online. You don’t need prior experience in health care or any health and social care qualifications. As mentioned above, there is no hard requirement for the undergrad degree to be in a science.

I have had a look online and I can’t find a university that doesn’t stipulate a health science or a healthcare-related degree as a requirement for entry to the course. So I’m asking you to please direct me to one.

Pinkfluffypencilcase · 03/05/2024 22:01

Leeds wants health sciences / anatomy bias

BPquestion · 03/05/2024 21:58

TwelveAngryWhiskers · 03/05/2024 21:48

Please can you direct us to a PA MSc that allows people without health science or healthcare related degrees onto the course?

Yep - the majority of them - take a look online. You don’t need prior experience in health care or any health and social care qualifications. As mentioned above, there is no hard requirement for the undergrad degree to be in a science.

OP posts:
TwelveAngryWhiskers · 03/05/2024 21:48

BPquestion · 03/05/2024 21:20

The three year degree could be in interpretative dance.

Please can you direct us to a PA MSc that allows people without health science or healthcare related degrees onto the course?

Piglet89 · 03/05/2024 21:43

NHS trusts are subject to the Freedom of Information Act. If time allows, were I you, I might do a FOIA request asking how many PAs work in the obs/maternity/surgical/anaesthetics [insert relevant] specialisms of the hospital in which you are scheduled to have your ELCS. If the answer is zero, this might give you confidence and obviate the need to place something in your birth plan, which might be ignored.

LordPercyPercy · 03/05/2024 21:37

YABU. If you don’t want NHS treatment then pay privately. We don’t get to pick and choose.

You'd think given the amount of tax we all pay to fund the NHS it wouldn't be too much of an ask to be treated by a real doctor not a pretendy one.

Pinkfluffypencilcase · 03/05/2024 21:28

It’s life sciences or health/ nursing?
Where is accepting dance?

BPquestion · 03/05/2024 21:20

Pinkfluffypencilcase · 03/05/2024 21:14

PA has had 3 years degree plus 2 years postgrad

The three year degree could be in interpretative dance.

OP posts:
Pinkfluffypencilcase · 03/05/2024 21:14

Pintoo · 03/05/2024 21:11

A junior doctor with two years of experience has had 7 years of intensive training.
A PA is a physician associate who has done a 2 year training course.
The issue is that their training is so superficial that they don't know what they don't know.

PA has had 3 years degree plus 2 years postgrad

Pintoo · 03/05/2024 21:11

gkuyg · 03/05/2024 19:57

I had an ELCS (was breach baby and they wouldn't allow a vaginal delivery) by a junior doctor with only 2 years experience - is this what you mean by a PA?

Anyway they completely messed up, nearly had to have a hysterectomy and left me long term damage.

A junior doctor with two years of experience has had 7 years of intensive training.
A PA is a physician associate who has done a 2 year training course.
The issue is that their training is so superficial that they don't know what they don't know.