After publishing more than 600 reports of serious concerns about the use of physician associates, the BMA is calling for an immediate halt to their use. 

The British Medical Association (BMA) has again called for immediate intervention after publishing testimony from doctors of patient safety concerns caused by the NHS’ use of physician associates (PA) and anaesthesia associates (AA). 

The BMA has long called the continued use of physician associates a patient safety scandal and in its recommendations to the Leng Review accused the NHS of gambling with patient safety. 

The BMA has again called for immediate intervention to protect patient safety in the NHS after publishing more than 600 reports of serious concerns submitted to the BMA by doctors and medical students who have witnessed unacceptable blurring of the lines between the role of PAs and AAs, and doctors. 

“We have long talked about “patient safety”, “scope of practice” and competencies. Now this shocking testimony shows precisely what these words mean on the ground,” said BMA chair of council Philip Banfield. 

“Here is a chronicle of a health system that is seeing far too many near misses, with one simple cause: PAs and AAs are doing things they are neither trained nor legally supposed to do. These testimonies are of critical importance to Professor Leng’s impending review which must end this dangerous free-for-all,” he continued. 

A clear disconnect

The testimony, collected via an online reporting portal between November 2023 and February 2025, has been submitted to the ongoing government-commissioned Leng Review as evidence of a clear disconnect between how PAs are meant to be working and the way they actually are. 

The testimonies include PAs making incorrect clinical decisions in place of doctors, introducing themselves as doctors, dangerously prescribing medication, and taking part in surgical procedures for which they were not qualified. 

“PAs inserting chest drains unsupervised, prescribing dangerous levels of opioids to patients or even those outright impersonating doctors – the sheer number of these accounts is hair-raising,” said Banfield. 

Given the seriousness of the safety concerns highlighted, and the number and spread of examples of actual and potential patient harm, the BMA is calling for the NHS to introduce urgent interim safety measures. It wants an immediate halt to the recruitment and expansion of PA and AA roles; implementation of the BMA’s safe scope of practice and supervision guidance; and an immediate investigation into PAs and AAs being placed on doctor rotas, all while the Leng Review is ongoing.