Physician associate review after Oldham woman's death

The review comes after a coroner has raised concerns surrounding PAs following the death of a woman due to an "unnecessary medical procedure" and "neglect" at Royal Oldham Hospital.

Susan Pollitt was aged 77 when she died at the hospital in July last year having been admitted two weeks earlier after collapsing at her home in Failsworth.

Following an inquest that concluded on July 29 this year at Rochdale Coroners' Court, senior coroner for Manchester North, Joanne Kearsley, raised concerns regarding the circumstances surrounding Mrs Pollitt's death and the framework around PAs in hospitals and GP surgeries.

Ms Pollitt's is not the only death which involves concerns surrounding PAs and now the review will look into how the roles affect safety and how they support wider health teams including GPs.

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Last week,  Susan's husband Roy Pollitt, speaking to the BBC, accused the NHS of using “cheap labour” when it comes to PAs.

The inquest into Mrs Pollitt's death heard that on July 3 last year, she collapsed at her home on Shaw Head Drive, Failsworth, and was taken to Royal Oldham Hospital.

She was treated for a number of medical issues including acute kidney injury and during her admission, Mrs Pollitt developed ascites, a condition where fluid collects inside a person's abdomen.

The consultants involved in her care decided an ascitic drain, which is used to treat ascites, was not required at that time.

On July 11, a junior doctor reviewed Mrs Pollitt and decided that an ascitic drain should be placed, however, the inquest found that the procedure was not clinically indicated at that time.

Royal Oldham Hospital said it has undertaken a considerable amount of work since Mrs Pollitt's death (Image: Google)

The procedure was carried out by a PA, which according to the NHS Careers website is a role which supports doctors in diagnosing and managing patients in either GP surgeries or hospitals.

The PA who carried out the procedure was not aware of the local hospital guidance on the insertion of ascitic drains or of some of the risks that come with them.

Mrs Pollitt developed bacterial peritonitis and died on July 16.

Following the inquest, Ms Kearsley wrote to the Department of Health and Social Care, the chief executive of the General Medical Council and the president of the Faculty of Physician Associates, citing a number of concerns surrounding the roles of PAs

Dr Jonathan Moise, Medical Director at the Royal Oldham Hospital, which is run by the Northern Care Alliance NHS Foundation Trust, said in a previous statement:  “We offer our deepest condolences to Susan’s loved ones for their sad loss.   

 “The trust accepts the findings of the inquest and apologises to Susan’s family that the standard of care she received was not what we would expect. 

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“We have taken the learning arising from this investigation extremely seriously.    

“Since this sad case, we have undertaken a considerable amount of work in relation to the training and supervision of Physician Associates.

"We have developed a Northern Care Alliance NHS Foundation Trust (NCA) Physician Associates governance framework.

"It is planned that the national statutory regulation of Physician Associates will begin under the General Medical Council at the end of this year." 

The review, which will report in the spring, will also publish recommendations on how new roles should work in the future.

It has been commissioned after the Academy of Medical Royal Colleges wrote to Health Secretary Wes Streeting in September calling for a review of PAs and anaesthesia associates amid “mounting concern” from doctors.