Breast cancer tragedy shows it's vital health chiefs clamp down on physician ... trends now

Breast cancer tragedy shows it's vital health chiefs clamp down on physician ... trends now
Breast cancer tragedy shows it's vital health chiefs clamp down on physician ... trends now

Breast cancer tragedy shows it's vital health chiefs clamp down on physician ... trends now

A young mother died earlier this year from aggressive breast cancer after delays caused by a misdiagnosis from a physician associate (PA) at her GP surgery, this newspaper has learned.

Colleen Howe was 34 years old and eight-months pregnant with her second baby in August 2021 when she visited her Suffolk GP practice after discovering a lump in her right breast.

The photographer and business owner from Bury St Edmunds believed she was seeing a doctor – but her appointment was in fact with a PA who carried out an examination and reassured her the lump was simply ‘a blocked milk duct’, giving her the impression that there was nothing to worry about.

PAs are NHS staff brought in to help doctors and nurses in their daily duties. They have two years of training, but are not permitted to treat patients and it is illegal for them to prescribe medication.

By the time Colleen was finally diagnosed on October 20 later that year – having recently given birth – her breast cancer was incurable and tumours had spread to her liver, pelvis and spine.

Colleen Howe was 34 years old and eight-months pregnant with her second baby in August 2021 when she visited her Suffolk GP practice after discovering a lump in her right breast

Colleen Howe was 34 years old and eight-months pregnant with her second baby in August 2021 when she visited her Suffolk GP practice after discovering a lump in her right breast

She received multiple cancer treatments, including chemotherapy, radiotherapy and even an experimental trial drug which had severe side effects. However, the cancer continued to spread around her body. Colleen passed away on April 9 this year, surrounded by her family.

In July 2022 – while she was still alive – the NHS opened an investigation into her misdiagnosis. It concluded that the advice she was given by the PA was in line with official guidance. Colleen had been told to take paracetamol and return for another appointment if the lump worsened or persisted after giving birth.

However, the review also reported that GPs at the surgery said ‘usual practice’ would have been to arrange a follow-up appointment within two weeks for a pregnant woman with a breast lump – which did not happen.

Colleen’s devastated mother, Catherine, 60, contacted us last week to share her shocking story in support of The Mail on Sunday’s Health campaign to Rein In The Physician Associates.

Yet the Government plans to enlist thousands more PAs over the next decade in order to plug dire NHS staff shortages. Doctors overwhelmingly say the move, as it stands, is a risk to patient safety.

PAs are permitted to take patients’ medical histories, perform physical examinations and analyse test results, all under the supervision of a doctor. They can also fill in forms and carry out basic checks which can sometimes clog up GPs’ workloads.

In recent weeks, though, we have received numerous reports that they are operating far beyond this remit – seeing patients with little supervision, bending the rules to write prescriptions and performing risky procedures.

That’s why we are urging Ministers and health chiefs to intervene and limit the medical tasks that PAs are allowed to undertake.

Still reeling from the loss of her daughter, Catherine, a retired NHS clerk, says: ‘Five weeks after giving birth, Colleen was told she had terminal cancer and could have just months to live. It was horrific and we still can’t believe she’s gone.

The government plans to enlist thousands more physician associates (PAs) over the next decade in order to plug dire NHS staff shortages. Doctors overwhelmingly say the move, as it stands, is a risk to patient safety

The government plans to enlist thousands more physician associates (PAs) over the next decade in order to plug dire NHS staff shortages. Doctors overwhelmingly say the move, as it stands, is a risk to patient safety

‘Would it have made any difference if she had been diagnosed sooner? It plays on my mind. She first saw the PA on August 2, 2021, and due to the misdiagnosis her cancer treatment didn’t start for another three months.

... AND PROOF OF THEIR RECKLESSNESS BY THOSE ON THE INSIDE

Tragic tales and unforgivable mistakes recalled by doctors about the UK’s 2,500 physician associates (PAs) have been compiled and handed to The Mail on Sunday. Here are just a handful of those submitted to our team...

‘PAs are frequently under-supervised, especially on night shifts. They are allowed to review chest X-rays and are often vague about their qualifications with patients. We were encouraged by a senior member in the department not to question the PAs’ decisions because “they know their stuff” and “it makes them upset”.’

‘PAs at [name of hospital withheld] lead ward rounds – including for intensive-care patients. I have been asked to prescribe for a PA and have witnessed other junior doctors prescribe on behalf of them. I have also seen PAs sign-off paperwork as “Mr X” with no clarification of the clinician’s role. In a surgical context, this is confusing and could denote a surgical doctor.’

‘I’ve seen PAs asking for doctors’ logins to request radiation and attempting to “work around” the law. They are being sent to see patients alone and are unwilling to perform what they consider menial jobs such as blood tests and placing cannulas.’

‘The PA would not correct patients when they called him doctor and he would not write his role when he referred patients to A&E. He is unsafe to be working independently – which he is most of the time – and absolutely should not be supervising medical students.’

‘Our Trust has 40 PAs with one in almost every team. It’s particularly bad in the emergency department where I’ve seen PAs running resus [resuscitation] wards.’

‘A newly qualified PA was involved in a cardiac arrest. The consultant determined the rhythm was shockable while another staff member was bagging [using a hand-held pump to resuscitate] the patient. Upon hearing the rhythm was shockable, the PA delivered a shock with no warning. This resulted in the staff member being electrocuted and taking time off work for tachycardia, PTSD, and clear exit wounds from the current. This was initially reported but closed immediately as “no further

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