Physicians Associates

Correct but it demonstrates how the system is dangerous. Drs are seeing their own patients while also having a lesser qualified, non doctor sticking something under their nose saying “can you prescribe xyz”.

Details get lost in the chain of poor communication. Maybe the PA didn’t tell the doctor that the OP was pregnant 🤷‍♀️. The doctor doesn’t have time to look at OPs notes, or go take a history themselves (and the model is that they shouldn’t need to take a history). If a doctor had seen the OP they’d have had that information. If I was a doctor I wouldn’t want to prescribe without seeing the patient and taking my own history.

The history is only as good as the questions asked and that can rely on the questions asked. I remember as a HCP doing a history with a patient before surgery and asking them if they were normally fit and well/any issues. Patient said they were normally fit and well. I went and told the anaesthetist we were good to go. Anaesthetist went to speak to the patient and came back and said they had a brain tumour and the surgery couldn’t go ahead as planned. I later asked the patient why they hadn’t told me and she said it doesn’t cause her any problems so in her mind she was fit and well. 😁. I learnt a lesson that day.

Paramedics can prescribe - do you think they carry doctors around on ambulances to prescribe all the drugs they give? some nurses can also prescribe as can some podiatrists

You’re so so lucky you checked. This is absolutely unforgivable- who is the GP who signed this off? I’d make a formal complaint to their trust and bar the PA and their comments about them being „pretty sure“ it’s fine.

The GMC hold a list of PAs. That’s about it. And for the last two years it’s been voluntary. It’s a whole load of wishy washy bollocks.
No one is listening to doctors and their concerns (Leng review recommendations are being ignored). Maybe it’s time for patients to make a stand.

The argument that ‘Drs make mistakes too’ is null and void. GPS for example have 5 yrs med school, 2 yr Foundation doctor, then several years GP training. PA have 2 year course. If an experienced GP can make the occasional mistake, why do people think that a PA with 1/5th of the training of a GP is going to be anywhere near as safe and make fewer mistakes.

patient safety should be at the front of this conversation but as usual the feelings and ambitions of a certain cohort yet again take priority.

The GMC hold a list of PAs. That’s about it. And for the last two years it’s been voluntary. It’s a whole load of wishy washy bollocks.
No one is listening to doctors and their concerns (Leng review recommendations are being ignored). Maybe it’s time for patients to make a stand.

The argument that ‘Drs make mistakes too’ is null and void. GPS for example have 5 yrs med school, 2 yr Foundation doctor, then several years GP training. PA have 2 year course. If an experienced GP can make the occasional mistake, why do people think that a PA with 1/5th of the training of a GP is going to be anywhere near as safe and make fewer mistakes.

patient safety should be at the front of this conversation but as usual the feelings and ambitions of a certain cohort yet again take priority.

It’s not like PAs have been caught illegally prescribing independently though is it?

if the prescription request did go to the GP, and the GP signed it off without seeing the patient or checking the history the yes, it’s a GP problem.

However, GPs have been forced to work this model. It increases their own work load. The level of supervision PAs need to be safe is too much. It would take GPs away from seeing their own patients. And it appears that the GP is merely a liability sponge. GP surgeries are strapped for cash. To force them to employ PAs the govt have funding called ARRS which stipulates that this money cannot be used to employ actual GPs. The other stipulation in this contract is that PAs employed must see undifferentiated patients (to stop GPs from getting them to do routine stuff like chronic illness reviews etc.

it would appear the recommendations of the Leng review have been ignored by many.

I voted Yabu because if you are in the UK , PA's can NOT prescribe. Someone else has prescribed the medication for you.

"Some" PAs are better than GPs as some actually listen to you rather than fob you off.

My DH saw a succession of GPs over a couple of years for a number of apparently unrelated conditions, after literally never setting foot in the surgery for about 20 years. Each GP just fobbed him off. It was only when a PA actually listened to him and took a few minutes to read his notes/history properly that he was referred for a specific blood test, which led to his diagnosis of cancer!

When we had the diagnosis of the exact name/type of the cancer, we Googled it and his conditions were literally text book as to his cancer. We still fail to see how several different GPs completely missed the glaringly obvious!

On the other hand when DH was seen by a PA she stated straight away what she was and was open about having to check with a doctor.

Not so long ago my GP surgery tried to make me have a hospital prescription that came with no instructions decided by the pharmacy( amount and frequency). I held firm and said I wanted a doctor to decide how much and how often . A doctor messaged me with the info saying I’d absolutely done exactly the right thing and it should be my GP deciding on the dosage not a random pharmacist. Same system tried to palm me off with a medical practitioner when I wanted a GP appointment for something I was concerned could be linked to something quite serious I’m under the hospital
for. They weren’t honest and I looked her up on the site and realised. Again held firm and got a GP appointment which we have a right to do.

Happy to see pharmacists and nurses for things that are relevant for them but I’m not dumb and when I know I need to speak to a GP a GP is who I expect to speak to.

We can and should reject staff who aren’t GPs if we don’t feel they or their advice are relevant.

What medication was it?

I will going forward, but I imagine it would feel a bit odd as surely they should be offering that info without us having to dig it out of them. It's worrying!

So you admit you were wrong? Countersigning is not a GMC requirement.

@MooBaggage the prescribing safety assessment is generally sat at the end of medical school by all before they become F1s

Well we certainly have an example of the problem on this thread…

Pressure has been applied…

They have since backtracked from this and nothing is currently being implemented, subject to further consultation and review.

The government recently accepted the recommendations of the Leng review that they should be renamed back to physician assistants. It also recognised there were significant legitimate safety concerns about the role.

www.gov.uk/government/news/patient-safety-boost-as-pa-review-recommendations-accepted

But this was the job of the pharmacist, who appears to have done it very well. The role of the pharmacist is to have an in-depth knowledge of drug interactions, safety in pregnancy, etc. Their knowledge of drugs far outweighs doctors, and if there are any complicating factors like pregnancy, existing medication, existing conditions etc, it's always worth checking with them that a new medication is safe.

Nope. Driven and decided by Health Education England.

Paramedics are prescribers anyway.

What’s wrong with seeing a paramedic and them prescribing? You wouldn’t complain if the prescribed morphine if you broke you leg in an RTA.

Under supervision and with the precriptiom countersigned by someone with full GMC registration...

Absolutely. There should never be such under qualified people making such serious medical decisions.

From being found to have repeated acted beyond their knowledge and training?