Introduction
The important role played by physician associates within the NHS is currently the subject of discussion in the press and on social media. We are providing this statement in order to clarify the contribution of physician associates at Alder Hey and to provide reassurance regarding their supervision.
Physician Associates at Alder Hey
We employ 10 physician associates to provide support to our clinical teams across various departments. As well as their general training, they undergo training specific to the area in which they are working.
The physician associates assist our clinical teams by taking medical histories, performing basic physical examinations and diagnostic procedures and developing management plans. They are not able to prescribe medications or order exploratory tests such as X-rays.
It is important to understand that their work is always supervised closely by a medical consultant.
The Safeguarding Team
This is a multi-disciplinary team led by medical consultants. In 2019 a physician associate was employed to provide additional support and, like other members of the team, the individual completed additional safeguarding training. Their role was subject to appropriate limitations:
- Whenever it is known or suspected that a child or young person has been raped and/or subject to sexual assault/abuse, any examination is always performed by a Specialist Consultant. The Specialist Consultant conducts all forensic aspects of an examination, writes a report and then provides a forensic opinion to a Court. Sometimes, the physician associate would assist in the completion of a joint holistic welfare examination. The holistic examination considers other aspects of health, for example, dental health and emotional health and wellbeing. It is important to emphasise that this is distinct from the assessment of the Specialist Consultant.
- The physician associate did perform other child protection medicals undertaken for children and young people where it is known or suspected that they have experienced physical abuse and/or neglect. Close supervision was provided by senior medical consultants in the department and all reports were quality assured by the supervising Consultant.
In early 2024, we became aware that the Crown Prosecution Service and Police, in relation to hearings in the Family Court, did not feel able to rely upon examination reports prepared by a physician associate. This was not because of any specific concern with those reports or the individual preparing them. The Trust took the decision in March 2024 that it would no longer deploy a physician associate within the safeguarding team. This decision was taken in the interests of supporting the Police, the CPS and the Justice system in its important safeguarding role, and was not any reflection on the individual physician associate, whose work was always deemed by internal and external colleagues to be of a high standard. The Trust is proud of the work they delivered and the support they provided to children and young people in the most difficult circumstances.
The Future of Physician Associates
The Trust welcomes the discussion about the role of physician associates in the NHS and will play its part in ensuring appropriate supervision, governance and regulation. The best interests and welfare of our patients are always our first concern.