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

[BPquestion]

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?

There have always been non-doctors in support roles eg operating department practitioners are universal.

www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/roles-allied-health-professions/operating-department-practitioner#

If you needed a section than it is very likely that you would not benefit from excluding them.

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.

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

Because i am not stupid and you weren’t there. There were also questions she wasn’t sure of so called in the GP when needed.

No I wasn’t and I’m sure you aren’t.

But you have no idea how capable she is of listening to a newborn heartbeat and understanding the nuances of the clinical exam. And she didn’t have the minimum ten year training that a GP doing it would have had. I know where I would place my trust.

You can’t know someone’s competence from just watching them as a bystander and the more complex the task the harder it is to judge. So we have to go on their training and the rigour of the exams and assessments they undertake to get into their role.

Six week checks might appear really quite straightforward and about having warm hands and a nice smile. They are actually much more complex, difficult and important and I would not let a PA loose on my newborn to sign them off. You can obviously do otherwise.

I think you have to be aware of how toxic the debate currently is at the moment so you will be seeing the worst stories to make a point/ very rarely will you be hearing the positive stories about care given by PAs. That’s not to say I don’t disagree with some of the concerns raised but it must be pretty terrible to be a PA at the moment.

For what it’s worth I said no to students doing stitches in my birth plan. I ended up with the most lovely student midwife who stayed past the end of the shift to see the birth. She was kind, professional and an amazing support to me. She ended up doing my episiotomy and possibly some stitches under the supervision of the dr. Not something I’d have imagined consenting to pre-birth plan but she was great.

I was told a PA might give the anaesthetic for my operation. Would I let his person anaesthetise my dog ? No, so I cancelled. Costing me ££££ to go private.

I agree they are different. But still similar in that they work in middle grade medical roles without medical training which is what is being discussed. Yes regulated but only so far as every nurse is regulated. The GMC are going to regulate PA’s so that’s coming, but NMC have still to update regulation for ANP’s appropriately in my opinion. It leaves ANP’s vulnerable, education is not standardised etc. nor is remit or responsibility adequately acknowledged for individual roles. I would rather have care from ANP in some situations than medic and preferable to PA but would I refuse care which is the statement. Not on NHS no. I don’t think the OP can either. She would need to get care privately and even then it’s not assured that no additional roles would be used

I hate to tell you but GP training is usually:
See one.
Do one.
Teach one.

I am a programme director for GP training. I can assure you it isn’t.

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.

I've had a number of aesthetics and I've never come across this

Not that it's totally relevant to this thread, but those checks are the same as the ones carried out at birth, which can be performed by newly qualified midwives straight out of uni. Yes they're important but they don't need 10+ years of experience.

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

The three year degree could be in interpretative dance.

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

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.

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.

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.

Leeds wants health sciences / anatomy bias

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.

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

Im finding the same.

Also read the modules - very science heavy.