In response to queries regarding practices employing Physician Associates, we asked GPC England for their view on what the risks are to employing GP partners if they continued to employ PAs, and didn’t adhere to the updated guidance on their scope of practice that the BMA and RCGP have issued*. This was their response:
Whether a GP is liable for any harm done to a patient depends on all of the facts. Delegating safely and appropriately is an essential responsibility for GPs supervising other clinical staff. Paragraphs 66 to 68 of the GMC’s Good Medical Practice provides:
66 You must be confident that any person you delegate to has the necessary knowledge, skills and training to carry out the task you’re delegating. You must give them clear instructions and encourage them to ask questions and seek support or supervision if they need it.
67 If a task is delegated to you by a colleague but you’re not confident you have the necessary knowledge, skills or training to carry it out safely, you must prioritise patient safety and seek help, even if you’ve already agreed to carry out the task independently.
68 You must follow our more detailed guidance on Delegation and referral.
Paragraph 24 of the GMC Delegation and referral guidance provides:
24 When you delegate or refer care you are accountable for:
1. your decision to delegate or refer care
2. the steps you take to make sure patient safety isn’t compromised
3. the instructions you give
4. the overall management of a patient if you’re the responsible consultant or clinician.
Doctors have a professional responsibility to delegate safely, which includes delegating to PAs, and the BMA guidance on PAs represents the BMA’s view on best practice in that regard. The BMA encourages doctors to follow that advice. Whether a doctor is negligent in a particular case would be for a court to determine.
*Other guidance:
BMA guidance on Physician Associates in general practice
RCGP Physician Associates guidance
While this isn’t a black and white answer, and as the BMA team have highlighted it does not represent formal legal advice, it gives a strong steer that we hope practices find helpful as they try to address this difficult situation. If you have further questions or would like signposting to legal support, please contact the LMC via the usual routes.
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