Has she been "mis-sold" this job?

Marcon

need_some_help1 said:

I'm new to this forum but feel it will be a safe place to ask for some advice.

Four years ago, my daughter qualified as a Physician Associate (PA) after a 2 year Masters course and started working in a hospital. She loves her job.
I was pleased because a few years earlier, while I was working as a careers adviser, I found out about this job role which was being heavily promoted by the NHS with glossy A4 booklets etc.

We could not pay our daughters post-grad fees so she took our another loan on top of the undergrad loan she already had.

About a year ago, the working environment for PAs started to become increasingly toxic, to such as extent that the Secretary of State for Health has commissioned the Leng review. This might result in a change of job title, approved tasks that PAs can do and recommendations for their numbers in the future NHS workforce.

The Royal College of GPs have already said there is "no role" in GP practices for PAs. One of my daughter's friends, who was employed as a PA in a GP practice, had her job role changed so significantly that she has already successfully sued the practice for constructive dismissal.

I have no issue with the review taking place - it is vital for patient safety and might help to defuse the toxic environment.
However, if the result is that the PA role either disappears altogether or is reduced to such an extent as to be almost unrecognisable, could my daughter (and other PAs) take out a class action against the NHS or Department of Health for having been "mis-sold" this job role and potentially have their student loans cancelled or receive grants to re-train for another role?

I don't have any legal training or knowledge so would welcome advice/opinions from those who do.
Thank you in advance.

I think the answer is almost certainly no for a number of reasons, chief amongst them being the lack of money available to the government to take any such action - and nobody from whom they could claim it back, save another public service arm (the NHS). 

It seems to me that this situation is comparable in some ways to Home Information Packs - introduced in 2007 in the teeth of bitter opposition from many property professionals, and quietly shelved a few years later. A whole industry had grown up around the provision of HIPs, including a lot of people who had spent their own money to train as home inspectors, only to find that the wonderful new career they thought they were investing in had vanished before it was even properly off the ground.

Clearly there is a huge difference between the health of a property and the health of a person, but the principle will probably hold good, not least because it's difficult to see who would have the influence to take up the cudgels on behalf of PAs - and who would fund a class action.

saker75

I was a HE careers adviser when these postgrads started appearing. I confess I urged caution because I couldn’t see where the role would fit - it was like biomedical science, full of failed wannabe doctors. No doubt the role will evolve - my GP practice has one and she comes across as very engaged and knowledgeable. The loan makes this seem more transactional but with any academic programme there’s never a guarantee of employment or progression.

EnPointe

the irony of course is that the Royal Colleges pushed PAs   as a 'better'alterrnative to 'filthy mudblood' Advanced Clinical Practitioners who retain their  original  Primary registration with the NMC or HCPC   and whom can only access the ACP Master;s degree after a numberof years of post0registration ptractise in their  Primary Registration. 

 the PA role is unclear and the  education and  training for the role is such that they will unfortunayely never measure up against Doctors or ACPs . 

 the actual role Doctors needed   to support them was a  pure technician likely Band 4 role who did things like  bloods  , running around  with  samples and referrals and scribing - and this is what PAs may end up doing  ( some trusts experiemented with this kind of role when  AfC first came in  at b3 or 4) 

TELLIT01

Grumpy_chap said:

As a comparator, two other similar scenarios that have occurred in our lifetimes:
 - Police Officers objected to PCSOs
 - Teachers objected to Teaching Assistants
There remains a shortage of all four...

I really don't think the comparison of PCSO or teaching assistant with PA is reasonable.  The worst that can happen if a teaching assistant gets something wrong is bad spelling or spilling paint during an art class.  A wrong decision by a PA could potentially be fatal.

Flugelhorn

Never worked with a PA but worked with others  who never quite managed to work independently - one of those problems where the employers think it is a marvellous idea and don't realise that everything takes twice as long and lands the responsibility on others 

Flugelhorn

I am sorry @need_some_help1 your daughter really has been sold a pup. I hope they win in their battle and ultimately find a more rewarding job to do. 

