Physician associate negligence: six patient deaths and NHS scrutiny

Physician Associates are assistants to doctors who have received less extensive medical training. Due to expanding NHS pressures, they are increasingly being used to treat patients, sometimes with catastrophic consequences. Despite not having the same level of training as doctors, they have reportedly been used on many occasions as a substitute for qualified doctors in the NHS, but may not offer the same level of treatment, competence, or accountability.

Recently, six patient deaths have been linked to contact with Physician Associates. There are currently more than 3500 Physician Associates working in the NHS.

One example was the death of Emily Chesterton, 30, who died in November 2022 after suffering a pulmonary embolism. She went to see her GP at a North London surgery twice in the weeks before her death - and on both occasions was seen by a Physician Associate who failed to diagnose the blood clot, diagnosing her with anxiety in the alternative. Emily had thought that she had seen a doctor and that is what she had told her parents.

Emily’s Father stated, "If she come out and said I've seen someone called the Physician's Associate I'm sure we would have insisted that, you know, let's go back and insist that you see a doctor. She never knew." Emily’s family feel that her death could have been prevented had she been reviewed by a doctor instead of a Physician Associate.

Another example of a death caused by Associate Physician Negligence is Susan Pollitt, who died after a drain was mistakenly left in her abdomen for 21 hours in Royal Oldham Hospital, leading to an infection. Her husband, Roy Pollit, did not know that his wife was being treated by a Physician Associate.

Health Secretary Wes Streeting ordered a review last November as a result of rising concerns that Physician Associates were incorrectly being used as substitute Doctors. Professor Gillian Leng, President of the Royal Society of Medicine, lead the review and recently presented her findings 15th of July 2025. The review can be read here.

The report's findings indicated that Physician Associates should not be permitted to review patients who have not already been reviewed by a doctor, in order to prevent irreversible harm to patients like Emily Chesterton and Susan Pollit.

The report also suggested that the job title should be changed to Physician Assistant to reflect the fact Physician Associates are support staff. In her report, Professor Leng called for a requirement for Physician Associates to work in a hospital for at least two years before being allowed to practice in a GP surgery or mental health trust, as well as the need to have a senior doctor as a line manager. They must be clearly distinguished from doctors through identifiable clothing or lanyards, to prevent patients from being unaware that they are not being assessed by a doctor.

The Bolam test is derived from the case of Bolam v Friern Hospital Management Committee and sets out the principles for establishing a breach of duty in 1957.

It is based on determining whether the actions of the medic are in line with the actions of other medics who are in their position.  It asks the question, did the professional act in line with a ‘reasonable body of opinion in their field’.

But what happens when you think that you are being treated by a doctor?

Physician Associates are NOT doctors; they are assistants. There ought to be transparency to facilitate consent.

1. Has there been clear communication of this?

2. Has there been documented training and progression?

3. Does the level of supervision reflect capabilities?

4. What is the Physician Associate’s scope of practice, and has it been appropriately assessed, particularly in high-risk procedures, such as surgeries?

5. What are the demands in that area? Are they correctly deployed?

6. What safeguards are in place?

As evidenced by recent press reporting, we anticipate more litigation where Physician Associates are being used in circumstances where treatment goes wrong and the patient thinks that they are being treated by a fully qualified doctor.

How Forbes Can Help

If you or someone you know has been affected by negligent treatment from a Physician Associate, or you believe you were misled into thinking you were being treated by a doctor, our expert Clinical Negligence team is here to help.

At Forbes Solicitors, we specialise in investigating medical negligence claims and ensuring that patients and families receive the answers, accountability, and compensation they deserve.

You can speak confidentially with a member of our experienced team today by calling 0800 037 4625. We will listen to your story, assess your case, and guide you through your options with compassion and expertise.