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NHS Grampian ‘risks patient safety’ in uniform row for trainee doctors and physician associates

Doctors told the P&J the controversial graduate fast-track role of "physician associates" must not be confused with a fully trained medic.

Medical students and trainee PAs will wear the same uniform. Image: Kim Cessford/DC Thomson
Medical students and trainee PAs will wear the same uniform. Image: Kim Cessford/DC Thomson

Doctors claim NHS Grampian is blurring the lines between medical and controversial “physician associates” students by allowing them to wear the same uniforms.

They fear patients will not understand the clear difference between a trainee doctor – and someone training to be an assistant to a doctor.

Aberdeen University offers a post-graduate course for the PA role, where people from a science or other non-medical background undergo a two-year training course.

One worried medic told The Press and Journal: “Not making it clear risks misleading patients into believing they’re seeing someone with more training and experience than they really have. It isn’t safe.”

Pile of NHS staff uniforms.
Doctors say the uniform policy will make it difficult to distinguish who is on a ward. Image: DC Thomson.

A second medic who works in NHS Grampian added: “There is a big difference in the knowledge of a medical student on placement and a trainee physician associate.

“They are not doctors and never will be.

“Confusing the two roles is a risk to patients.

“NHS Grampian must make that clear even with something as basic as a uniform.”

Serious concerns have been raised about the controversial PA role across the UK.

Leading doctors say the role is ill-defined and poses a threat to patient safety.

'NHS Scotland' embroidered on uniform.
Experts say the physician associate role is ill-defined and risks patient safety. Image: DC Thomson.

PAs are intended to support doctors to diagnose and manage patients. This could include doing tasks traditionally completed by a doctor or nurse, including taking a medical history, carrying out examinations, ordering tests and undertaking medical procedures.

But surveys by the British Medical Association found 80% of doctors were concerned they were working beyond their competence – and most think PAs are adding to their own workload.

NHS Grampian said the uniform worn by medical and PA students was decided by the University of Aberdeen.

Asked about the concerns, a university spokesman said careful consideration was given to the design.

Unlike other groups of staff, such as nurses and physiotherapists who wear different colours, PA and medical students wear a black uniform with a label identifying their course.

Physician Associate students and medical students ‘clearly identified’

He added: “Physician Associate students and medical students are clearly identified as they have the name of their course and the university they belong to embroidered on their uniforms.

“In addition, as part of their training, all students are instructed to introduce themselves to patients with their names, what course they are studying and at what level.”

A spokeswoman for NHS Grampian said: “There is not a nationally mandated uniform for either medical or physician associate students. The uniform referred to is one issued by the University of Aberdeen.

“We would welcome the opportunity to discuss further the concerns raised.”

In May, we revealed how NHS Grampian was recruiting for the “experimental” role at Aberdeen Maternity Hospital.

It prompted fierce criticism online among the medical community.

‘Mission creep’

In a statement today, BMA chairman Dr Iain Kennedy said they were aware of the uniform problem

“Anything which further blurs these lines between these two very different roles – such as the use of similar uniforms – is simply unacceptable and is an issue which must be addressed urgently,” he said.

In an interview for the Press and Journal’s politics podcast, The Stooshie, Grampian surgeon Dr Simon Barker, of the BMA, previously warned there is concern the PA role will lead to “mission creep”.

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