A woman left with lifelong lung damage after a medic missed the signs of a chest infection is calling on the Government to take urgent action to protect patients.
Ann Birtwistle, 62, visited her GP in August 2024 with yellow phlegm – a common symptom of pneumonia, a bacterial lung bug.
However the retired charity worker, from Bath, was not seen by a doctor but by a physician associate (PA) – a medic with just two years’ experience – who had been working at the practice for less than a year. The PA dismissed Ann’s symptoms as a ‘runny nose’ and instructed her to treat it using nasal spray.
Three days later, Ann began to struggle to breathe at home and was rushed to hospital in an ambulance, where she was immediately diagnosed with pneumonia and given antibiotics.
While doctors were able to successfully treat the pneumonia, the infection left Ann with an incurable lung condition called bronchiectasis.
The disease causes a persistent cough, shortness of breath and raises the risk of other life-threatening lung infections.
Ann believes that had she been seen by a qualified doctor and not a PA, her bronchiectasis could have been prevented.
She is now urging the Government to halt the recruitment of PAs.
‘When I arrived at hospital in the ambulance, an A&E doctor said he couldn’t understand why my GP hadn’t given me the drugs already,’ Ann says
‘Had I been given antibiotics at the appointment with the PA, that could have made all the difference,’ she says.
‘When I arrived at hospital in the ambulance, an A&E doctor said he couldn’t understand why my GP hadn’t given me the drugs already. I replied that I hadn’t been seen by a GP – I was seen by a PA.
‘I don’t think the Government should be hiring more PAs. Patients should be seen by a doctor, not by someone with no medical degree.’
PAs are health workers with no medical degree, simply meant to assist doctors and nurses. They are not qualified to diagnose patients, prescribe drugs or order scans – and they should be supervised by a doctor at all times.
The NHS employs more than 3,000 PAs in England and plans to increase this to 10,000 by 2036.
The Mail on Sunday first raised safety fears about PAs in 2023 and is running a campaign, Rein In The Physician Associates, as we believe there should be strict limitations on PAs. Several patient deaths have been linked to mistakes made by PAs. These include Emily Chesterton, 30, who died in November 2022 after a PA at her local GP missed the symptoms of a deadly blood clot twice.
Last month, it was revealed that Pamela Anne Marking, a 77-year-old from Surrey, died after a
PA working at her GP surgery mistook the symptoms of catastrophic internal injuries for a nose bleed.
At the end of last year, Health Secretary Wes Streeting announced a safety review into the use of PAs in the NHS.
The findings of this report are expected to be published in the coming months.
Experts say one of the most crucial steps in preventing bronchiectasis is treating chest infections as soon as possible.
Bronchiectasis, which is the third-most common lung condition in the country, occurs when the airways become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
It affects more than 200,000 people in the UK. It can be triggered by a number of conditions including asthma and chronic obstructive pulmonary disease (COPD).
However, untreated chest infections are one of the most common causes.
While there are steps to manage the symptoms, including physiotherapy and medicines that improve airflow within the lungs, it cannot be cured.
‘If you think you have a chest infection then you need to be treated immediately to avoid the risk of bronchiectasis,’ says Dr Andy Whittamore, a GP and the clinical lead at the charity Asthma And Lung.
‘The symptoms to look out for are breathlessness, coloured phlegm or chest pains.’
Ann Birtwistle says her experience shows PAs should not be allowed to work in GP practices.
‘I wasn’t given the option to the see a GP, just a PA,’ she said. ‘She told me she had a supervising GP, but he wasn’t there and she didn’t check her diagnosis with a doctor before sending me home.
‘I later complained about the care I received, but was told by the GP practice that, due to a lack of doctors, they can’t run the practice without PAs.
‘But they have at least 18 GPs working there, so why do they need to rely on PAs? It doesn’t seem sensible or safe.’
A Department of Health and Social Care spokesman said: ‘Our thoughts are with Ann.
‘The Secretary of State has launched an independent review into Physician and Anaesthesia Associate professions to establish the facts and make sure that we get the right people in the right places providing the right care.’
- To learn more about bronchiectasis, visit: asthmaandlung.org.uk.