So much in the NHS these days just accepts that there is a body (anybody) there to do a task - forgetting how much experience is needed to spot the odd / recognise when something doesn't fit the guidelines etc - when my DD was born, the junior doctors wanted a particular regime of treatment whereas the grown ups (me, DH and the paed consultant) all said no, wait and see. experience won out. 

Andy_L

TELLIT01 said:

Grumpy_chap said:

As a comparator, two other similar scenarios that have occurred in our lifetimes:
 - Police Officers objected to PCSOs
 - Teachers objected to Teaching Assistants
There remains a shortage of all four...

I really don't think the comparison of PCSO or teaching assistant with PA is reasonable.  The worst that can happen if a teaching assistant gets something wrong is bad spelling or spilling paint during an art class.  A wrong decision by a PA could potentially be fatal.

It not so much the consequences of a mistake, its that the Dr is personally & professionally liable if the PA cocks-up. The Copper or the the teacher aren't if the PCSO/TA do

Grumpy_chap

TELLIT01 said:

Grumpy_chap said:

As a comparator, two other similar scenarios that have occurred in our lifetimes:
 - Police Officers objected to PCSOs
 - Teachers objected to Teaching Assistants
There remains a shortage of all four...

I really don't think the comparison of PCSO or teaching assistant with PA is reasonable.  The worst that can happen if a teaching assistant gets something wrong is bad spelling or spilling paint during an art class.  A wrong decision by a PA could potentially be fatal.

My comparison was not in the context of consequence of a mistake but the context of established members of a Profession pushing back against a lower grade being introduced, yet the change happened and the original members of the Profession have not seemingly lost out in terms of opportunity.  
More related to the fact there appear to be too few Drs (or Police or Teachers) so a lower grade role PAs (or PCSOs or Teaching Assistants) that can take some of the more mundane workload factors away from the Drs (or Police or Teachers) seems plausible.

LightFlare

EnPointe said:

the irony of course is that the Royal Colleges pushed PAs   as a 'better'alterrnative to 'filthy mudblood' Advanced Clinical Practitioners who retain their  original  Primary registration with the NMC or HCPC   and whom can only access the ACP Master;s degree after a numberof years of post0registration ptractise in their  Primary Registration. 

 the PA role is unclear and the  education and  training for the role is such that they will unfortunayely never measure up against Doctors or ACPs . 

 the actual role Doctors needed   to support them was a  pure technician likely Band 4 role who did things like  bloods  , running around  with  samples and referrals and scribing - and this is what PAs may end up doing  ( some trusts experiemented with this kind of role when  AfC first came in  at b3 or 4) 

It actually isn’t unclear and they were never meant to match or replace other professions - merely supplement and support.

They have a very clear scope of practice - but unfortunately (largely GPs) this is being massively abused and they can be subjected to some very nasty comments and behaviours towards them when in hospital settings.

I have some very direct knowledge of the whole situation* and sadly, there is a lot of misinformation being spread by the media and BMA

*my other half left a long career in the NHS to take a role in a PA program and is absolutely disgusted by the way some of the students are treated. Although to be fair, it doesn’t sound as though the students are without fault in some areas.
I think the recruitment criteria needs to be addressed, the course revamped and significantly better communication with healthcare providers and the public.

need_some_help1

saker75 said:

I was a HE careers adviser when these postgrads started appearing. I confess I urged caution because I couldn’t see where the role would fit - it was like biomedical science, full of failed wannabe doctors. No doubt the role will evolve - my GP practice has one and she comes across as very engaged and knowledgeable. The loan makes this seem more transactional but with any academic programme there’s never a guarantee of employment or progression.

I would suggest that not all biomedical science degrees are full of wannabe doctors. My son studied biomedical sciences at Imperial college who were very explicit that they would not allow a transfer onto a medical degree - ideal for him as he has zero interest in being a doctor. He went on to complete a PhD at Cambridge and is now doing research into medicines to help those with diabetes - never happier than peering down a microscope!! The biomedical sciences degree enabled him to explore a variety of life sciences. I doubt if he would have ended up in his current career had he not been able to complete such a broad based first degree.